For more than 40 years, Duke Anesthesiology has fostered the development of world-class physicians committed not only to clinical excellence and research, but also to a zealous, lifelong pursuit of learning. Our highly successful training programs are fueled by the passion and dedication of our department faculty.
Over the past 40 years, we have witnessed many developments in anesthesiology residency education. The duration of required training increased from two years to three years in 1986. Most current residents now pursue fellowship training as well. The resident application and selection process has become more automated with online application processes and the uniform use of the National Resident Matching Program, both for residencies and increasingly for fellowships. Currently, 800 to 1,000 applications are received annually, and only about 120 of these applicants are selected for interviews for 14 residency positions. We are fortunate to be able to recruit top-notch residents from all over the country and internationally.
Despite the tremendous growth in clinical operations (there are now approximately 70 anesthetizing locations), we have intentionally kept the residency program small so that each resident can receive personalized attention, and excellent case volume and complexity. This allows residents and fellows to handle their own cases, rather than share them, providing each trainee with the greatest amount of hands-on experience possible. Trainees benefit from the subspecialized clinical structure of the department and the guidance of program leaders and faculty mentors in each subspecialty. CA-3 residents are able to tailor their final year of training toward their career ambitions, and some residents engage in research projects. Consequently, our residents and fellows are very confident in their ability to work independently in any setting once they graduate from the program.
In 1998, the residency added a department-sponsored internship program. Interns rotate on a variety of services, including medicine, surgery, pediatrics, critical care, and emergency medicine, and can take advantage of the expertise of other Duke departments. In addition, interns are usually able to rotate on three anesthesia electives – Acute Pain Service, Hyperbaric & Undersea Medicine, and a general anesthesia rotation.
In 2009, we received the American Board of Anesthesiology (ABA) and Accreditation Council for Graduate Medical Education (ACGME) approval for an innovative curriculum program known as ACES (Academic Career Enrichment Scholars). This program is intended to increase the number of graduates pursuing academic careers and help them gain status as independently funded researchers. This highly selective program matches up to two residents per year. An internship, core residency program, subspecialty fellowship training, and over a year of protected research time are incorporated into five years of training. Dedicated mentorship and a lecture series are integral to the program’s success. We are among a handful of such programs in the country, and our first class graduated in 2013.
Duke Anesthesiology boasts some of the finest faculty in the country, including worldwide-recognized leaders in anesthesiology practice and research. Our faculty are not only dedicated to recruiting the best and the brightest minds in medicine, they are extremely engaged with resident education and career development.
The Department of Anesthesiology was thrilled when Dr. Annemarie Thompson re-joined the Duke family in May of 2014 as Residency Program Director and Professor of Anesthesiology. Dr. Thompson moved to Duke from Vanderbilt University where she was an Associate Professor of Anesthesiology and Medicine and served as Director of the Adult Cardiothoracic Anesthesiology Fellowship.
Dr. Thompson completed residency training in Internal Medicine and Anesthesiology at the University of California San Francisco. She completed a fellowship in Adult and Pediatric Cardiothoracic Anesthesiology at Vanderbilt University in 2002. In addition to Dr. Thompson’s active clinical practice, she writes about evidence-based decision support in clinical practice and is an oral examiner for the American Board of Anesthesiology.
Residents at Duke have a unique opportunity to maintain a close relationship with the Chair of the Anesthesiology Department, Joseph P. Mathew, MD, MHSc, MBA, Jerry Reves, MD, Professor of Cardiac Anesthesiology. Dr. Mathew takes a personal interest in every trainee and plays an instrumental role in their career planning. He is dedicated to actively taking part in recruitment season and personally interviews almost all applicants to the residency program.
Dr. Mathew’s contributions to clinical perioperative medicine have long been recognized in the fields of cardiology, surgery and anesthesiology. He is internationally respected in the area of transesophageal echocardiography (TEE) and is highly regarded for his groundbreaking research which focuses on improving perioperative patient outcomes.
Mark Stafford-Smith, MD, CM, FRCPC, FASE, Anesthesiology’s Vice Chair of Education, is committed to enhancing the experience of anesthesia residents throughout the spectrum of their career trajectories from private practitioner to bench researcher. As the department’s Fellowship Education Director, he has personally mentored more than 170 fellows and served in numerous national leadership positions, including his seat on the Board of Directors of the Society of Cardiovascular Anesthesiologists which promotes excellence in clinical care, education and research in the subspecialty.
Two Assistant Program Directors play a vital role in the success of a 54-trainee residency program. Dr. Brian Colin is the Assistant Professor of Anesthesiology in the General, Vascular, High Risk Transplant and Critical Care Division. And, Dr. Ankeet Udani, Assistant Professor of Anesthesiology in the General, Vascular, High Risk Transplant and Critical Care Division, is a champion for patient safety. His passion is in the simulation lab where he creates and executes didactics for faculty, fellows, residents, interns and medical students.
The Duke Anesthesiology Residency Program has a long history of strong resident leadership. The chief resident role fosters a positive learning environment, boosts resident morale, and serves as a liaison between residents and faculty. In 2008, the academic chief resident position was created in conjunction with the Academic Career Enrichment Scholars (ACES) Program to help Dr. Thompson and Dr. David S. Warner, Director of the ACES Program, schedule conferences and events. And, senior residents who are recognized as excellent teachers and mentors are named teaching scholars who aim to enhance the educational experience of medical students.
At all levels, leadership, faculty, staff and the residents themselves raise the bar to bring the highest level of dedication and commitment to the Duke University Department of Anesthesiology Residency Program.
Duke Anesthesiology’s fellowship programs have also experienced similar growth, creating the need for a director of fellowship education, a position currently held by Mark Stafford Smith, MD, CM, FRCPC. The department has nine fellowship programs: Adult Cardiothoracic Anesthesiology, also directed by Dr. Stafford Smith; Critical Care Medicine, directed by Dr. Young; Pain Medicine, directed by David Lindsay, MD; Pediatric Anesthesia directed by John Eck, MD; Neurosurgical Anesthesiology and Neurocritical Care, directed by Michael James, MD; Obstetric Anesthesia, directed by Cathleen Peterson-Layne, MD; The Global Health Residency and Fellowship Program both directed by Adeyemi Olufolabi, MB BS, FRCA; Regional & Ambulatory Anesthesia, directed by Karen C. Nielsen, MD; and Undersea & Hyperbaric Medicine directed by John Freiberger, MD, MPH.
These programs have grown enormously in size and academic output since the department’s first fellowship—Cardiothoracic Anesthesiology—was inaugurated in 1984. As our most mature program, Cardiothoracic Anesthesiology has experienced great success, gaining international recognition for its proficiency in teaching transesophageal echocardiography (TEE). Training in TEE has recently been expanded to the Critical Care Medicine fellowship program as well. Furthermore, Duke Anesthesiology, which is known for pioneering the use of ultrasound in regional anesthesia and peripheral nerve catheters for ambulatory regional analgesia, has a tremendously successful Regional & Ambulatory Anesthesia fellowship program that continues to gain in popularity each year.
The department offers a variety of opportunities for practicing physicians to gain continuing medical education (CME) credit through internal lectures and conferences as well as external educational programs that highlight the department’s expertise in many subspecialties. Two of the most sought after programs are the preceptorships in regional anesthesia and transesophageal echocardiography. Internally, the marquee event is the weekly Anesthesia Grand Rounds Series, which is complemented by a range of subspecialty conferences hosted by every division in the department. Finally, we have been approved as a simulation site for the American Board of Anesthesiology’s mandatory Maintenance of Certification in Anesthesiology (MOCA) process, which attracts a number of anesthesiologists to Duke.
The use of technology in education has historically been one of our greatest strengths. Faculty member Dr. Taekman serves as assistant dean of Educational Technology at Duke, and director of the Human Simulation and Patient Safety Center (HSPSC). This educational center and applied safety laboratory was created in 2001 as a result of the joint effort of three groups at Duke: the School of Nursing, which provided the center’s first high fidelity simulator; the School of Medicine, which furnished the funds necessary to renovate the space; and the Department of Anesthesiology, which provided the faculty, research and support staff, and curriculum development for the unit. In addition to training medical school students, residents, fellows, and practicing physicians, the HSPSC focuses on human factors engineering and qualitative research. Through leadership of the HSPSC, Dr. Taekman and his team dramatically increased both interest and investment in educational technology at Duke. We will continue to develop simulation and the use of virtual environments in the new medical education building, currently under construction.
The need to effectively manage the department’s array of conventional and innovative educational offerings has resulted in the development of the Duke Anesthesia Center for Innovative Education (see table on page 54), led by Solomon “Sol” Aronson, MD, MBA. This umbrella organization will facilitate the development and commercialization of novel educational technologies, and integration with current traditional techniques.
In the near future, the department plans to offer educational programs via web-based and handheld device-based platforms in a variety of formats, including medical games, interactive simulation, interactive lectures, and videos. Currently, the department offers virtual environments through the use of 3DiTeams, a first person video game that creates an interactive environment in which trainees care for patients and hone their communication skills in a clinical setting.
Dr. Taekman has received a grant through the Doris Duke Foundation for a five-year project known as ILE@D (Immersive Learning Environments at Duke), which will develop enhanced virtual environments for healthcare education. A strong emphasis on the use of virtual environments combined with simulation will not only provide a fun and interactive learning environment, but will also enable trainees and practicing physicians to gain important skills needed to respond to real life crises.
Duke Anesthesiology fosters a unique and innovative educational environment that encourages physicians to devote their careers to the quest of knowledge and actively participate in shaping the next generation of learners. This is evidenced by the success of our alumni, many of whom have gone on to become department chairs, chiefs, and leaders in academic anesthesiology organizations, both nationally and internationally. We celebrate their success just as we take pride in the accomplishments of our current faculty and trainees. Together, we are ensuring the future success of both our department and the specialty of anesthesiology.