Anesthesiology Residency Program

Main (Program Overview/Mission/Vision/Aims)

The goal of the San Antonio Uniformed Services Health Education Consortium Anesthesiology Residency is to develop the very best anesthesiology consultants, who can excel in the military environment. Our graduates are warrior physicians, crisis managers, and expert consultants.

Curriculum/Rotations/Locations/Partnering Institutions

Four year program (Clinical Base 1 Year + Clinical Anesthesia 3 years)

Clinical Base Year Outline

• Medical, Trauma and Cardiac ICU
• Chronic Pain
• Internal Medicine Wards
• General and Trauma Surgery
• Emergency Medicine
• ENT
• Labor and Delivery
• 4-6 weeks of Anesthesia balanced with research time
• CBY Research Opportunities
  • Research project development throughout the year
  • Up to 4 weeks of dedicated Research prior to CA-1 year
  • IRB submission if desired
• Resident Academic Days once per month away from off-service clinical duties

Clinical Anesthesia 1/2/3 years include general and subspecialty anesthesia; trained by board certified and fellowship trained Anesthesiologists CA-1 Year

• Orientation
• OR – General Surgery, Ortho, ENT, Urology, GYN, OMFS, Plastics
• ICU – 4 weeks (STICU)
• *Chronic Pain – 4 weeks
• Acute Pain Service – 2-4 weeks
• *Pediatric anesthesia
  • Pediatric sedation unit – MRI, CT, ENT, GI cases
• *OB – 4 weeks
• *Neuroanesthesia
• *Cardiothoracic anesthesia – 4 weeks
• PACU – 2 weeks
• PAU – 2 weeks
• *POCUS – 2 weeks
• Out of OR cases – GI, Pulmonology clinic, Interventional Radiology, EP lab
• Trauma Night Float – 4 weeks (2 2-week blocks)

* Denotes rotation may be in CA-1 or CA-2 year

CA-2 Year

• Burn ICU – 4 weeks
• Burn (ISR) OR- 4 weeks
• UTHSCSA OB – 4 weeks
• UTHSCSA CT – 4 weeks
• Methodist Neuro- 4 weeks (Houston)
• Methodist CT – 4 weeks (Houston)
• UTSW Neuro – 4 weeks (Dallas)
• Driscoll Hospital Peds – 4 weeks (Corpus Christi)
• Regional Anesthesia – BAMC, WHASC
• Advanced Clinical Anesthesia
• OB nights
• Trauma Night Float – 2 to 4 weeks

CA-3 Year

• UTHSCSA OB – 4 weeks
• Driscoll Hospital Peds – 4 weeks (Corpus Christi)
• Baylor Vascular – 4 weeks (Dallas)
• TEE – 2 weeks
• OB nights – 2 weeks
• Regional anesthesia – varies
• Trauma Night Float (4 weeks)
• Advanced Clinical Anesthesia
• Anesthesia Floor Coordinator (AFC) – 1-2 weeks
• 2 week elective

Research & Quality Improvement, Patient Safety (QIPS) CA1-3

• APD for Research and APD for QIPS to help guide through the processes
• Multiple opportunities available to design and implement a QIPS project
  • Participation in QIPS is a graduation requirement

Away rotations to Dallas (Neuro and Vascular), Houston (CT and Cardiac ICU), Corpus Christi (Pediatrics) and University Hospital in San Antonio (CT and OB) during CA1-3 year.

Other Opportunities

• Humanitarian Missions
• ASA Conferences
• Leave
  • CBY: 2-3 weeks
  • CA-1: 3 weeks
  • CA-2 & 3: 4 weeks

Military Relevance (military relevance of specialty/how program prepares trainees to be ready for military mission & first assignment)

The importance of anesthesiologists in a forward-deployed environment cannot be overstated. Our graduates currently fill roles on Ground Surgical Teams (GSTs), Forward Surgical Teams (FSTs), Role 2 Teams, Role 3 Teams, Special Operations Surgical Teams (SOST) and Critical Care Air Transport Teams (CCATT) in deployed locations worldwide. Training our residents to be warrior physicians, crisis managers, and expert consultants results in fewer lives lost on the battlefield, less morbidity, and better return to function at home.

Our program utilized multiple avenues to accomplish this. Army residents attend Combat Casualty Care Course (C4) and become Advanced Trauma Life Support (ATLS) certified. All residents that graduate from USUHS attended Bushmaster and also become ATLS certified. All residents are expected to maintain Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support (BLS, ACLS, and PALS) certifications. A Military Unique Curriculum (MUC) has been instituted and includes lectures and discussions from recently deployed members of our department. Knowledge, Skills, and Attributes (KSAs), Comprehensive Medical Readiness Programs (CMRPs), and Individual Critical Task Lists (ICTLs) are reviewed, and residents receive simulation training ranging from ultrasound techniques, mass casualty management, invasive line placement, regional anesthesia, and blood transfusion protocols and practices. Residents do not attend CCATT or GST training during residency, but they do receive lectures regarding these trainings. We typically send 8-10 residents per year on Medical Readiness Training Exercises (MEDRETEs), providing a valuable experience in anesthesia care in more austere environments. Recent MEDRETE locations have included El Salvador, Panama, the Dominican Republic and Honduras. Our robust simulation program takes advantage of the technology available in our in-house simulation center. Residents participate in these exercises every four weeks. Some examples of military relevant simulations are blood transfusion practices, mass casualty, head trauma, chest and abdominal trauma, cardiac tamponade, etc. Our graduates routinely deploy within 1-2 years of graduation (some within 90 days) and have an outstanding performance record. We conduct an annual porcine “live-patient model” lab where residents get to practice CMRP/ICTL required skills that don’t happen often, but can be lifesaving. Residents have the opportunity to participate in FRST field exercises at Camp Bullis that are held several times a year.

Application Instructions (Eligibility/Interview Process/Program Application Details)

Contact the Clerkship Site Director, Clerkship Coordinator, or Program Coordinator for a Clerkship Rotation.

• Air Force: typically 6 categorical medical students accepted to SAUSHEC and dozens are sent for civilian deferments; if not selected, medical students are encouraged to apply in their intern year for PGY-2 entrance; 2 PGY-2 starts are at SAUSHEC each year.
• Army: 5 categorical every year on average with roughly 7 applicants selected for training at Walter Reed; no routine civilian deferments offered; typically 1 PGY-2 spot is available per year.
• Ensure Program Coordinator has all requested materials prior to interview
• Interview in Person: Service Dress, Class A’s or civilian equivalent for those who have not attended officer training
• Points system:
  • Preclinical performance earns 0, 1 or 2 points
  • Clinical performance 0, 1 or 2 points
  • Potential for Successful Practice as a Specialist and Military Officer earns a maximum of 6 points
  • Daily evaluations may be incorporated into the interview and final selections
• Program Director Interview
  • One-on-one interview, notification of date and time to be arranged by Program Coordinator
  • Your opportunity to ask questions that were not answered by the residents or staff you have worked with in the perioperative settings
• Panel Interview
  • Two to three staff within program leadership
  • Scheduled day is noted on the month calendar
• Daily Interviews
  • We highly value the input from all staff and residents. Every day is an opportunity to excel and be recognized via your daily evaluations