A component of the senior years of training will involve two blocks of community-based rotation in Anesthesia. This rotation is completed in the PGY-4 or PGY-5 year. While one of these rotations must occur in a community centre, elective opportunities at other academic centres may also be arranged for the second rotation, if desired.
Residents at McMaster are involved in weekly academic sessions. Tutorials are facilitated by faculty members, involving subject material targeted to the residents' level of training. Residents receive objectives and references in advance and sessions are highly interactive. Below, the level-specific academic programs are described.
At McMaster, Anesthesia residents enjoy a FULL ACADEMIC DAY during the on-service years (PGY-2, 4, and 5). Academic day activities include both academic teaching sessions as well as our simulation curriculum. There is also a significant amount of unscheduled time that allows for more independent study time to PGY-2, PGY-4, and PGY-5 residents.
PGY-1s start off their academic program with an intensive summer "boot camp" which involves a full academic day, the PGy-1s receive extensive simulator training throughout the summer. In the fall, the PGY-1s join the PGY-2s for the academic sessions in the afternoon, so they will encounter much of this fundamental material twice, once as PGY-1s and again as PGY-2s.The academic half day for PGY-1 is Thursday afternoon. During the PGY-1 year, residents will be provided with an introductory course on research methodology; the main assignment associated with this course will be to design a research protocol, which the resident can then use as their required research project, if desired.
PGY-2 sessions cover the basics of clinical and theoretical anesthesia, physiology, and pharmacology, as well as the instruction of the intrinsic CanMEDS roles. The academic day for PGY-2 is Thursday. There is a 6-week Regional Anesthesia module during the winter; residents participate in this module both in PGY-1 and PGY-1 years.
PGY-3 curriculum primarily incorporates critical care and internal medicine topics, as they relate to anesthesia. The academic half day for PGY-3 is Wednesday afternoon. There is a hands-on Regional Anesthesia refresher in the anatomy lab during the summer (with PGY-4s). There are two other special workshops that are provided for PGY-3s and PGY-4s: Ultrasound (POCUS) workshop and the "Can't intubate, Can't ventilate" (CICV-Surgical airway) workshop.
PGY-4 curriculum focuses on topics in subspecialty anesthesia, medicine, and surgery. The academic day for PGY-4 is Wednesday. The PGY-4s also encountrer three critical hands-on workshops that they first received as PGY-3s: Regional Anesthesia, POCUS, and CICV.
PGY-5 curriculum targets the material required for the Royal College written and oral examinations. Throughout the first part of the academic year, the PGY-5 residents have their academic day (Tuesday) to study, mostly as free time, although simulation sill also occur on the academic day. Starting around January, they will have formal oral exam prep sessions that continue until just before the oral exam.
Residents in the McMaster Anesthesia Residency program have an excellent track record at the Royal College examinations. We have a 100% pass rate for the past 4 years, for both CMG and IMG candidates. Our success rate primarily reflects our strong clinical and academic programs. In addition, we have a structured program to prepare residents for the Royal College Examinations that includes:
- The core curriculum in PGY-2, PGY-3, and PGY-4 which is tailored to the National Curriculum. The Royal College asserts that all written and oral exam questions are taken from the National Curriculum.
- Formal program oral examinations are held twice yearly for PGY-2, PGy-4, and PGY-5 anesthesia residents.
- In the PGY-5 year, oral exam preparation is formally on a weekly basis.
- The PGY-5 residents also organize informal practice oral exams with different McMaster Anesthesia faculty throughout the year.
- The PGY-5 residents are fully funded to participate in the annual "Making a Mark" program.
- The PGY-3 and PGY-4 residents write the American in-training exam once per year.
- PGY-2 and PGY-4 residents write the Anesthesia Knowledge Test (AKT).
- The program generates n-house MCQ exams three times a year, for PGY-2 to PGY-5 levels.
- Currently, we are able to fund our PGY-3 to PGY-5 residents to a subscription to the Open Anesthesia "Self-Study Plus" app, which is a tremendous resource identifying and working on areas of weakness using an MCQ format.
The Simulation Program at McMaster University is one of the many strengths of our residency training program. It affords the anesthesia residency training program with the opportunity for both teaching and learning in the high-fidelity Simulation Centre. One of the differences at McMaster is that the resident performs the simulation scenarios on their own (i.e. not as a collaborative group or watching others). In general, resident at McMaster will complete approximately 15 different simulation scenarios by the end of residency. Five of these are the scenarios that have been produced by the National working group (CanNasc) and it is mandatory for CBD residents to pass each of these CanNasc scenarios before being licensed to practice Anesthesia. Some of our simulation sessions involve "inter-disciplinary" settings, collaborating with residents from OB, ENT, or ER. All simulation scenarios are run by trained faculty for anesthesia residents.
Residents teach medical students during the Anesthesia Clerkship rotations using the resources in the Simulation Centre.
In order to complete the training program, residents are required to complete a scholarly project. This requirement can be a quality assurance project (chart review), systematic review, meta-analysis, questionnaire study, or clinical trial. PGY-1 residents complete an introductory course in health research methodology. Protected time can be made available for research activity in the form of a research elective, usually in the PGY-3 year. This project affords residents the opportunity to grow in their academic ability and allows them to fulfill the Royal College Anesthesiology Objectives of Training and CanMeds competencies requirements.
The Department of Anesthesia is able to provide support and assist residents with their projects. Available to provide assistance is.
- A full-time research coordinator (Toni Tidy)
- An associate professor/research methodologist and biostatistician
- A research associate in biostatistics
Residents receive funding to present their results at an academic meeting.
Funding may be made available to residents for graduate degree studies in any field through the Department of Anesthesia.
Resident Exchange Day
This event is held each year with the University of Western Ontario Anesthesia Residency Program, with the host site alternating between the two universities. Research and academic projects are presented and judged. A friendly trivia competition takes place during lunch, and award presentations follow the presentations.
The Anesthesia Department has a bright, centralized space for the operations of the residency program, including a large library/conference room. This space is located at the McMaster University Medical Centre and is where you will have your academic sessions and where your mailboxes will be. The program coordinator and program director have their offices right there. The library is well-resourced with books for reference and for signing out by Anesthesia residents. Funds are made available for residents to choose a book (or two) to be added to their library each year. Residents have meetings in their conference room, or study together.
The Health Sciences Library is on-site at McMaster Medical Centre. Additionally, hospital libraries are located at the Hamilton General Hospital, Juravinski Hospital, and St. Joseph;s Healthcare. All are accessible to the residents.
Computer access and Wi-Fi is available at clinical sites and residents are registered with Lib.access, which provides a comprehensive list of online medical journals and resources.
The McMaster University Anesthesia Residency Program comprises of four clinical teaching units. These units are located at:
- St. Joseph's Healthcare
- Hamilton General Hospital
- Juravinski Hospital and Cancer Centre
- McMaster University Medical Centre
The latter three sires are all part of Hamilton Health Sciences.
St. Joseph's Healthcare (SJH) is the regional centre for respiratory, renal, and head and neck disease, and also houses a busy obstetrical schedule (an average of 3,000 deliveries per year).
The Hamilton Health Sciences' General campus is the regional centre for the cardiac and vascular neurosurgical and neuroscience, spine, burn, and trauma programs.
The Hamilton Health Sciences' Juravinski campus is a regional centre for the arthroplasty, hepato-billary, colorectal, and oncology programs and is affiliated with the regional cancer care centre.
The McMaster University campus of Hamilton Health Sciences (MUMC) contains the regional high-risk obstetrical unit, an extensive ambulatory surgery program, and rapidly-growing pediatric and neonatal programs.
Chronic pain care is provided at both SJH and MUMC sites.
These clinical resources offer the anesthesia resident unlimited opportunities to obtain the fundamentals of anesthesia, as well as explore areas of subspecialty interest and scholarly activity in both education and research. One of the strengths of our program is that our residents get OB and pediatric experience during many of their rotations, not during dedicated subspecialty rotations. The repetitive exposure makes it easier to develop confidence in these key areas of practice.
Outreach in International Health: An Opportunity for McMaster Anesthesia Residents
Dr. Alez Dauphin, an anesthesiologist at St. Joseph's Healthcare and a McMaster faculty member, has provided extensive work and teaching in Haiti over the past two decades. Anesthesia residents from Haiti periodically perform rotations in Anesthesia in Hamilton.
Dr. Stephen Ttendo, an anesthesiologist in Kampala, Uganda, holds a faculty position with the McMaster Department of Anesthesia. Dr. Ttendo supervises a four-week elective in Uganda for one McMaster anesthesia resident each year. The Uganda elective is funded by the Department of Anesthesia at St. Joseph's Healthcare.
In 2016, McMaster University formally initiated a collaboration with the Anesthesia Residency Program in Guyana, and currently hosts 2 residents from Guyana per year, for four blocks each.