Mission of the Residency Program
To provide the highest quality resident training through excellent clinical material and outstanding teaching.
- Work schedule and case volume
- Career development
- Do faculty members teach?
- What is didactic teaching like at Virginia?
- How do residents do on Board exams?
- What are we looking for in a resident applicant and what is the interview process?
- What are the clinical anesthesia rotations?
- What is the ICU experience?
- What is the pain/regional experience?
- What is the pediatric experience?
- What research experiences are available?
- What electives are available?
- Is it possible to do "away" electives?
- What are the clinical strengths of the program?
- Are there any changes expected in the department and is the department stable?
Work schedule and case volume
Our goal is to provide residents with the clinical experience that offers them the greatest educational benefit. Our residents work an average of 50 to 60 hours per week, depending upon level of training and rotation requirement. While our total hours are slightly lower than the national average, all of our residents achieve case volumes that are considerably above the national averages for cardiac anesthesia (57% above the national average), thoracic anesthesia (37% above the national average), neuroanesthesia (26% above the national average), regional anesthesia, (37% above the national average), and pediatric anesthesia (23% above the national average). We accomplish this by preferentially assigning residents to high quality cases.
In addition to operating room assignments, all residents rotate on the Acute Pain Service and through our nationally regarded Pain Management Clinic for an educational experience that is unparalleled.
Our work schedule allows for ample reading and didactic time. We believe that optimal resident education depends upon a balance of didactics, self-directed study, and clinical experience. The resident work schedule follows the ACGME requirements and we adhere strictly to duty hour rules.
Residents graduate and enter private practice, fellowships, and/or academics. The department has an exceptionally strong record of placing residents in the best fellowship programs for pain, OB, pediatrics, cardiac, ICU, and research. Our former residents practice in 46 different states, creating a network of job opportunities across the country. Additionally, many of our faculty are nationally recognized and can assist in job placement for private practice, fellowships, and academic positions.
Of the 52 residents who graduated in the years 2010 through 2013, one-half went into private practice. Nineteen of our graduates entered fellowship programs. Seven entered the Pain Medicine fellowship at the University of Virginia, one entered the Critical Care fellowship at the University of Virginia, one entered a cardiac anesthesia fellowship at the Mayo Clinic and a second at the University of Washington, and two entered the pediatric anesthesia fellowship program at Children's Hospital Boston. Four residents were appointed to faculty positions, three at the University of Virginia and one at the Cleveland Clinic.
See more information on recent residency graduates and their placements.
Do faculty members teach?
Resident education is a departmental priority. We are fortunate to have some of the best teachers in the world in our department. Our Program Director, Ed Nemergut, and our Vice Chair for Education, Keith Littlewood, are recognized nationally for their innovative teaching. Ed Nemergut won the 2011 IARS Award for Innovation in Education. Anesthesiology faculty members have won more teaching awards then any other department at the University of Virginia. Three have won the Master Educator award, the School of Medicine’s most prestigious award for GME teaching, five have won the Dean’s Award for Excellence in Teaching, and many others have become members of the University’s Academy of Distinguished Educators in the past 6 years.
Residents are taught by nationally recognized teachers in all areas of anesthesia. We are fortunate that many of our faculty members are at the forefront of academic anesthesiology. In fact, we have more faculty on the editorial boards of Anesthesiology and Anesthesia & Analgesia than any other institution in the world. Ed Nemergut, our Program Director, is the founding editor of OpenAnesthesia. Many of our faculty lecture nationally at the ASA, IARS, ASRA, SEA, and other organizations. UVA faculty have authored and contributed to many major anesthesiology textbooks and monographs and are experts in areas of anesthesiology.
The residents evaluate our faculty on their teaching every year. This past year the departmental average score across 11 areas was 3.6/4.0, indicating the amount of effort the faculty as a whole puts into teaching. The department incentive plan and promotion is heavily based on resident teaching evaluations.
What is the didactic teaching like at Virginia?
There are multiple didactic teaching opportunities available each week at the University of Virginia.
Required sessions include Tuesday afternoon Resident Conference and Wednesday morning Grand Rounds Conference. Our Tuesday afternoon Resident Conference, from 4PM-5PM, during which residents in the operating room are relieved of clinical duties by CRNAs and faculty, includes case-based discussion, lecture, and journal club formats.
Wednesday Grand Rounds are attended by all residents, CRNAs, and faculty and are separated into two sessions. The first hour features a resident academic presentation and the second hour is a faculty academic presentation (with faculty from both inside and outside the department as well as visiting professors).
Tuesday Resident conference and 8AM Wednesday Grand Rounds sessions follow the topic schedule according to the teaching block curriculum which is repeated every two years.
One Wednesday per month features the split anesthesia curriculum from 6:30AM-7:50 AM, designed by our Program Director. CA0 and CA1 residents are exposed to basic clinical anesthesia education topics in a case-based forum while CA2 and CA3 residents participate in a perioperative ultrasound course, including TEE, TTE and critical care ultrasound, in addition to mock oral board case conferences.
Throughout the week there are elective didactic learning opportunities as well. Our chief residents provide a morning report conference each Thursday at 6AM prior to the start of the operating room schedule. On Friday morning at 6AM there is a faculty-facilitated morning report. Both of these sessions tend to focus on clinical cases and anesthesia key concepts, suitable for residents throughout their training. In addition, prior to the in-training exam, the Department sponsors and organizes a board review course each year.
How do residents do on Board exams?
Virtually 100% of our graduates over the past 30 years have become board certified. Overall, our resident classes are generally above the 90th percentile on the written boards and have no difficulty passing the oral boards. For example, in 2010, 4 UVA residents scored in the top 100 scores in the nation, 2 in the top 50, and 1 in the top 12. Indeed, most residents achieve a score high enough to pass the certification exam by the end of their CA1 year. We have 4 current oral board examiners in our department, along with 3 former examiners to assist in oral exam preparation.
What are we looking for in a resident applicant and what is the interview process?
We are looking for bright, hard-working, inquisitive applicants who will get along with peers and function as a team. Our residents come from all over the country and have diversified backgrounds and interests. Applicants are screened based on academic achievements and potential. Once offered an interview, the applicant is offered several dates to join us for an interview. Applicants will have the opportunity to meet with the chair, the Program Director, several faculty members, and as many residents as possible. Applicants are ranked based on academics and the personal interviews.
What are the clinical anesthesia rotations?
The University of Virginia is a tertiary care hospital with a large referral base encompassing the states of Virginia and West Virginia, along with portions of Tennessee, North Carolina, and Maryland. There is also a significant community base for more straightforward cases. Our cases tend to be high quality teaching cases with high acuity, including trauma and organ transplantation. We are fortunate to have tremendous volumes in all of the clinical areas. Residents rotate through general, ambulatory, pediatric, OB, regional, neuro, pain management, vascular, cardiac, and thoracic anesthesia. Our clinical volumes in all areas are well above the national average and far exceed minimum requirements.
What is the ICU experience?
Our four-year residents complete month long rotations in the pediatric, surgical, neurologic, and cardiac ICUs. Our department has anesthesiologists/intensivists who attend in the surgical, neuro, cardiac and pediatric ICUs. Most ICUs use a combination of input from anesthesiologists, surgeons, internists, and pediatricians in both semi-open and closed units. It should be noted that the RRC requires 4 months of critical care, therefore new CA1s without critical care experience in their internship will need to complete 4 months of ICU. Three-year residents who have completed 2 months of ICU in their internship will do 2 months total of cardiac, surgical, or neurologic ICU. Residents interested in pursuing fellowship training in critical care may take additional rotations during their CA3 year.
What is the regional/pain experience?
We are fortunate to have a high volume regional service and pain service. Our residents complete rotations in regional anesthesia and in pain management, which includes both acute and chronic pain. These rotations are taught by nationally respected leaders in the area, all of whom have subspecialty training. Training includes ultrasound techniques for upper and lower extremity blocks, continuous catheter techniques, a busy thoracic epidural service, and fluoroscopy guided pain blocks.
What is the pediatric experience?
Children constitute about 20% of our patient population and our volume of cases for neonates and pediatrics is considerably above the national average. The pediatric experience ranges from procedural sedation to complex craniofacial and cardiac reconstruction. The best part of our experience is that you will be taught by experienced clinician educators. Our 7 pediatric anesthesiologists are boarded in anesthesiology and are fellowship trained in pediatric anesthesia. Several faculty members are additionally trained in the subspecialties of pediatric intensive care and pediatric cardiology.
What research experiences are available?
Both laboratory and clinical research is available but not mandatory. Many residents are involved in research leading to publications in peer-reviewed journals and presentations at national meetings. Elective time for research is available upon request and a research track is an option to some residents during the CA3 year. We have 4 NIH-funded laboratories and a host of clinical studies to provide excellent experience in research.
What electives are available?
Most of our residents elect to do additional rotations through OB, cardiac, pediatrics, research, regional, or pain management. The number of months of electives varies with resident interest. Our goal is to train residents for their individual future needs, be it academics, specialties, or private practice. Therefore, we do everything possible to accommodate requests for electives that benefit the resident.
Is it possible to do “away” electives?
Away rotations are not necessary as all the ACGME requirements for case volume can be met at our hospital. However, several residents each year participate in faculty led medical missions to South America, Africa, and Asia. Most residents also elect to do an OB rotation at Fairfax Hospital in northern Virginia.
What are the clinical strengths of the program?
All of our case volume requirements far exceed the national average and minimum requirements. However, our high-volume rotations are cardiac, thoracic, and neuroanesthesia. We also have a busy pain and regional service.
Are there any changes expected in the department and is the department stable?
Many of our faculty members have been at the University of Virginia for over 10 years. We are relatively unique in having a high percentage of faculty members who have stayed at the University of Virginia and are committed to teaching. Dr. Rich, our department chair, has been on the faculty for 25 years and previously served as program director. Likewise, Dr. Nemergut, our program director, and Dr. Littlewood, our vice-chair for education, have an extensive history at the University of Virginia. We also have many new and energetic young faculty members who have been recruited from all areas of the country. Our program has received a 5 year accreditation so no major changes are needed or expected. Nevertheless, we continue to strive for constant improvement in order to train the best residents in the United States and prepare them for the future of anesthesiology.