Anesthesiology, Perioperative and Pain Medicine

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Q&A with Stanford Anesthesia's Residency Director

August 2011

Is step 2 score required to complete the residency application?

On Wed, Aug 31, 2011 at 8:47 AM the following question arrived:
There is a growing trend of programs in CA and across the country requiring applicants to have taken the USMLE Step 2 and have their scores reported before they will be considered for ranking. Does Stanford currently (for the 2012 PGY1 or 2013 Advanced Anesthesiology residency) require Step 2 scores prior to ranking an applicant?

Answer
Thanks for your question and I am pleased you are aware of the new 2012 pgy1 categorical positions now available at Stanford Anesthesia. We do not require the step 2 score prior to submitting our rank list. When we review applications in october, we do find that applicants that scored poorly on step 1 are more likely to have taken step 2, probably to get their score up and strengthen their overall application. On the other hand, we often see applicants that have high step 1 scores wait on taking step 2 so that result is not available to us during the interview season.

We know there is a lot more to being a good doctor than high test scores so during the review of applications we emphasize the applicant's overall medical school performance as well as recommendation letters and the interview.

BTW there isnít a requirement for the timing of step 3 with the exception of needing to pass it prior to starting the PGY2 anesthesia residency year. The earlier you take it will mean the earlier you can get the paperwork going for your CA medical license. We generally recommend you start the licensing process around Oct. of your internship.


Thank you,
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Combined residency training in anesthesia and critical care

Question: I am interested in a career in ICU and anesthesia. I know there are a couple of residencies that have a combined anesthesia/critical care medicine track. Does Stanford offer one?

Answer: Great question. Thank you. Critical care medicine has a long (36 years) and strong (157 fellows trained) tradition at Stanford. And, I have been impressed by how many medical students consider anesthesiology for a career because of their interest in critical care.

Stanford Anesthesia has applied this year for approval from ACGME for a combined anesthesia/critical care medicine training track within the residency. We expect to hear back from the ACGME in November 2011. Should the combined program be approved it will be an option for applicants graduating medical school in 2012. We have requested to make available two slots for CA1 through CA4 training (i.e. it does not include the PGY1 year) so that after 5 years the trainee would be eligible for board certification in both specialties.

The intent of a combined track in anesthesiology and critical care is to facilitate the training of the dual anesthesiologist-intensivist. During the CA1 and CA2 years, there would be increased critical care exposure (2 months/year instead of 1), so that by the CA3 year, additional ICU months are performed in a fellow's role with more supervision of junior residents.

The proposed Stanford combined tract would also involve moving some of the CA3 rotations to the CA4 year. This allows residents in the combined track to do OR anesthesia rotations during their last year of training.

The proposed program also offers space in the CA3 year for electives (up to six months). These elective months can be spent doing either critical care relevant rotations (such as infectious disease, transthoracic and transesophageal echo, nephrology, pulmonary medicine) or as research months so that the trainee can design and finish research that facilitates their move toward grant awards and a successful launch to an academic career.

The way it was proposed to ACGME the combined training track would be a separate entity from the standard anesthesia residency with its own match.

This program is expected to attract someone who knows early in medical school that they want to be an anesthesiologist-intensivist. We believe trainees will benefit from the overlapping of the residency and fellowship training that is not allowed by the traditional sequential training (3 yr Anesthesia Residency followed by 1 yr critical care fellowship). Patients in the OR and in the ICU will benefit from physicians cross-trained in both areas.

As soon as there is more to update you with I will,
Thank you,
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