Anesthesia residents at Maine Medical Center complete a medicine preliminary internship prior to their anesthesia training. Residents must have a solid base of medical knowledge to build upon in the following years.

The intern year is spent rotating with the internal medicine residency teaching services. The intern year is split into 13 four-week blocks.  Seven of these blocks will be on-service, and the remainder of this time will be spent in subspecialties off the medical services.

The on-service requirements include 3 blocks on the general medical service, 1 block of medical critical care, plus a total of 3 blocks spent rotating on the subspecialty inpatient medical services – nephrology (Med R), oncology (Med A) and cardiology/cardiac ICU (Med C).

Of the 3 general medicine blocks, two weeks will be spent cross covering as a night float intern. The remaining 2 weeks on-service are spent on a night float cross-covering the subspecialty services (Med C, A,R). The call schedule has been recently changed to comply with the ACGME duty hour changes effective 7/1/11 to eliminate 24 hours shifts.

Off-service blocks include neurology, OB (2 weeks), emergency medicine, one elective, plus pulmonary and cardiology consultation.  Interns are given a total of 4 weeks of vacation, which may be taken during neurology, the elective block or consultation months.  Also, 4-5 weekends each year, off-service interns will be required to help cross-cover the medical services overnight.

Block Structure
(3) General Medicine
(1) Cardiology/Cardiac ICU (Med C)
(1) Oncology (Med A)
(1) Nephrology (Med R)
(1) OB
(1) Medical Critical care
(1) ED
(1) Neurology
(1) Pulmonary consults
(1) Cardiology consults
(1) Elective

(13) Total 4-week blocks

 
The CA1 year is designed to ease the resident into the clinical practice of anesthesiology. Beginning July 1, each new CA1 will participate in an intensive
1-week orientation curriculum designed to introduce the resident to the policies and procedures of the department as well as simulation of basic principles in the practice of anesthesiology.

Upon completion of the orientation curriculum, each resident will be paired with an attending anesthesiologist for the month of July. The attending anesthesiologist will have no additional resident or CRNA oversight responsibility during this time to ensure exceptional oversight and training during the resident’s first month.  Additionally, the CA1 resident will participate in daily didactic lectures presented by an attending anesthesiologist that will encompass airway management, anesthetic delivery systems as well as basic physiology and pharmacology as it pertains to the anesthetized patient.

Beginning in August, each CA1 will be assigned to general OR cases on a daily basis for the first 6-months of training. Thereafter, each CA1 will rotate through month-long subspecialty assignments.

Subspecialty rotations include:
- Pediatric Anesthesiology
- Vascular/ Thoracic Anesthesiology
- Neuro Anesthesiology
- Obstetrical Anesthesiology

The CA1 will have no overnight call responsibilities for the first month of training.  Thereafter, overnight call will be 5-6 per month that will include 2 weekends (Friday and Sunday one weekend, Saturday one weekend), with the remainder being weekday call. The CA1’s responsibility will be predominantly obstetrical anesthesia and cardiac arrest/ emergency airways (CODE). Occasionally, the CA1 will deliver anesthetics in the general OR as needed or as educational opportunities arise during call.

 
The CA2 year consists of 2 months of Advanced Clinical Tract (ACT) anesthesiology encompassing advanced general OR cases as well as 9 subspecialty training months including:
- Cardiovascular Anesthesiology
(2-months)
- Pediatric Anesthesiology
- Surgical Critical Care (2-months)
- Regional Block/ Post-Operative Pain Management
- Outpatient Pain Management
- Outpatient Surgery Center
- Vascular Thoracic anesthesiology

The CA2 call schedule consists of 4-5 overnights per month including 2 weekend days per month. The CA2 call responsibility consists of managing the Acute Pain Management Service (APMS), as well as delivering more advanced anesthetics in the general OR.

 
The CA3 year allows more flexibility in training offering 4 elective months. Elective rotations include, but are not limited to:
- additional general subspecialty months
- medical simulation
- TEE
- medical direction/ supervision to CRNA’s at Southern Maine Medical Center

To accommodate each CA3’s individual educational goals, the department is extremely proactive in facilitating elective rotations that have not necessarily been created for previous residents, as long as they meet educational requirements set forth by the ACGME.

Required subspecialty months during the CA3 year include:
- Pre-Admission Unit (outpatient preoperative evaluation)
- Pediatric Anesthesiology
- Vascular/Thoracic Anesthesiology
- Regional Block/ Post-Operative Pain Management
- Obstetrical Anesthesiology
- Post-Anesthesia Care Unit (PACU) and Blood Bank
- Neuro Anesthesiology
- Research

The CA3 call schedule consists of 3-4 overnights per month, including 1 weekend day. The CA3 call responsibility consists of managing the Acute Pain Management Service (APMS), as well as delivering more advanced anesthetics in the General OR and responding to anesthesia needs elsewhere in the hospital.