Anesthesiology is a major specialty in the practice of medicine. The country’s need for well-trained anesthesiologists has increased greatly in the past few years, and the opportunities in community hospitals as well as in academia are legion. The scope of the specialty has dramatically expanded over the years. Anesthesia is one of the great medical discoveries of humanity, allowing the advancement of surgery. The anesthesiologist, who initially provided pain relief and amnesia to the patient, has become the clinical pharmacologist and physiologist in the operating room. The scope of the anesthesiologist has broadened to include obstetrical analgesia, acute and chronic pain therapy, intensive care, office-based anesthesia and sedation and monitoring of patients undergoing GI, radiologic and ECT procedures.
The mission of the Residency Program at Stony Brook University is to educate and facilitate the achievement of excellence in anesthesia care and thereby create physicians, who in the course of their careers will play a role in improving the quality of health care in our nation. The Department of Anesthesiology provides a faculty of national and international renown who excel in Patient Care, Teaching and Research and from whom the residents receive their educational experience. As a demonstration of our commitment to the residency program, the department has created several new and exciting initiatives. These include an educational intranet, a unique didactic program, a dedicated faculty mentor for each resident, a generous educational allowance and a compensation package that is among the best in the country. The end product of this anesthesia residency education is a superbly trained consultant in anesthesiology, able to provide the highest quality of care to patients even when they present the most challenging clinical conditions.
Residency Program Inquiries: Joan.Claeson@stonybrookmedicine.edu
The Residency Program At-a-Glance. Click a topic to learn more.
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Clinical Base Year
The Stony Brook Anesthesiology Residency Program is a four-year program. During the clinical year (PGY- 1), our interns rotate through the Emergency Room, Surgery, Medicine, ICU, Pain and Anesthesiology Departments.
The department is organized into clinical division that emphasize the many subspecialties of anesthesiology. Many members of each division have complete fellowship training in that subspecialty. Residents benefit from having experts as teachers as they do rotations through the clinical divisions.
Learn about and meet the members of each division here.
Clinical Skills Center and Simulation
Simulation is now a major component of our residents’ educational experience. There are numerous values to simulation. These include standardization of education, allowing residents to have their medical decisions proceed to a logical conclusion without attending intervention, identification of weaknesses in knowledge base as well as improving technical ability and learning through a kinesthetic teaching process.
The Clinical Skills Center at Stony Brook Medicine opened in 2006. It is a 4,000 square foot state-of-the-art training center that can be used as a resource for specialized training of physicians and other healthcare professionals. The Department of Anesthesiology has played a critical role in this Center from its inception. An operating room, complete with a high fidelity mannequin and a realistic setting, makes this an exciting educational experience. This teaching effort is spearheaded by Dr. Christopher Gallagher, author of Simulation in Anesthesia and a member of the ASA’s National Committee on Simulation in Education. Dr. Gallagher has trained a number of our faculty to teach using the simulator. These are generally group sessions. For example, all of the CA-1’s will work together on various scenarios, observing each other as well so that they can learn from each other. The majority of the Wednesday morning teaching sessions include a simulator component.
The simulator is used to create rare and dangerous situations that the resident may never see during the course of a residency. Examples include airway fires, malignant hyperthermia, anaphylaxis and the incapacitated surgeon. In addition, more routine types of cases and complications can be taught in the simulator, so the resident can encounter such scenarios as “cannot intubate, cannot ventilate” or serious arrhythmias in a safe environment. They can practice clinical skills such as intubate and placing lines on mannequins instead of “real patients”.
Medical students who undertake clinical rotations within the Department of Anesthesiology are also provided with an opportunity to participate in anesthesia specific simulator scenarios. Furthermore, all Stony Brook medical students have multiple opportunities to learn in the Clinical Skills Center. One of our own faculty, Dr. Peggy Seidman, has developed OSCE’s for teaching basic technical skills to the students. Our faculty and residents volunteer their time to work with Dr. Seidman to administer these OSCE’s to the students. Lastly, the Stony Brook University Simulation Center is an ABA (American Board of Anesthesiology) approved Simulation Center. It was the very first simulation Center to offer MOCA (Maintenance of Certification) Examinations in the nation.
In summary, our department is at the forefront of simulation education. In a recent survey distributed to our residents, they unanimously voted their simulation experience as the best point of their education. We are looking towards the future and are developing several interesting projects in which simulation will play a critical role.
From the outset, the department has maintained a fully accredited residency training program. We are a four-year program. The Clinical Base Year (CBY) consists of rotations in the Departments of Medicine and Surgery, including two ICU months; one month in the Emergency Room and one month in Pain Management. Whenever possible, the CBY residents will have the opportunity fo interact with faculty and residents in the Department of Anesthesiology.
Three groups of residents undergo training in each of the three clinical anesthesia years of training (CA-1, 2 and 3 years equivalent to PGY 2, 3 and 4). There is large variety in a very substantial caseload. All specialties and subspecialties are represented. All anesthetics are delivered by residents under the direction of an attending anesthesiologist. This supervision is given 24 hours per day, either on a one-to-one basis or, at most, in a ratio of one attending for two residents. It is an expression of our standard: optimal care, for all patients, at all hours. This applies not only in the operating rooms, but also in the obstetrical delivery suite, the intensive care units and the pain clinic.
Residents and attendings make separate pre-anesthetic visits. The resident proposes a comprehensive plan for preoperative preparation, intra-operative monitoring, anesthetic management and postoperative care to the attending anesthesiologist. After conferring together, the resident performs the anesthetic under the direct supervision of the attending.
In addition to their ICU experience, our residents administer well over 500 anesthetics in each of their three years of training. Many patients receive the benefit of regional anesthesia and nerve blocks. More importantly, the patients present all the taxing problems and complications one is likely to encounter in an operating room, obstetrical delivery suite or intensive care unit.
This clinical instruction may be strenuous and demanding; it is alleviated by the strong personal relationship between attending and resident and by certain amenities, such as lunches, coffee breaks, and relief from clinical assignment following night call. In addition, residents are on call every fourth night. In accord with New York State Law, residents do not work more than 80 hours per week maximum.
Clinical Training Sites
Wednesday 7 AM Conferences
Wednesday 8-11 AM Conferences (1 per month for each CA cohort)
Written and Oral Board Reviews
Wednesday morning 3 hr conferences
There are over 60 faculty members in the Department of Anesthesiology. Many of them are involved in all three aspects of the department: clinical care, teaching and research. Some of them, including four Ph.D scientists, focus on one particular aspect. Faculty members have joint appointments in other departments and training programs in the Medical School including Physiology & Biophysics, Pharmacological Sciences, Health Sciences, Biochemistry, Neurological Surgery, Pediatrics, Dental Medicine and Urology. Some also have appointments at Brookhaven National Laboratories. Many are active in the field of anesthesiology at the state, national and international levels.
Journal Club is held monthly July through May. Meetings take place during dinner at nearby restaurants in a relaxed atmosphere. All faculty, residents, CRNAs and medical students rotating through the department are invited to attend.
Journal club is a didactic tool to teach life-long learning skills. It is a way to keep current in the anesthesiology literature and to learn to read the literature with a critical eye.
There is a three year syllabus. In the first year, we explore different types of articles and how to evaluate them. In the second year we read some of Anesthesia's Golden Oldies for perspective, and finally in the third year, we turn to current literature.
Journal Club is moderated by Ursula N. Landman, D.O. and Rany Makaryus, M.D. organizes the sessions. All residents and faculty members have an opportunity to present at least once during the three year cycle.
We provide exposure to Office based surgery. CA-3 residents rotate with an anesthesiologist where they are exposed to the isolated lonely environment of an office setting. This office is fully certified and offers the highest possible safety standards. This should prepare the residents to set the highest standards for themselves when they eventually are exposed to this growing arena. Office-based Anesthesia is a component of the Ambulatory Anesthesia rotation.
The Department has a strong commitment to its academic mission. One of the cornerstones of our departmental mission is to be a leader in creating new knowledge through basic, translational, clinical and educational research that will enhance patient care. To promote these efforts, the department faculty includes productive, externally-funded Ph.D. scientists and scientist clinicians. In addition, the department supports graduate students, post-doctoral fellows, research nurses and technicians.
Resident Presentations at National Meetings
We encourage our Residents to present research posters and Medically Challenging Cases at national meetings such as the ASA and PGA. Dr. Rishimani Adsumelli is the Director for Resident Research. Residents whose abstracts are accepted for presentation are fully funded to attend the meeting.
Presentations at ASA October 2014
Pak A, Asaad B, Azim S. Anesthetic Management in Primary Autonomic Failure
Andraous WF, Schabel J, Abola R. Unusual Cause of Third Trimester Hemorrhage After Fall
Brezina DE, Vuong W. Pneumonia With Sepsis Masquerades as Surgical Abdomen in 12 Week Parturient
Nunziata RL, Beg T. Coiling or Cesarean Section? Anesthetic Management of a 30-week Pregnant Female with Grade V Intracerebral Hemorrhage
DeVeaux E, Adsumelli R, Delemos M. Quadriplegic Parturient for Repeat Cesarean Section: Challenges and Multidisciplinary Problem Solving Approach for Successful Outcomes
Enyinna CS, Adsumelli R. Persistent Unilateral Epidural Block: Resolution by Orienting the Bevel of Tuohy Needle to Unblocked Side
Haque A, Fernandez H, Izrailtyan I. Anesthestic Challenges of a Patient with Ebstein’s Anomaly undergoing Significant Cardiac Surgery
Haque A, Fernandez H, Izrailtyan I. Subclavian Artery Occlusion Intraoperatively Manifested by Arterial Line Dissipation and Decreased Flow Through a New LIMA-LAD
Wang M, Schabel J. Obstetric and Anesthetic Management of a Parturient with Extensive Lower Extremity DVT
Tam C, Cho B, Bilfinger T, Izrailtyan I. Percutaneous Right Atrial Thrombus Removal via Angiovac- A Review and Discussion of the Role of intraoperative TEE in this case.
Tam C, Cho B, Fan R, Izrailtyan I. Percutaneous Left Atrial Appendage Occlusion in Patients with Atrial Fibrillation- A Review and Discussion of the LARIAT Procedure and the Utility of Intraoperative TEE
Wang M, Fernandez HA, Izrailtyan I. Anesthesia Management for Minimal Incision Mitral Valve Replacement
Praslick A, Tewari N. Anesthetic Management in Mitochondrial Disease: A Case Report of an Adult Patient with Overlapping MERRF and Kearns-Sayre Syndrome
Hu L, Gruen A, Samara GJ, Moller D. A Case of Difficult Airway Management for a Patient With Epiglottic Fibrosis
Adsumelli RS, Evans BM, Wong VS, Lynch A. Analysis of High Scores in Obstetric-Early Warning Scoring Systems Tool: Maternal Safety Improvement Initiative
Presentations at NYSSA December 2013
Tam CW, McClarty A, Bilfinger T, Fernandez H, Izrailtyan I. Percutaneous Right Ventricular Assist Device (RVAD) Placement: A Review of Intraoperative Anesthetic Management and the Utility of TEE.
Andraous WF, Izrailtyan I, Bilfinger T. Inadvertent Perforation of Superior Vena Cava and Entrapment of a Central Venous Catheter in Patient Undergoing Cyst Resection
Evans BM, Scott B, Shah S. Challenge of Central Venous Access with Simultaneous Mechanical CPR (Thumper)
Evans BM, Landman U, Steinberg E, Adsumelli R. Successful Delivery of a Parturient with Hereditary Haemorrhagic Telangiectasia (HHT)
Evans BM, Oleszak SP, Kowal R, Bilfinger T. Thymectomy for Myasthenia Gravis: To Paralyze or Not
Praslick A, Besleaga D, Bao P, Izrailtyan I. Management of Severe Acute Subcutaneous Emphysema Following Pancreatic Necrosectomy
Cho BS, Gruffi C, Regenbogen E, Moller D, Izrailtyan I. Intubation with Video Laryngoscope Causing Pharyngeal Injury and Airway Bleeding in a Patient on Anticoagulation Therapy
Tam CW, Haque A, Poovathoor S, Richman D, Telem D. Diaphragmatic Pacemaker Implantation in a Patient with Amyotrophic Lateral Sclerosis: Discussion of Intraoperative Anesthetic Management and Mechanical Ventilation
Tam CW, Scott B. Transfemoral Transcatheter Aortic Valve Replacement (TAVR) in a Patient with HIT: Discussion of Intraoperative Anticoagulation Management with Bivalirudin (Angiomax)
Tam CW, Scott B. What is this Mass Located in the Right Ventricle?
Haque AR, Stellaccio FS Duchenne Muscular Dystrophy: The Older Patient
Haque AR, Szafran M. Solution to a Patient Too Contracted to Appropriately Assess
Haque AR, Kogan A. Anesthetic Management of Stickler Syndrome
Kim E, Tam C, Gupta S, Izrailtyan I. 3D Echocardiography Guiding Management During Intracardiac Thromboembolectomy
Alcala CA, Haque A, Schabel J. Anesthetic Management of a Parturient with a Cerebral Cavernoma for Cesarean Section
Eisenstat C, Bilfinger TV, Seifert FC, Izrailtyan I. Autoimmune Hemolytic Anemia in Patients Undergoing Aortic Valve Replacement: Anesthetic Considerations and Management
Park S, Dogra A, Izrailtyan I. Massive Bleeding During Nephrectomy and Inferior Vena Cava Tumor Thrombectomy
Haque A, Lokshina I. Anesthetic Management of the Parturient Status Post Konno Procedure
Chiu K, Kim M, Probst S, Szafran M. Rupture of a Carotid Cavernous Aneurysm during a Transsphenoidal Resection of a Hemorrhagic Pituitary Mass
Shah S, Stellaccio FS. Cardioversion in a Patient with Increased Echogenicity on TEE?
Shah U, Chandrakantan. A Prolonged Neonatal Apnea After a General Anesthetic
Praslick A, Paccione MF, Tewari N. Anesthetic Management in Mitochondrial Disease: A Case Report of an Adult Patient with Overlapping MERRF and Kearns-Sayre Syndrome
Andraous W, Adsumelli R. Intravascular Migration of a Previously Functioning Labor Epidural Catheter: A Rare Complication that Requires Vigilance
Molinari WJ, Rosa D, Moses B. Anesthesia for ECT during the Methohexital Shortage
Presentation at SOAP May 2014
Cho BS, Lee K, Adsumelli R. Pre-printed Syringe Label.
Presentation at IARS May 2014
Haque A, Alcala C, Schabel J. Parturient with Cerebral Cavernoma.
Rotations at Stony Brook Medicine assigned as four-week blocks
Rotations at Northport VA Hospital
Faculty mentors for all residents
Residency - What Next ??
In the past 5 year cohort, 82% of residents received ABA certification
20-30% of our residents pursue fellowships. Recent ones include:
20-30% of our graduates go directly to academic positions
Resident training in Anesthesiology is provided in two medical centers: Stony Brook University Medical Center and the Northport Veterans Administration Hospital.
Since we began providing care in 1980, the staff of Stony Brook University Medical Center has been committed to delivering excellence in patient care, research, education, and community service.
Northport Veterans Administration Medical Center offers quality medical, surgical, psychiatric, rehabilitative and skilled nursing care to Long Island veterans. With highly qualified and experienced healthcare professionals, state-of-the-art technology, a full range of services, and high ratings with the Joint Commission on Accreditation of Healthcare Organizations and other respected accrediting health care organizations, Northport VA Medical Center has a reputation for providing superior healthcare to Long Island's veterans.
Dr. Christopher Gallagher and colleagues have put together several series of instructive and entertaining videos to assist Residents and Medical Students.
Cardiac Anesthesia: A series of videos designed to prepare Residents for a Cardiac Anesthesia rotation.
Stony Brook University
From its beginnings in 1957, Stony Brook University has been characterized by innovation, energy, and progress, transforming the lives of people who earn degrees, work, and make groundbreaking discoveries here. A dramatic trajectory of growth has turned what was once a small teacher preparation college into an internationally recognized research institution that is changing the world.
Stony Brook's reach extends from its 1,100-acre campus on Long Island's North Shore: encompassing the main academic areas, an 8,300-seat stadium & sports complex, a performing arts center, Stony Brook University Medical Center, the Health Sciences Center, and the Veterans Home to Stony Brook Manhattan, a new Research and Development Park, three business incubators and the new Stony Brook Southampton campus on Long Island's East End. Stony Brook also co-manages Brookhaven National Laboratory
Stony Brook is still growing. To the students, the scholars, the health professionals, the entrepreneurs, and all the valued members who make up the vibrant Stony Brook community, this is a not only a great local and national university, but one that is making an impact on a global scale.
The Stony Brook area is one of the most attractive residential communities in the Northeast. Amid the hilly dunes near Long Island Sound the woods and fields along the water offer a variety of scenic delights. Fishing, boating, golf and horseback riding are among the many opportunities for recreation. Small wonder that the area has always been attractive to artists and scholars. The local museums and neighboring communities provide recreation and educational experience.
The department sponsors a monthly Visiting Professor lecture series. Invited speakers present clinical and/or research topics at our Wednesday morning Grand Rounds. Whenever possible, residents get to meet separately with the Visiting Professor during lunch or dinner.
The Visiting Professorship in April or May is combined with our annual Research Evening. During the poster session, Residents, Faculty and Students present display their research accomplishments. Several Residents and Students are selected to give oral presentations as well. The Visiting Professor presents the keynote speech. This is followed by dinner and an awards ceremony.