Anesthesiology, Perioperative and Pain Medicine

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Q&A with Stanford Anesthesia's Residency Director

January 2009


Dr. Macario, I was very impressed by Stanford's program. The residents all seem to be very happy, but they did mention didactics as an area that is being worked on. Is there anything being done to address this situation? Thanks for the insight!

Another good and timely question! This past year the education committee composed of residents and faculty has looked at revamping the didactic program, in particular the lecture series given in the afternoon. Review of the evaluations by the housestaff revealed that the talks themselves received high marks, but the committee felt it important to add an active learning session, sometimes referred to as experiential learning. This might include PBLDs, or case conference, or review of board type questions. This is in addition to the monthly journal club.

As a result, as of July 2009, on Mondays the CA1s will have an active learning session from 4-440pm, followed by the faculty presentation from 450pm-530pm. Similarly, on Tuesdays for the CA2s and on Wednesdays for CA3s the active learning session (4-440pm) will be followed by the faculty presentation (450pm-530pm.

A summary of the daily lecture offerings:
Download file or View in New Window

As you can see from the weekly schedule, many of the 1500 plus lectures/year are while the resident is on a subspecialty rotation, and that didactic content supplements the core lecture series in the afternoon and the Grand Rounds Monday morning. Since many of the residents that come here for training want to have a career in academics and teaching, one of our goals is to have even more resident to resident teaching so for example we ask the Chief Residents to run PBLDs for the CA1 which are quite well received!

thank you,


Management Fellowship alumni

Applicant question
Partly to help inform my long-term plans, I was wondering if you had on file a descriptive list of what former residents who were involved with the perioperative management fellowship ended up doing both for their main project and their career. (For example, whether they obtained faculty positions, or if they ended up working for industry, etc.)

Stanford offers fellowships in a wide variety of areas, including the
Management of Perioperative Services. This 1-2 yr program arose in the mid 1990's when there was increasing emphasis on the anesthesiologist as medical director of the surgical suite. Now, Fellows have an expanded breath of interests including management, entrepreneurship, and leadership. Alumni have gone on to do a variety of things including academics, start-ups, and community practice.
Alumni list:
Download file

thank you,


Advice for first years

Applicant Question
What advice do you have for when we start residency (hopefully) at Stanford?

So sorry not to have posted a blog entry in a couple of weeks. I was energized to write an entry by an applicant during our interview today who was nice enough to say she was looking forward to the next posting.

The question above is a great question, and has a lot of possible dimensions, but I chose to focus on the perspective of our housestaff.

I surveyed some of our senior anesthesia residents and asked them, "What advice do you have for new CA1s?"

Here are their their answers:

  1. "The secret to being a good resident is common sense. Show up on time, work hard, do not complain or whine, unless absolutely necessary. Listen to attending because they have much more experience."
  2. "My advice for first year residents would be: give yourself a lot of space. Realize that you won't know how to do things, or know things, and don't beat yourself up about not being fast enough with IVs for example."
  3. "Everyone will do anesthesia differently so at least for first year put your head down and go with the flow. Take everyone's nuances about anesthesia as an educational opportunity."
  4. "Don't beat yourself if you don't nail something. Talk to other CA1s because it is likely others are going through what you are experiencing."
  5. "First 3-4 months of CA1 year the learning curve is steep and you will come home everyday and be tired, completely exhausted which is normal and you will not be able to read (this was biggest surprise for me). But the revamped orientation program really helps."
  6. Do not be afraid to ask questions since people know you don't know anything, so expect to ask questions."
  7. "Use senior residents as resource to ask questions (how to get stuff done)."
  8. "Be patient with yourself and it all comes eventually. Know that people do care about you in the department."
  9. "It is easy to believe you are staying in OR later (or taking more call) than your classmates but you are not."
  10. "Keep your eves and ears open, more than you think you need. Work as hard as you can but don't forget to have fun."
  11. "Do not be afraid to ask lots of questions, know your limits."
  12. "Three years goes by fast so take advantage of all the great cases and teachers here."

Here is my advice to you:

  • When at the hospital dedicate yourself to the care of the patient.
  • Have a good support structure/family/friends at home.
  • Get to know your classmates.
  • Introduce yourself to everyone in the operating room.
  • Have fun! You are beginning a journey toward a long and rewarding career in a well-respected profession. Your training at Stanford will enable you to care for the sickest patients, safely guiding them through some of their most stressful life experiences.

thank you,


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