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Anesthesia Residency Program

Overview

Anesthesia is a rewarding specialty which involves both knowledge-based and procedural skills, practiced in a team environment. The practice of anesthesia provides interpersonal contact with patients at a time when they are particularly vulnerable and in need of compassionate care.

 

The Anesthesia program at McMaster offers the breadth of clinical education that covers the full array of anesthesia subspecialties in and out of the operating rooms. Residents who aspire to seek more advanced training after graduation will be well-prepared to seize such opportunities. Opportunities exist for further training in areas of sub-specialty Anesthesia practice as well as Critical Care Medicine, Trauma, Palliative Care, Acute and Chronic Pain Management and Research Methodology.  A fellowship in Transfusion Medicine has been developed by the Hematology Department, with Anesthesia training as an accepted prerequisite.  Equally, residents who wish to pursue a community-based practice will have a solid clinical foundation on which to commence independent practice. 

 

There are abundant opportunities for residents to grow and engage more deeply within the process of patient care such as through undergraduate medical education, simulation, or participation in the development of protocols that enhance patient safety, efficiency or interdepartmental collaboration.

 

The Department of Anesthesia at McMaster University is a collegial and cohesive department which values and promotes professionalism and enjoys an excellent track record for resident success in both Royal College examinations and (more importantly) subsequent clinical practice. Our goals will remain to provide a high standard of education in a collegial environment while endeavoring to apply new technology and educational practices to improve the educational experience of the learner.

 

Residency Program Highlights

The Anesthesia residency program at McMaster is unique in its ability to offer a wide range of clinical activity at four acute care hospitals within the setting of a relatively small and intimate residency program. We have approximately 40 residents, 95 Hamilton-based faculty and 95 faculty with adjunct appointments.  Residents and faculty have the opportunity to get to know each other very well over the course of 5 years. This "family" feel does not come at the expense of clinical exposure, however, with a full range of busy surgical services servicing Hamilton and the regions from Niagara Falls up to Owen Sound. Our residents are a tight-knit group who are highly collegial and supportive of each other.

 

Residency Program Strengths
  • a strong simulation program, where residents have frequent opportunities to learn in this environment (not just as "observers")
  • the opportunity to be involved in clerkship teaching, in didactic sessions, simulation and the clinical setting
  • strong research infrastructure to support success, both for the resident who is highly interested in research as well as for the resident who is research-phobic
  • a finely-tuned academic (curriculum) program, which is tailored to each clinic year; each session is led by expert faculty member with usual ratio 6 learners:1 faculty.  Our Curriculum Chair is Dr. DeTina and she works to ensure a balanced curriculum that is responsive to resident feedback. 
  • call schedule that addresses fatigue-management and is tracked closely to ensure fairness and transparency for all residents.  Average call per month is 3 weekend split-call shifts (encompassing no more than 2 weekends) and 2 weekday call for a total of 5 call shifts/month (3 of them being half-shifts)
  • clinical exposure to obstetrics and pediatric anesthesia throughout the residency program, rather than just during specific limited rotations
  • strong support of exam preparation with biannual program oral exams as well as ample MCQ practice through in-house exams and National in-training examinations. In addition, weekly practice oral session are offered to the PGY 5 group a few months prior to the exams.  We have had an excellent pass rate at the Royal College exams over the past few years for both CMG and IMG residents.
  • PGY5 residents have a full academic day each week, with formal, organized oral exam training
  • full academic day for PGY2's and PGY4's (September-June), in addition to the full day that our PGY5's have throughout the year. This allows for a lot more independent study time for residents throughout residency, not just during the PGY5 year. PGY 1’s have a full academic day in the summer, and subsequent AHD. PGY 3, which is an off-service year, have an AHD (academic half day)
  • the opportunity to be involved in international health through our liaison with Uganda- this elective is a  4 week opportunity which is funded by St. Joseph's Healthcare; as well, a similar collaboration is beginning with the Anesthesia residency program in Guyana. 
  • superb administrative support from program coordinator, Candice Stroud-Grundy
  • experienced, dedicated and accessible Program Director and Assistant Program Director (Dr’s Reddy and Parrish)
  • a dynamic group of dedicated, enthusiastic,  and skilled clinical teachers
  • highly engaged residency program committee with ample resident representation, that meets monthly.  As part of the CBD infrastructure, , the  Clinical Competence Committee is comprised of strong clinicians with an interest in Residency Education. 
  • the opportunity to apply to and complete the "Clinical Investigator Program" at McMaster during the Anesthesia residency.
  • resident wellness, well-being and support are a serious consideration of the program. We have resident buddies, faculty mentors, a Wellness Director, and an Ombudsman that functions independently of the program, as well as a host of resources offered by the Post Graduate Office.

 

Social Events

The Anesthesia residency program has an infrastructure which has helped to build and maintain the collegiality and "family atmosphere" for which we are known. Some of these events are:

  • Resident retreats (3/year): These are organized by residents and in the past have included curling, white-water river rafting, Canada’s Wonderland, the Canadian National Exhibition  and pool parties.
  • "Reach for the Top", an annual year-end social event with a cut-throat trivia contest pitting faculty versus residents
  • Journal Clubs, evening events occurring 4x/year
  • Resident research exchange day, an annual event collaborating with UWO, involving presentations, awards, trivia contest and dinner
  • Chair's barbeque, an annual summer event for residents, faculty and their families, to welcome new residents to the program
  • Research Interest Group Dinner meetings, where residents (and others) can present their research proposals and/or results in a collegial environment and receive feedback

 

About Hamilton

Hamilton is a "best kept secret" in Southern Ontario, set on the shores of Lake Ontario. A vibrant arts scene as well as abundant hiking and biking trails at your doorstep will help you keep a balanced lifestyle during your residency program. As a city, it has a small town feel and is easy to navigate, while Toronto and its amenities are a short drive or train-ride away. While you are living here, you will get to know the Farmer's markets (indoor and outdoor); the fabulous concerts at Hamilton Place; the Locke street stores, restaurants and bars; the Dundas Conservation area with its forests, trails and wildlife; and

all those waterfalls and more waterfalls!

 

Program Curriculum

Competency By Design (CBD)

As you are aware, the Royal College is transitioning to Competency By Design. Anesthesia is one of the "early adopters" and we welcomed our first cohort of CBD residents in July 2017 after several years of preparation. For the next two years, we will continue to have two streams of residents within our program, as the Traditional Model stream gets smaller each year. CBD aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their educational process. On a practical level, CBD aims to ensure that residents have achieved specific skills prior to graduation. It is hoped that CBD will address the problem of "failure to fail," where residents are automatically promoted from rotation to rotation based on time spent.

CBD will use time as a framework rather than as a basis for progression. It is not anticipated that the duration of training will change for the majority of the trainees. In CBD, residency programs are broken down into stages, and each stage has a set of required competencies to be achieved.

 

What will this mean for the Anesthesia resident enrolled in the CBD program?

Programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification.

Under CBD, we have worked to define our specialty very precisely. The Anesthesia Program Directors across Canada have identified 49 Entrustable Professional Activities, or "EPAs," that we perform as anesthesiologists. Each EPA is allocated to a particular phase of training (see below) and the resident must be observed to perform the EPA safely and independently multiple times by multiple observers.

 

Will residents be able to finish residency in 4 years under CBD?

As described, CBD is not "time-based," however there is still a basic framework of expected lengths of time for each of the four phases of the CBD model: Transition to Discipline, Foundations, Core, and Transition to Practice. All Anesthesia Residency Programs are modelling an equivalent length of time as the traditional Anesthesia Residency Program (5 years), although the amount of time spent in various types of rotations has changed slightly. The Anesthesia Residency Program Directors from all schools worked along with the Royal College to design a common CBD curriculum for Anesthesia. Although aspects of local implementation vary, the combined efforts across the country ensure a high-quality and consistent experience for all Anesthesia residents under CBD. From a practical perspective, the Royal College examination is offered only once a year, so there is no logistical advantage (in fact, be a disadvantage) to complete residency several blocks early.

 

Progress Through the CBD Curriculum

Under CBD, we describe the resident's progression through residency by the four phases, but also by the year (PGY-1 to PGY-5) depending on whether we are describing the timeframe or the level of clinical performance.

Transition to Discipline: 3 months

Foundations: 18 to 24 months

Core: 18 to 24 months

Transition to Practice: 6 to 12 months

 

Example CBD Curriculum
PGY-1 Year

Residents begin with three blocks in Anesthesia in which to complete the objectives of the "Transition to Discipline" phase. There is no call done by the TTD residents. There are 3 EPAs to be achieved in the TTD phase.

After TTD, the resident enters Foundations (at block 4 of the first year based on typical progress track); they spend 8 blocks in off-service rotations to complete the objective (or EPAs) associated with those rotations. The template below explains how that 8 blocks is spent:

 

Internal Medicine (CTU) - 8 weeks (consecutive)

Obstetrics and Gynecology - 4 weeks

ICU - 4 weeks (Kitchener-Waterloo or St. Catharines)

Pediatric General Surgery - 4 weeks

Emergency Medicine - 4 weeks

 

Surgical Rotation (1 block)

Thoracic Surgery - 4 weeks

ENT - 4 weeks

General Surgery - 4 weeks

 

Pediatric Experience (1 block)

Neonatology/Level II - 4 weeks

Pediatric ER - 4 weeks

 

The PGY-1 resident then returns to Anesthesia for the last 2 blocks of their first year (still in Foundations) and at this time, they will start doing "Call" (first buddied, then independently). Foundations continues into the PGY-2 year (it is 18 to 24 blocks in total) and there are 16 EPAs to be completed in Foundations. The Anesthesia rotations in Foundations are "general" (i.e. no subspecialty) rotations, although there is dedicated time spent in both Pediatric and Obstetrical Anesthesia.

 

PGY-2 Year

As mentioned above, as a PGY-2, the resident is in the "Foundations" phase of training and will be based mostly on Anesthesia rotations. During the PGY-2 year, you will learn the fundamentals of the practice of anesthesiology. Working one-on-one with a faculty member each day, you will be exposed to a variety of cases and a variety of perspectives. The PGY-2 year is spent rotating through all four teaching hospital sites and the two obstetrical units. Pediatric anesthesia experience is obtained at McMaster University Medical Centre. Residents also take part in the pre-assessment clinics and the acute pain services affiliated with each hospital site.

Under CBD, the PGY-2 year would likely be spent working on the goals of the "Foundations" phase, which are described by the 16 EPAs that are associated with this phase of training. Although some of the EPAs are achieved in off-service rotations, most of those off-service rotations are positioned within the first year.

 

PGY-3 Year

Early in the PGY-3 year, the resident will transition to the "Core" phase of training, where there are 25 EPAs to be achieved, encompassing a broad range of skills within subspecialty Anesthesia, Critical Care, and Medical specialties. We are able to provide the resident with some options and flexibility while still ensuring that they will have the training experiences (rotations) to achieve those EPAs. The Core phase of training is 18 to 24 months in duration. Most of the off-service rotations are positioned within the PGY-3 year. This allows our residents to remain (mostly) on Anesthesia rotations for the entirety of the final two years of their training. Therefore, the PGY-3 year is largely an off-service year, and the template below describes the composition of this year.

 

Mandatory Experiences

ICU - 2 blocks (HGH)

ICU - 2 blocks (JH or SJH)

CCU - 2 blocks

Nephro - 1 block Dialysis/Transplant rotation (SJH)

Respirology - 2 blocks

NORA

Palliative Care

Perioperative Medicine

Echo


Electives in research, if approved, are scheduled in the PGY-3 year, replacing one of the "medicine" blocks. The Guyana elective is also positioned within this year in block 10 and counts as a regular anesthesia rotation.

We are constantly evaluating all of our rotations based on resident feedback to ensure that we are offering the optimal learning experiences for our residents, making changes to our template accordingly.

 

PGY-4 Year

In the fourth year, the resident continues on in "Core," now pursuing the EPAs that focus on subspecialty areas of anesthesia. The rotations therefore include:

  • Cardiac anesthesia
  • Neurosurgical anesthesia
  • Pediatric anesthesia (complex)
  • High-risk obstetrical anesthesia
  • Regional anesthesia
  • Chronic pain medicine
  • Thoracic anesthesia

 

Two blocks of community Anesthesia rotations are mandatory. One of these rotations may be shifted in the PGY-5 year, depending on scheduling requirements. At least one of the community rotations must take place at a community hospital while there is some latitude in the planning of the second rotation, such as an elective at another university teaching hospital in Ontario.

 

PGY-5 Year

The final year of training is a general clinical year where the resident learns to embody their role as "consultant." The resident will spend most of this year in the "Transition to Practice" phase. The 5 EPAs associated with this phase focus on developing the intrinsic CanMEDS roles (Manager/Leader, Health Advocate, Communicator, Collaborator, etc.) and using those skills along with the well-developed Medical Expert role. Senior residents begin the experience of practicing more independently, though always with the "safety net" of a dedicated faculty supervisor. PGY-5 residents complete five "Junior Consultant days" during their final 6 months of training. Opportunities for further experience in subspecialty anesthesia, research, or other scholarly activity (such as further study within the Clinical Investigator's Program) and are readily available for the resident that is thriving within the baseline requirements of the program.

 

Community Experience

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.

 

Academic Sessions

Residents at McMaster are involved in weekly academic sessions. Tutorials are facilitated by faculty members, involving subject matter targeted to the resident's 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, PGY-4, and PGY-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; 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 the PGY-2s is Thursday. There is a 6-week Regional Anesthesia module during the spring - residents participate in this module both in the PGY-1 and PGY-2 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 the PGY-3s and PGY-4s: the 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 encounter three critical hands-on workshops that they first received as PGY-3s: Regional Anesthesia, and POCUS.

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 still also occurs on the academic day.  They will have formal oral exam prep sessions that continue until just before the oral exam.

 

Exam Preparation

Residents in the McMaster Anesthesia Residency Program have an excellent track record at the Royal College examinations. 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, which 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 held formally on a weekly basis
  • The PGY-5 residents also organize informal practice oral exams with different McMaster Anesthesia faculty members 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 Anesthesia Knowledge Test (AKT)
  • The program generates in-house MCQ exams three times a year for PGY-2 to PGY-5 levels
 
Simulator Training

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 by watching others). In general, residents 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.

 

Resident Research

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
  • 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 students in any field through the Department of Anesthesia.

 

Resident Exchange Day

This event is held each year with the Western University 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 an awards ceremony follows the presentations.

 

Library Facilities

The Anesthesia Department has a bright, centralized space for the operations of the residency program, including a library/conference room. The 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 coordinators and program directors have their offices right there. The library is well-resourced with books for reference and for signing out by Anesthesia residents. Residents have meetings in their conference room, or study together.

The Hamilton Health Sciences Library is on-site at the McMaster University 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 are available at clinical sites, and residents are registered with Lib.access, which provides a comprehensive list of online medical journals and resources.

Training Sites

The McMaster University Anesthesia Residency Program is comprised of four clinical teaching units. These units are located at:

  • St. Joseph's Healthcare Hamilton (SJH)
  • Hamilton General Hospital (HGH)
  • Juravinski Hospital and Cancer Centre (JH)
  • McMaster University Medical Centre (MUMC)

 

The latter three sites are all part of Hamilton Health Sciences.

St. Joseph's Healthcare (SJH) is the regional centre for respirology, renal, and head and neck disease. It also houses a busy obstetrical schedule (an average of 3,000 deliveries per year).

The Hamilton General Hospital (HGH) campus is the regional centre for the cardiac and vascular neurosurgical and neuroscience, spine, burn, and trauma programs.

The Juravinski Hospital (JH) campus is a regional centre for arthroplasty, hepatobiliary, colorectal, and oncology programs and is affiliated with the regional cancer care centre.

The McMaster University Medical Centre (MUMC) campus of Hamilton Health Sciences 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 only 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. Stephen Ttendo, an anesthesiologist from 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.  This collaboration was initiated by Dr. Alex Dauphin, an anesthesiologist at St. Joseph's Healthcare, and dates back to 2003. 

In 2016, McMaster University formally initiated a collaboration hosting two residents each year with the Anesthesia residency program in Guyana.  This outreach is coordinated by Dr. Joel Hamstra, Associate Clinical Professor with the McMaster Department of Anesthesia and anesthesiologist with St. Joseph's Healthcare.

 

Resident Resources

In July of each year, the McMaster Anesthesia Residency Program welcomes the addition of new residents to the PGY-1 cohort. A unique aspect of our residency program is the collegiality amongst the residents. Historically, the McMaster anesthesia residents form a tight-knit group and we share good times with one another, both within and outside of academic settings. We also demonstrate collegiality with residents from other Canadian programs, as evident by our residents' annual involvement in the CAS conference and the McMaster-Western Resident Research Exchange Day. We are also actively involved in global health development, with two residents being selected every year for an international elective in Uganda.

Our training program has always maintained a strong reputation as we constantly strive for improvement and renovations. The regional anesthesia block has received great resident feedback and has been identified as a strength in our annual internal reviews. The simulation program is undergoing changes to its curriculum, with increased involvement and participation. Our residency program is always striving toward excellence, and the resident group is an integral part of this process.

The resident webpage is designed with the intention of providing a commonplace for sharing academic resources, program information, and links that are relevant to anesthesia residents at all levels of their training. Contents of the site will be continually updated with relevant articles, practice guidelines, and notices for upcoming academic events. Specific information pertaining to the residency program, such as schedules, academic core teaching programs, and archived presentations can be accessed at the password-protected link to Medportal. Contents of the Medportal site are meant to be available for McMaster anesthesia residents only.

Frequently Asked Questions (FAQ's)

 

1) What is the call like?

 

Residents do call at each of the four clinical sites. At the JHCC, they cover daytime weekends only (8 am- 8 pm) and none of the weeknights. At all the other sites, (HGH, McMaster and SJH), residents do 24 hour call during the week and do "split call" on the weekends (8 am- 5 pm shift and a 5 pm-8 am shift).  On average, residents do 3 weekend shifts a month (no more than 2 weekends) and 2 weekday shifts, totaling 5 calls overall for the month. Anesthesia residents are always off at 8 am post-call.  At the end of PGY1, when you return to Anesthesia rotations in May, you will do several buddied calls prior to doing solo call.  At the HGH, residents do not do solo call until they are halfway through the PGY2 year, again, after several buddy calls. The reason for this is the higher-level demands of the airway management of the trauma patient. 

 

 

Most programs have eliminated 24 hour call entirely.  However, most staff positions involve 24 hour call.  At McMaster, we feel it is important that residency prepare you for practice.  We also feel that there is more to wellness than the length of the call shift, such as the amount of call in total, the length of the non-call days and the amount of academic time that is given. It is interesting to note that in the US, 24 hour call has been "re-approved" again and a recent (March 17, 2017) NEJM article explores that topic.  It's not a simple issue and it impacts on patient care in some paradoxical ways.  

 

 

We track all the residents' call while on Anesthesia on a spreadsheet in real time, that is shared amongst all the residents and used to ensure equity in call distribution.

Call during off-service rotations is specific to the service. During several of the "medicine year" rotations, Anesthesia residents do Anesthesia "fly-in" call, thus maintaining a connection with their home program.

 

 

 2) How long are the workdays?

 

 

Anesthesia is not a "lifestyle specialty". We work unsociable hours and sometimes our days are unpredictable in terms of when they will end. As a resident, you will be involved in lists of all durations. We have lists that end at 3:30 pm, 4:00, 4:30, 5:00 and 6:00 pm. The cardiac rooms are booked until 7 pm. You will be assigned to all types of lists during your residency and during the PGY4 year (subspecialty rotations), the frequency of long days is greater.  Unless on call or on subspecialty, it would be unusual not to be finished by 5 pm and often quite a bit earlier.

 

 

 3) How much do I get to control my learning, as a resident?

 

 

At McMaster Anesthesia, the assigning of residents to lists is done by the "admin resident" at each site, who is usually a PGY4. The admin resident also constructs the call schedule. Part of the admin resident's role is to be in dialogue with the other residents at the site to ensure that their learning needs are being met. PGY5's have more input into their list selection as they are keen to round out their residency and ensure a balanced exposure to all types of patients and cases.  We have a fair, transparent online process where residents can make their requests for vacation time or days off.

 

 

There are many other ways in which residents have control over their learning. Our academic curriculum is very interactive and is optimized through self-directed learning. Research opportunities are myriad such that almost any interest can be explored. There are many optional rotations to explore in the off-service years as well as while in Anesthesia, including the Uganda elective.

 

 

Finally, many of our residents explore alternative learning programs towards the end of their residencies, through the Critical Care Medicine Program or Chronic Pain residency program (both are two year programs which can overlap for one year with the PGY5 year of Anesthesia) or through the Clinical Investigator Program.

 

 

 4) Are there opportunities to teach as a resident?

 

 

Absolutely!  Residents are involved in teaching clerks throughout residency. Residents participate in the clerkship curriculum, where they teach didactic sessions and facilitate sessions with task trainers and our standardized simulation scenarios. On average, each resident would spend approximately 2 days per year teaching within the clerkship program. As well, the clerks spend one night "on call" and are attached to the anesthesia resident for that experience.

 

 

Some residents chose to participate in teaching "Clinical Skills" to Undergraduate medical students. Finally, the McMaster Medical School (Undergrad) has an active "Anesthesia Interest Group" which organizes weekend workshops with volunteer Anesthesia residents and faculty as facilitators.

 

 

Residents also have the opportunity to develop their presentation skills through their Journal Club presentations, Research Exchange Day presentation and mandatory presentations at academic half days and rounds. For example, PGY4 residents "teach" the PGY3 summer academic half-day curriculum along with a faculty facilitator.

 

 

 5) Are there opportunities to be involved in committees?

 

 

Yes! Each PGY year has a resident representative on the resident advisory council, which sits on the Residency Program Committee. There are also many other committee opportunities through the postgrad office. Amongst our residents we have the PARO past-president and several PARO board members. 

 

 

 6) Do you have a Mentorship Program?

 

 

Yes, you will be assigned a faculty mentor when you arrive. You will have a mentor for the full five years of your program; during the early stages of residency, they will help you get oriented, and as you progress through the program they will be there to provide advice in areas such as exam preparation, electives, fellowships, and career decisions. We will also you assign you a more senior resident "buddy". Many residents naturally find many other "informal mentors" as they move through the program.  One thing to be aware of is that each resident also has an academic advisor (AA).  The AA fulfills a different role than the mentor. The AA tracks your academic progress and ensures that you are on track regarding the achievement of your EPA's, in particular. 

 

 

 7) Why do your residents do all their "medicine" rotations during one year, rather than breaking it up a bit?

 

 

I suppose ,"We've always done it this way" is not a satisfying answer?  OK, well, we think there are several benefits to the way we have ordered our rotations.  For one, once you finish that PGY3 medicine year, you are on Anesthesia rotations for the rest of your residency, so you can focus exclusively on your core material as you hit the home stretch of exam preparation.  Also, as a PGY4, you encounter all your Anesthesia subspecialty rotations, so you have the equivalent "medicine" background experience in order to optimize your rotation.  For example, when you do Cardiac Anesthesia, you have already done CV-ICU; When you do Thoracic Anesthesia, you have already done Respirology and gained  experience in bronchoscopy; when you do High-Risk Peds, you have already done your NICU (or PICU) rotation) etc. etc. Finally, because we offer a FULL ACADEMIC DAY to our residents (which doesn't apply when they are off-service), by keeping the off-service rotations bunched into one year, it allows us to plan the academic time more coherently for each PGY cohort. (If some of your group was getting a full day, and some a half day, it would be difficult to avoid having some residents miss part of the day).   Other programs who only offer an academic half-day throughout the entire residency (or until the end of PGY4) do not have these logistical considerations of where to place the off-service rotations. 

 

 

Like all aspects of our program, this issue is on the table for discussion and we are constantly seeking input from our residents. Recently, when I asked the PGY4's if we should look at deconstructing the "medicine year" to intersperse the rotations rather than having them occur as a one-year block, they were unanimous in saying that the block of rotations is preferable.  As it stands, most residents have one or two Anesthesia rotations during their PGY3 year and that, as well as the buddy call, helps them stay in touch with their home base. 

 

 

 8) What do your residents do once they graduate?

 

 

Great question! Since candidates always ask this question, we started to track it. The left column shows what the each resident did for their first year after graduating and the right hand column shows their permanent staff position. As you can see, McMaster Grads have no difficulty securing excellent fellowship positions leading to academic positions, or jobs in the community. 

 

 

2014 grads

Right after graduationCurrent Position:
Cardiac fellowship OttawaICU/Anesthesia staff positions in Eastern Ontario/Quebec
Cardiac fellowship TorontoHHS staff
Simulation OttawaOttawa- community (Montford)
locumsBrampton staff
clinical scholarHHS then Credit Valley staff
LocumsBarrie staff
locumsCambridge staff

 

2015 grads

Right after Graduation:Current Position:
direct to Cambridge staff positionCambridge staff
clinical scholar HHSHHS staff
clinical scholar HHSHHS staff
Fellowship (regional) OttawaSudbury staff
ICU fellowship (Hamilton)HHS staff
fellowship OB HarvardHHS staff
Pain fellowship HamiltonHHS staff

2016 grads  

Cambridge staff
Regional Fellowship Toronto
Pain Fellowship Toronto
OB Fellowship Ottawa- joined HHS staff 2017
locums
Clinical Scholar HHS- joined HHS staff in 2017

2017 grads  

Cardiac Fellowship Hamilton
Cardiac Fellowship Toronto
Thoracic Fellowship Toronto
OB Fellowship Dalhousie
Regional Fellowship Australia
locums
Pediatric Fellowship McMaster
Neuro-Trauma Fellowship Toronto

2020 grads  

Critical Care Fellowship x 2: McMaster
Cardiac Anesthesia Fellowship: McMaster
Neuroanesthesia Fellowship: Western (London)
Clinical Scholar: St. Joseph's Hospital (Hamilton)
Regional Anesthesia Fellowship: Vancouver
Locum: St. Catherine's
Chronic Pain Fellowship: California (USA)

 


9) I don't know anyone in Hamilton. Will I feel at home in the program? In what ways do we interact with other residents outside of the operating room?

 

We have residents from British Columbia and Nova Scotia and many provinces in between. Our residents are a tight-knit, social group who are very supportive of each other. See the "program highlights" section for some of the structured social elements.  In addition, many residents chose to collaborate on research projects. Residents get to know each other well through their academic half day program, which brings them together each week in small groups. As well, residents have three retreats per year, scheduled during academic days.

 

PGY1 residents are assigned a "resident buddy" to act as an informal mentor.

 

You will also get to know our faculty, many of whom host social events or have the residents over to help with exam prep, to celebrate successes, or just to socialize.

 

10) Where do residents in Hamilton live?

 

We have residents who commute from as far as Toronto or Woodstock, but most live in and around Hamilton. The hospitals in Hamilton are situated in the four corners of the city, each a 10-15 minute drive from any other. Many residents chose to live near McMaster, in either Westdale or West Hamilton. Another popular area would be near St. Joe's, in the area of Bay, Caroline, Bold, and Herkimer streets.  A number of residents live in the area around Locke Street South. From here, you’re just steps to great cafés and restaurants, the grocery store, gyms and parks (http://lockestreetshops.com). It’s a 10 minute walk to St. Joe’s, and just under 10 minute drive to each of the other 3 hospitals. Nearby communities of Dundas and Ancaster are popular with families as is Westdale.

 

We have several faculty who live in or around Toronto.  Toronto is a great city, and one if its best attributes is that it's not too far a drive to Hamilton.  However, most would find that too far of a commute for the lifestyle of a resident. 

 

11) How sketchy is Hamilton really?

 

Every city will have those sketchy areas and Hamilton is no different. The Hamilton General is in close proximity to those less desirable areas. Fortunately, residents are almost always coming and going during daylight hours. Most of the city is quite lovely.  

 

Hamilton is currently undergoing a boom: the city has a rapidly growing economy, the downtown core is being revitalized with an influx of new businesses and condos, a new GO station with all day service to Toronto, and dedicated bike lanes (along with a new bike share program) are being built throughout the city. There is a burgeoning restaurant, bar and night life scene happening at the moment.

 

There is no shortage of activities in Hamilton. If you like the outdoors, you have direct access to the Bruce trail and hundreds of kilometres of hiking and cycling trails. There is sailing and rowing on the lake and rock climbing nearby. Hamilton also has a vibrant arts and music scene, with lots of festivals throughout the summer.  There is a wonderful year-round Farmer's market in the downtown mall (Jackson Square) as well as outdoor Farmer's markets in Dundas and Ancaster seasonally. 

 

One of our (now) PGY2's, who moved to Hamilton from a nearby, larger city says it best: "Life in Hamilton and surrounding area is just awesome and if I have to choose one thing I personally like SO much is that traffic has never been an issue. I feel thankful that I don't need to trade struggling with traffic for a strong residency training. Where else can you get that?"

 

12) Are there gyms at the hospitals?

 

HGH, McMaster and JHCC all have Fitness Centres on site as part of their "Shine" Wellness Centres (you can check it out online). St. Joe's has a wellness centre that offers spin and yoga classes.

 

13) Is there a mountain in Hamilton?

 

No, there is not. Sorry.

 

CaRMS & Resident Entry Information

Program Goals

The McMaster Anesthesia Residency program has the primary goal of educating residents to become independent practitioners in the field of Anesthesiology, both nationally and globally, by providing a competency-based education with progressive clinical responsibility. This goal is attained through an extensive exposure to a diverse population of patients with varying degrees of complexity and pathologies in our hospital setting.  The clinical experience is complimented with a strong didactic curriculum, simulation training, research and creating a culture of inquiry through the teaching of skills to develop scholarly activity, quality improvement and patient safety.

The Anesthesiology Residency training will take place in an atmosphere of mutual respect and collegiality, promoting the ability of residents to acquire the knowledge, skills, clinical judgment and experience that will enable them to independently practice as an Anesthesiologist in a professional, competent and skillful manner.

Anesthesia Residency YouTube Channel

McMaster Anesthesia Residency

 

Town Hall to learn about the program

Visit PGME Site here:  Town Hall Link