Anesthesiology Fellowship Programs
Department of Anesthesiology Fellowship Application Form
Individuals may choose to complete subspecialty fellowship training (12-24 months) beyond the three clinical anesthesia years. Fellowship opportunities are available in the following:
Cardiothoracic Anesthesiology Fellowship Program
Overview
The Department of Anesthesiology at the University of Maryland School of Medicine has two ACGME-approved cardiothoracic anesthesia fellowship positions. Given our surgical volume, fellows receive ample opportunity to gain both personal and supervisory experience in managing the most interesting and challenging cases in anesthesia. Each cardiothoracic anesthesia fellow will participate in a total of six months in the cardiovascular operating room service, of which a minimum of three months will be conducted with the fellow providing direct clinical care of patients under the supervision of a faculty anesthesiologist and the remainder supervising residents under the direction of the attending anesthesiologist.
A two-year fellowship combined with critical care is also available. The fellows have a professional development/education fund that can be used to attend meetings or to purchase educational materials. Fellows are given time (five days per year) and fiscal support to present their research at national meetings. Fellows also have the opportunity to attend local and regional conferences, especially those sponsored by the anesthesia department, cardiac surgery or cardiology.
Clinical Curriculum
Fellows gain proficiency in and exposure to the perioperative evaluation and intraoperative management of cardiac surgical patients including:
- elective and emergency cardiac patients undergoing primary and redo revascularization
- valvular repairs and replacements
- combination procedures
- pericardial procedures
- neoplastic procedures
- heart and lung transplantation
- thoracic aortic surgery: ascending, transverse and descending aortic surgery with and without circulatory arrest
- endovascular techniques
- ventricular assist devices
- minimally invasive cardiac surgery
- robotics
The cardiac fellow will gain experience with pulmonary surgery including:
- thoracoscopic and open procedures
- lung reduction
- bronchopulmonary lavage
- lobectomy
- pneumonectomy
- bronchoscopy
- endoscopic, fiberoptic, rigid and laser resections
- esophageal surgery
Experience will also be obtained with placement and utilization of thoracic epidurals for perioperative pain management.
Fellows are assigned for clinical duties so that their hours are limited to no more than 80 hours, averaged over a 4 week period. The fellows have no in-house call responsibilities.
Flexible Scheduling
The Cardiothoracic Anesthesia fellows can tailor the schedule according to their needs to gain competence in both cardiac and thoracic anesthesia cases. There are two months of elective rotations built into the curriculum including invasive cardiology, cardiac catheterization laboratory (adult and pediatric), perfusion services, pediatric cardiac surgery, cardiac surgical ICU and electrophysiology.
Echocardiography Training
Our fellows gain competence in TEE training with a minimum of two months of rotation in both the cardiology echo lab as well as intraoperative training. They receive training in TEE, TTE, epiaortic and 3D technologies. We insist that our fellows perform a minimum of 300 complete echocardiographic examinations, including 150 comprehensive intraoperative TEE examinations. Typically our fellows perform many more echocardiographic examinations over the course of a year. The goal will be to develop specialized expertise in the performance and interpretation of perioperative transesophageal echocardiography with the specific goal of attaining the American Board of Echocardiography's certification in perioperative TEE at the completion of the fellowship training. We typically offer fellows the opportunity to attend the week-long course offered by the Society of Cardiovascular Anesthesiologists in preparation for taking the ABE exam in TEE. The department has three echo technicians that are themselves skilled practitioners who support the technical aspects of the echo service, so the fellow can concentrate on learning the techniques of echocardiography.
Didactics
The didactic program includes a weekly lecture series, journal club, cardiac morbidity and mortality conference, as well as a monthly multidisciplinary valve conference for cardiac surgery, cardiology and cardiac anesthesia. The fellows are relieved of clinical duties by attending staff to attend all conferences.
Research Training
Each fellow will have an assigned mentor who is usually a member of the Cardiothoracic Anesthesiology faculty. The cardiac anesthesia fellow will have a defined project and will be expected to submit findings for presentation at a national meeting. Areas of active investigation in the department include neurodegeneration, neuroprotection, acute lung injury, perioperative coagulation changes, human factors and telemedicine. While most of our fellows spend a total of one year for training, it is possible to extend the fellowship for an additional year for more extensive research training.
Critical Care Medicine
Provides an in-depth experience in the care of seriously ill surgical, trauma, oncology and pediatric patients, frequently presenting with multisystem failure. All facets of care are encountered, including cardiopulmonary therapy, long-term mechanical ventilation, fluid and electrolyte abnormalities, renal and hepatic failure, the treatment of infections and nutritional failure. Rotations are provided in the following ICU's: general surgery, neurosurgery, cardiothoracic surgery, pediatric, trauma, medicine and NIH Clinical Center. Clinical and laboratory research are available in the department's basic sciences research laboratories and at the National Institutes of Health. The program is accredited by the ACGME.Applicants are invited to apply for a one- or two-year, ACGME-approved Anesthesiology Critical Care Fellowship at the University of Maryland School of Medicine, Department of Anesthesiology for the academic year commencing July 1, 2009. We are seeking aspiring academic anesthesiologists with strong interests in clinical care, education and research. Board certification/eligibility in Anesthesiology is required. Send curriculum vitae to Vadivelu Sivaraman, MD, Program Director, Anesthesiology Critical Care Fellowship, attention Maria Purcell, Fellowship Coordinator, Department of Anesthesiology, University of Maryland Medical System, 22 S. Greene Street, Baltimore, MD 21201 or e-mail: mpurcell@anes.umm.edu. The University of Maryland is an affirmative action/equal opportunity employer.
Neurosurgical Anesthesiology
Involves participation in the gamut of neurosurgical and neuroradiological procedures, participation in the somatosensory and motor-evoked potential program and participation in department's active clinical and laboratory investigation. The neurophysiologic monitoring program and the neurosurgical critical care services are provided exclusively by the department of anesthesiology.
Obstetric Anesthesiology
Under the direction of Andrew M. Malinow MD, Professor and Vice-Chair, the University of Maryland Section of Obstetric Anesthesiology, has two full-time and 10 part-time faculty providing full time 24-hour faculty coverage of senior residents and fellows. There are approximately 1700 deliveries a year (approximately 90% high risk), with 70% of women undergoing vaginal delivery receiving epidural analgesia. With a 28% abdominal delivery rate, this translates to about 80% of our patients receiving anesthesia.We have approximately 4,000 non-delivery admissions and are actively involved in the care of approximately 3-4 critically ill gravidae per month, often hospitalized with severe cardiac, neurologic, traumatic disease and requiring mechanical ventilation and invasive monitoring. The perinatal care team consists of Maternal-Fetal Medicine fellows and attendings including the Chair of the Department of Obstetrics, Gynecology and Reproductive Sciences, who is Board Certified in Critical Care Medicine and has a joint appointment in our Department.The Section has an active history of clinical research and can provide many opportunities within the Department of Anesthesiology, as well as in the Department of Obstetrics, Gynecology and Reproductive Sciences. These include basic and clinical science, an extensive fetal database and an obstetric emergency simulator program. Over the past 23 years, the Section of Obstetric Anesthesiology has trained approximately 30 fellows, many of whom have moved on to leadership roles in Obstetric Anesthesiology at other institutions. In the past, the Department has been able to secure instructor-level faculty appointments for Obstetric Anesthesiology fellows who have met certain qualifications.
Pain Management
Led by pain fellowship trained and certified anesthesiologists. The program includes acute, chronic and cancer pain management with modalities of acupuncture, biofeedback, psychotherapy, physical therapy, nerve blocks, transcutaneous nerve stimulation, patient-controlled analgesia, intracathecal and epidural opiates via implantable pumps. The program is accredited by the ACGME. Clinical research opportunities are available.
Research
Is structured for 6-24 months and provides an opportunity to learn basic concepts and to develop the skills necessary for an independent academic research career. The fellow will develop and carry out a project under the supervision of anesthesiology and basic science faculty. The School of Medicine and the Department of Anesthesiology are strongly oriented toward neuro-protection, molecular biology and telemedicine research. Collaboration with other departments is widespread and encouraged. Early planning of a research fellowship canenable the resident to begin research during the CA-3 year in the Clinical Scientist Track, allowing 18 months of uninterrupted research time.The University of Maryland Medical System is a not-for-profit healthcare organization, a tertiary care referral center, as well as a primary care center. The main facilities in the downtown Baltimore University Center Campus include a 747-bed private University Hospital, the Marlene and Stewart Greenebaum Cancer Center and the R. Adams Cowley Shock Trauma Center. Recent additions to the medical system include The Homer Gudelsky Building and the Harry and Jeanette Weinberg Building. The Homer Gudelsky Building is a nine-story clinical tower that houses the medical center's comprehensive programs in NeuroCare, Cardiac Care, Cancer Care, Transplantation and Surgical Critical Care. The Harry and Jeanette Weinberg building, opened in 2003, includes the Emergency Department, the Surgical Suites, the Ambulatory Surgery Care Unit, the Diagnostic Imaging Department, the Resident Call Rooms, the Patient Resource Center and the cafeteria.
Transplant Anesthesiology
Is complemented by one of the most successful transplantation programs in the country. The transplant experience includes cadaveric kidney, pancreas, liver, lung and heart transplantation, as well as a living, related-kidney program. Most patients have multisystem dysfunction requiring complex perioperative care. The transplant anesthesia fellow and faculty members provide preoperative consultation, recommend diagnostic evaluation and provide intraoperative and postoperative care. Participation in the weekly multidisciplinary transplant committee meeting is an integral part of training.
Trauma Anesthesiology
Provides active clinical experience in the comprehensive management of severely injured patients with multiple-system trauma. The emergency transport service is a rapid-response team (usually arriving within one hour after injury) to deliver patients requiring continuous care, from initial life support to surgical intervention to acute and long-term supportive care. Mobile telemedicine - technology developed by anesthesiology department researchers - provides real-time patient physiologic data for timely intervention during transport. Head and spinal cord injury from blunt and penetrating trauma offer challenging education and research opportunities.The division of trauma anesthesiology offers two-year, combined fellowship programs with a Masters in Public Health or a Masters in Business Administration. The MPH program is in partnership with the Johns Hopkins School of Hygiene and Public Health. The MBA program is in partnership with Loyola College of Maryland's Sellinger School of Business. Both masters programs are accredited. Clinical training is in trauma anesthesiology. Research includes collaboration with the National Study Center for Trauma, based at the University of Maryland, and faculty-led clinical research.
Department of Anesthesiology Fellowship Application Form
Fellowship Applications should be submitted to the respective Program Directors c/o Mrs. Maria Purcell, Anesthesiology Residency and Fellowship Coordinator, University of Maryland Medical Center, 22 South Greene Street, S11C, Baltimore, MD 21201. The applications for fellowship should include the following: Department of Anesthesiology Fellowship Application Form Curriculum Vitae Personal Statement 3 Letters of Recommendation, including recommendation from the current program director USMLE or NBOME scores, Steps 1, 2, and 3.
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