Combined Pediatrics Anesthesiology Residency

Stanford Combined Pediatrics Anesthesiology Residency

Overview

The combined pediatrics-anesthesiology residency seeks applicants with outstanding clinical abilities who show potential to be leaders in their field (e.g., pediatric anesthesiology, PICU, pediatric pain management, or other fields). The program trains physicians to be outstanding in two independent specialties. Graduates are board-eligible in both specialties.

Pediatrics Anesthesiology Program
Pediatric Anesthesia

The structure of our program consists of:

PGY-1	12 months of pediatrics internship
PGY-2	12 months of anesthesiology
PGY-3 through PGY-5	6 months per year devoted to each specialty, alternating in the three-month periods through senior level rotations

For the Combined Program in Pediatrics and Anesthesiology, the ERAS application material should be sent to the Combined Program in Pediatrics and Anesthesiology. Candidates will interview at both programs over 2 consecutive days. The NRMP code for the Stanford combined pediatrics-anesthesiology program is 1820726C0. If you are interested in also applying to the categorical programs in either Pediatrics or Anesthesia, please also apply through those ERAS programs.

Residents in this combined program are fully included members of both departments including advising, mentoring, research opportunities, and resident colleagues, etc.

Sample Schedule

_{Number of 4 Week Rotations Per Year}

HOSPITAL	PGY-1	PGY-2	PGY-3	PGY-4	PGY-5
Lucile Packard Children's Hospital	11	2*	5	8*	6
Stanford University Hospital	1	7	6	3	6
Veterans Affairs Palo Alto Health Care	0	2	1	1	1
Santa Clara Valley Medical Center	1	2	1	1	0
Valley Childrens Hospital (Fresno)	0	0	1	0	0

*Pediatric anesthesia, pediatric cardiac anesthesia, & adult obstetric anesthesia rotations are at Packard

PGY-1 Year

Participate in once a month online module: the Stanford Successful Transition to Anesthesia Residency Training (START) program along with the other anesthesia interns.
Along with all other local Stanford Anesthesia interns, combined residents also participate in the monthly simulation sessions (STARTplus) which are typically on the third Tuesday of each month from 1-5pm.

PGY-2 Year

PGY-3-5 Year

Didactics

Residents are encouraged to attend teaching conferences for both departments regardless of their current rotation when possible. They are expected to attend all teaching conferences offered by their current rotation.
Pediatrics conferences occur daily at 8 AM (morning report) and noon (lunch included) with pediatrics Grand Rounds occurring Friday at 8 AM.
Anesthesia conference occur daily (Libero) with weekly teaching conferences for each categorical anesthesia year and anesthesia Grand Rounds occurring select Mondays at 6:45 AM.

Exams

Residents in combined program are eligible to take written exams for both specialties. For anesthesiology, the BASIC Exam (Part 1 of the written boards) is taken at the start of PGY3 year. It focuses on the scientific basis of clinical anesthetic practice and concentrates on content areas such as pharmacology, physiology, anatomy, anesthesia equipment and monitoring.
The ADVANCED exam for anesthesiology (Part 2) is taken after end of residency and focuses on clinical aspects of anesthetic practice and emphasizes subspecialty-based practice and advanced clinical issues.
Residents take the each of the pediatrics and anesthesia in-training exams (ITE) 4-5 times over the 5-year program.

Vacation

Simulation

Stanford University has a state-of-the-art simulation center. Residents participate in simulation programs provided by both departments. Anesthesia Crisis Resource Management (once per year) and EVOLVE (twice per year) take anesthesia residents through various crisis scenarios in the operating room. Residents also participate in neonatal resuscitation and obstetric anesthesia simulation during the obstetric anesthesia rotation. Pediatric simulation experiences include procedure day during intern orientation and simulation experiences during academic half-days, PICU and NICU rotations, and PALS and NRP.

Other

Residents in combined program
- Are involved in residency recruitment (e.g., attend dinner night before interview day)
- Get-together regularly for educational and social events (e.g. review the residency program, for resident wellness, professional development)
- While on pediatrics rotations during years 3-5, residents get together for “anesthesia half-days” one afternoon a month for anesthesia educational, wellness, and social activities.

Required Rotations

Pediatrics

5 months in-patient rotations (may be general pediatrics, mixed or a single subspecialty)
5 months supervisory experience
3 months PICU, 2 months NICU, 1 month CVICU
7 months subspecialty rotations with a mix of inpatient and outpatient experience
3 months ER
1 month acute care illness
1 month normal newborn
1 month adolescent medicine
1 month behavioral/developmental pediatrics
40% of pediatric time is in ambulatory settings
Weekly pediatric continuity clinic during pediatrics rotations & once/month during anesthesia rotations. PGY-4 and PGY-5 years, residents may elect to participate in pediatric anesthesia pre-operative clinic to meet this requirement.

Anesthesiology

Two one-month rotations in each of obstetric anesthesiology, pediatric anesthesiology, neuroanesthesiology, and cardiothoracic anesthesiology
Two months in an adult ICU in addition to the requirements for training in neonatal and pediatric critical care medicine
Three months of pain medicine – one month in acute perioperative pain, one month in chronic pain, and one month of regional anesthesia/peripheral nerve blocks
Two weeks in a preoperative evaluation clinic
Two weeks providing anesthesia for diagnostic or therapeutic procedures outside the surgical suites
No single subspecialty, excluding critical care medicine, exceeds six months total
Minimum clinical experiences as defined by the anesthesiology program requirements
Rotations are not “counted” twice. Thus, rotations are not considered by the program to meet the requirements for training in pediatrics or anesthesiology simultaneously.

Faculty Resources

Dr. Tammy Wang Email Dr. Wang
Anesthesia Associate Program Director

Dr. Wang is a pediatrician and an anesthesiologist and is board certified in both specialties. She was Chief Resident and then a Pediatric Hospitalist at Children’s Hospital & Research Center Oakland for a number of years before completing residency in Anesthesiology and fellowship in Pediatric Anesthesiology at Stanford. She works at Lucile Packard Children’s Hospital and specializes in perioperative medicine as a member of the Anesthesia Resource and Pre-Anesthesia Resource teams. She directs the pediatric anesthesia rotation for the residency. Her interests also include quality improvement and resident advocacy.

Dr. Caroline Buckway Email Dr. Buckway
Pediatrics Associate Program Director
cbuckway@stanford.edu

Additional Contact Information

Carrie Rassbach, M.D., M.A.Ed, Program Director, Pediatrics Residency (crassbac@stanford.edu)
Alex Macario MD, MBA, Program Director, Anesthesiology Residency (amaca@stanford.edu)

Pediatric - Anesthesia Combined Residents

Alumni

ALUMNI	After Residency
Mary Lyn Stein	Associate Program Director and Chair Scholarly Activities Committee- ACGME Pediatric Anesthesiology Fellowship - Boston Children's Hospital and Harvard Medical School Assistant Associate Program Director - ACGME Combined Residency in Pediatrics and Anesthesiology - Boston Children's Hospital and Brigham and Women's Hospital Associate in Perioperative Anesthesia, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital Instructor of Anaesthesia, Harvard Medical School
Gavin Hartman	Private Practice, Reno, NV
Adam Was	Clinical Assistant Professor, Department of Anesthesiology, University of Michigan Fellowship: Pediatric Anesthesiology, University of Michigan (2018-2019)
Erin Conner	Assistant Professor, Dept. of Anesthesia and Perioperative Medicine, Oregon Health Sciences University with dual appointment in Department of Pediatrics Fellowship: Pediatric Anesthesiology, OHSU (2018-2019)
Jewel E. Sheehan	Clinical Instructor, Dept. of Anesthesiology, Perioperative and Pain Medicine, Stanford University (2019-2020) Fellowship: Pediatric Anesthesiology, Stanford University (2020-2021)
Andrew Giustini	Fellowship: Pediatric Anesthesiology, Stanford University (2019-2020) Advanced Clinical Fellowship: Pediatric Cardiac Anesthesiology, Stanford University (2020-2021)
Aidan Tait	Fellowship: Pediatric Anesthesiology, Stanford University (2020-2021)
Michael O'Hara	Private Practice Anesthesiology, Santa Rosa, CA

Current Residents

PGY-5

Allison Nye
Oregon Health Sciences School of Medicine
_{anye@stanford.edu}

PGY-4

Elena Brandford
Stanford University
_{ecb@stanford.edu}

PGY-4

Kara Furman
Yale University
_{kfurman@stanford.edu}

PGY-3

Sean Miller
Un of North Carolina Chapel Hill
_{seanmill@stanford.edu}

PGY-3

Clarice Nguyen
University of California, San Francisco
_{cdnguyen@stanford.edu}

PGY-2

Tyler Greenway
Yale University
_{tylerlg@stanford.edu}

PGY-2

Laura Tetri
University of Wisconsin
_{tetri@stanford.edu}

PGY-1

Sravanthi Puranam
Warren Alpert of Brown University
_{spuranam@stanford.edu}

PGY-1

Jeffrey Yu
Indiana University
_{jeffsyu@stanford.edu}

Sample Pediatrics Schedule

PGYI

PGY1 (Internship in Pediatrics)	Months
Blue (LPCH General Pediatrics Wards)	1
Valley (Valley General Pediatrics Wards)	1
Red (LPCH Renal/Rheumatology -- 2 wks inpt/2 wks outpt)	1
Yellow (LPCH Pulmonology -- 2 wks inpt/2 wks outpt)	1
PICU	1
LPCH NICU	1
PICN	0.5
Well Baby Nursery	0.5
Anesthesia	0.5
ED and QI	1
NF-Green Red (LPCH GI/Renal/Rheum)	0.5
DBP	1
Adolescent	1
Community	1
Vacation	1
Total	13 months

PGY3

PGY3	MONTHS
Purple Team (Cardiology)	1
Oncology	1
PICU	1
Primary Care	0.5
ED and QI	1
CFE	1
Elective (J wkends)	0.5
Vacation	0.5
Total	6.5 months

PGY4

PGY4	MONTHS
CVICU	1
LPCH NICU	1
Green (LPCH GI Wards)	0.5
NF Sup	0.5
ACC	0.5
Valley Urgent Care	0.5
CFE	1
Elective (J wkends)	1
Vacation	0.5
Total	6.5 months

PGY5

PGY5	MONTHS
Valley Sr	1
Red Sr (LPCH Renal/Rheum Wards)	1
NF Sup	0.5
ED and QI	1
PICU Fellow	1
Elective	1.5
Vacation	0.5
Total	6.5 months

Note: Subspecialty Continuity Clinic (i.e anesthesia preop clinic) is an Option in PGY-4 and PGY-5 Year (instead of Gen Peds Continuity Clinic).

Sample Anesthesiology Schedule, PGY-2 (CA-1) Year

PGY-2 (CA - 1 YEAR)

PGY2 (CA - 1 YEAR)	BLOCKS
Stanford multispeciality division (general OR)	5.5
Preoperative clinic	0.5
Acute pain	1
Palo Alto Veterans Administration OR rotatiom	2
Neuro 1 (intracranial)	1
Medical ICU (adult)	1
Santa Clara Valley Medical Center OR rotation	2
Obstetric Anesthesiology	1

ACGME ANESTHESIOLOGY GRADUATION REQUIREMENTS

REQUIREMENTS	MONTHS
Neuroanesthesiology (intracranial,spine)	2
Cardiothoracic anesthesiology	2
Pain management (Regional, chronic pain, acute pain)	3
Adult ICU (in addition to pediatric/neonatal ICU experiences)	2
Pediatric anesthesiology	2
Obstetric anesthesiology	2
Preoperative clinic	0.5
Out of operating room	0.5
PACU and Thoracic anesthesia (not stated requirements for combined program)	1.5

Financial Information

Department-specific benefits apply to the time which is spent in that department. As an example, below is a list of monies/stipends anesthesia residents receive:

Pre-tax stipends

One-time Stanford moving allowance from hospital of $3,000 (as PGY-1 or CA-1)
Housing stipend from anesthesia department of $3600 per year PGY-2 through PGY-4
Housing Stipend (pretax from hospital) $500/month=$6000/yr
Educational Stipend from hospital of $1000/ per year
Hospital GME bonus $2,000/yr (intended for parking, phone, etc)
Education stipend from anesthesia department of $775 per year PGY-2 through PGY-4

Other Funds

California medical license renewal: $895 paid by GME if application done on time
Presentation of research at academic meeting - expenses paid by anesthesia dept
ASA membership dues of $75 per year
Call meal money (dining dollars) of $10 for each 12-hour call shift worked
DEA registration fee of $731

FAQs

Does the combined residency force the resident into 1 or 2 specific subspecialty paths?

This issue was addressed in a recently published article, and an excerpt is below:

“I believe combined training leaves many doors open in each of the separate fields within pediatrics and anesthesiology. The ability to explore new, divergent career options was the ultimate reason for my application to combined programs… Combined training holds the promise of adding flexibility and divergent daily work for physicians who value those attributes. Fields such as pediatric sedation and pain services or novel fields yet to fully emerge could be an ideal match for dual-trained physicians. Additionally, there is the possibility of mixing tracts in unique ways such as pediatric critical care and pain medicine or pediatric anesthesiology and hospitalist care. It is easy to imagine a dual-trained physician working one-on-one with a patient in the preoperative clinic one day, the operating room the next, and rounding with a multidisciplinary team in the recovery room, ward, or intensive care unit in the same patient’s hospital stay…there will be a growing subset of applicants excited by the opportunity to use different parts of their “minds and hands” more often and interact with a broad group of colleagues.”

_{Sanford EL. Pediatrics-Anesthesia Combined Residency Training: An Applicant's Perspective. Anesth Analg. 2013;116(6):1386-8.}

What is the NRMP Match data nationally?

2011: 4 approved programs offered 3 positions, which were filled by 3 of the 9 applicants.
2012: The number of positions expanded to 7 (all filled from the 16 applicants) at the same 4 approved institutions.
2013: 7 approved programs nationally
2014: Stanford (2), Children’s Hospital Boston (2), UC Irvine (1), Hopkins (2), North Carolina (1),
Pittsburgh (1), Medical College of Wisconsin (1)
2017: 7 programs, 9 positions offered, 1 unfilled program, 24 US senior applicants
2018: 6 combined programs, 7 positions offered, 0 unfilled program, 15 US senior applicants, 21 total applicants
2019: 5 combined programs, 7 positions offered, 0 unfilled programs
2020: 5 combined programs, 7 positions offered, 0 unfilled programs

For application process itself, is there a preferred number of letters of recommendation and distribution between anesthesiology letters, pediatrics letters, or letters from other specialties? What is the process for coordinating the application process between the two departments?

The best bet is to apply as if you were applying to each residency separately with separate letters and essay (you can mention interest in combined program of course). This is because the faculty in both departments will want the applicant to fully fit in their own residency. Once both residencies invite you for an interview we work with the applicants to facilitate dates.

What feedback did the current interns provide about the internship?

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Stanford Combined Pediatrics Anesthesiology Residency

Menu

Overview

Sample Schedule

Required Rotations

Pediatrics

Anesthesiology

Faculty Resources

Additional Contact Information

Pediatric - Anesthesia Combined Residents

PGY-5

PGY-4

PGY-4

PGY-3

PGY-3

PGY-2

PGY-2

PGY-1

PGY-1

Sample Pediatrics Schedule

Sample Anesthesiology Schedule, PGY-2 (CA-1) Year

Financial Information

FAQs

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