Clinical Program

The clinical program is designed to assure that each resident training in the program has the opportunity to exceed the minimum case number requirements for each category as set by the American Board of Anesthesiology to be eligible for specialty certification by that board. The primary training hospitals are:

Teaching Hospitals

University Health System

The University Health System is the public district hospital for Bexar County, Texas. The University Hospital campus currently consists of three towers, with nearly 500 beds, including a $990M trauma tower that opened in April 2014 which expanded the operating room capacity by 33% and incorporates the latest designs utilizing state-of-the-art equipment and technologies. Since 2001, U.S. News has consistently ranked it amongst the best hospitals in Texas and San Antonio. University Hospital is the largest Level I Trauma Center, and the only Level I Pediatric Trauma Center, in the South Texas region. The hospital system is undergoing a $990M expansion and renovation, expected to increase the number of hospital beds to over 700 and nearly double floor space to about 2 million feet. A Women and Children’s tower is expected to open in 2022, with amenities designed for mothers and babies, such as care for high-risk deliveries in the peripartum setting.

South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital

Acute medical, surgical, psychiatric, geriatric, and primary care services are offered for over 80,000 veterans residing locally, regionally and nationally. Comprised of 268 hospital beds and a state-of-the-art Spinal Cord Injury Center, ALMVAH provides such tertiary care services and technology as bone marrow transplantation, open heart surgery, magnetic resonance imaging and positron emission tomography. As a Level II Research facility, ALMMVH has projects that include aging, cardiac surgery, cancer, diabetes and HIV. The facility also has one of three National Institutes of Health sponsored clinical research centers in the VA. In addition, the Geriatric Research, Education & Clinical Center (GRECC) is a “Center of Excellence.” In 2014, the ALMVAH was designated a Top Performer with Top Honors in Key Quality Measures by the Joint Commission.

Children’s Hospital of San Antonio (Christus Santa Rosa Health System)

Serving a 90-county area, the hospital is one of only a few children’s hospitals in Texas and was the first hospital in the region entirely dedicated to the care of children. In a typical year, the hospital system provides care to 5,000 inpatient children, 80,000 emergency department visits, and 73,000 outpatient visits. CHOSA has approximately 200 beds and has been providing comprehensive pediatric services at one location since 1959.

Clinical Rotations

All rotations are performed at the above affiliated hospitals/institutions in San Antonio, Texas.

PGY-1

A transitional year incorporating rotations in the departments of Medicine, Surgery, Pediatrics and Anesthesiology. Rotations include cardiology, pediatrics, internal medicine, general surgery, emergency medicine, neurosurgery, cardiothoracic surgery, and otolaryngology. Interns receive exposure to anesthesiology through a rotation in the Anesthesia Pre-operative Evaluation Clinic, the Surgical Intensive Care Unit at the VA hospital staffed by the Anesthesiology department, as well as an OR-based “boot camp” experience during the final block in preparation of PGY-2 year.

PGY-2

Twelve months of predominantly operating room experience at the affiliated training hospitals under the direct supervision of Anesthesiology faculty with increasing degrees of difficulty and a wide variety of surgical cases. Residents typically begin rotating through sub-specialty disciplines on the latter half of the academic year.

PGY-3 and 4

Twenty-four months of rotation assignments designed to enable the resident the opportunity to spend dedicated time experiencing specific types of sub-specialty anesthesia cases with increasing responsibilities and case complexity.

Minimum required experience (16 months)

  • 2 months of Cardio-thoracic Anesthesiology
  • 2 months of Neurosurgical Anesthesiology
  • 2 months of Pediatric Anesthesiology
  • 2 months of Critical Care Medicine
  • 2 months of Obstetric Anesthesiology
  • 1 month of Advanced Airway Management / Transition to Anesthesia Practice (TAP)
  • 1 month of Hepatobiliary/Advanced Anesthesiology
  • 1 month of Non-Operating Room Anesthesiology
  • 1 month of Regional Anesthesiology
  • 1 month of Perioperative Medicine
  • 1 month of Post-anesthesia Care
  • 1 month of Chronic Pain
  • 1 month of Acute Pain

Plus optional experience opportunities (depending on case logs, clinical need, and/or clinical interest)

  • Additional rotation(s) in anesthesia sub-specialties
  • One-month elective rotations available at the PGY-4 level only: Research, TEE / Ultrasound

Evaluation

Residents are provided both verbal and written feedback to reinforce behavior consistent with the standards of anesthesia care as well as to allow self-reflection and self-improvement. In addition to regular evaluations stemming from the daily interactions with faculty, each resident will also receive feedback from assigned faculty mentor based upon the cumulative evaluations and academic performance on a semi-annual basis. The faculty mentors are also available for guidance regarding academic, career, and personal counseling. The chair of the clinical competency committee will also be meeting formally with each resident on a semi-annual basis to discuss strengths and areas of improvement based upon academic performance and ACGME milestones.

Residents are also provided with the opportunity to anonymously evaluate the faculty and the program. Evaluations on the faculty are used to reinforce conduct consistent with the role of the clinician educator as well as to improve upon teaching practices. Evaluations on the program are used to improve the overall quality of the residency program through avenues such as, but not limited to, resident involvement in the Program Evaluation Committee, Chief’s Conference, and Program Director’s Conference. Residents are encouraged to seek out faculty as well as program leadership on an as-needed basis to discuss personal concerns or issues related to the program.

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