OHSU

Residency

Letter from the chief:

Raecker, Beth_residency

Dear Applicant,

Welcome to the Department of Anesthesiology and Perioperative Medicine in the Portland, Oregon!  Thank you for your interest in our exceptional residency training program.  We are excited about our department and the training we offer our residents to become phenomenal perioperative physicians.  Being is such a desirable area of the country, our residents and faculty come from throughout the country (and world), providing us a wonderful diversity.  At the end of their residencies, our residents are more than prepared for their careers in both academic and private practice settings.  Our residency program offers not only comprehensive clinical and didactic experience but also unique opportunities to serve abroad, conduct both clinical and laboratory research, early involvement in advocacy and the ability to tailor your education to best serve your interests and goals for your future career as an Anesthesiologist. OHSU campus includes the OHSU hospital and Emergency Room, Doernbecher Children's Hospital, Veterans Affairs Hospital, Casey Eye Institute and both OHSU Dental and Medical schools.  

OHSU campus is located up on Marquam Hill, 1 mile from downtown Portland.  The Center for Health and Healing (CHH) houses our ambulatory surgery center as well as outpatient clinic and is located 3,300 feet down the hill on the South Waterfront.  Easy access between the main OHSU campus and CHH is available via our aerial train.  Our residents rotate at the OHSU hospital, VA, Doernbecher, CHH and Casey Eye.  The close proximity of these locations is one of the benefits OHSU provides its residents and patients.

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Clinical Experience

The greatest strength and foundation of the OHSU residency programs lies in the clinical experience.  Our residents receive a comprehensive and progressive education.  Our graduates go on to pursue fellowships, academic careers as well as work private practice settings all over the country.  Our clinical faculty are phenomenal educators and mentors who work at OHSU because teaching is an important part of their practice.  We are fortunate to have experts within the subspecialities of anesthesiology such as neuro, cardiac, OB, pediatric, ambulatory, bariatric, airway management and regional.  Our residents have early exposure to TEE, pacemakers, cutting edge regional techniques and airway management.  This breadth of knowledge and opportunity provides our residents a diverse and complete education.

Currently we have available 10 Clinical Base Year positions and 2 Advanced positions.  For those interested in completing their intern year at OHSU we offer the Clinical Base Year program which rotates at all facilities at OHSU.  During this year, the interns have the opportunity to interact with other Anesthesiology residents and faculty on certain rotations such as the ICU and the Acute Pain Service.  In addition, by July 1 all interns will have completed a 4 week Anesthesiology rotation where they get an early start to their Anesthesia training.  Regardless, for all incoming CA-1 residents, the anesthesia curriculum begins with four week of one-on-one training with a faculty member or senior resident.  This is an important time for our residents to become acquainted with working in the operating rooms and to develop the foundation for their skills practicing anesthesia.  During this same time, CA-1 residents have daily lectures providing a knowledge base of pharmacology, physiology, airway management, monitoring and details of the anesthesia machine.  This initial steep and manageable learning curve leaves residents feeling more than prepared to start taking in-house call after the first 6-weeks of training. 

The majority of your CA-1 year will be spent in the general OR solidifying your both your technical skills and understanding of patient management.  However, one of the benefits of our program is early exposure to taking care of high complexity patients and exposure to the subspecialties within Anesthesiology.  This early exposure has a number of benefits.  First, early on you will feel very confident in your ability to care for complex patients undergoing complex procedures.  You will provide anesthesia for neurosurgical, vascular, thoracic, transplant and large abdominal cases during your CA-1 year.   This allows you to focus on refining and expanding your technique when you start your subspecialty rotations.  Second, many rotate on obstetric, pediatric, pain, intensive care, regional and cardiothoracic rotations during their first year.  This variety is helpful in providing residents exposure to these subspecialties early on, should they develop a specific interest.  It also provides variety in clinical experience that is refreshing and helpful in preventing fatigue.

As you continue throughout your clinical training, the acuity of patients you see and your level of autonomy in making decisions increases.  You are able to tailor and expand your training based on your interests and what anesthesia practice you are looking to be a part of.  Through our ASPIRE programs you can increase your knowledge and skills in regional, TEE, pacemakers, acupuncture and global health.  At this time you can do extra cardiothoracic, pediatric or obstetric rotations depending on your specific interests.  By your CA-3 year, all of our residents feel confident to enter whatever practice they choose and in addition have skills that make them stand out as perioperative physicians.

Didactic Experience

Didactics lectures are scheduled into the curriculum and are a valuable part of the overall residency education.  Incoming residents have daily hour long lectures focused on important introductory topics such as workings of the anesthesia machine, volatile anesthestics and pharmacology.  After this 4-week period of daily lectures, residents have weekly hour long lectures by expert faculty on subspeciality topics.  These topics progress in depth throughout the 3 clinical anesthesia years and are focused on preparing our residents for their annual in-training exams and anesthesia board exams.  In addition, residents on the Oregon Scholars Critical Care Track have hour long critical care lectures which include all OHSU critical care fellows.  Monday mornings our department holds a Grand Rounds which include lectures from visiting professors, M&M discussions or presentations from our residents and faculty.  Prior to our weekly APOM grand rounds, our department chair Dr. Jeffrey Kirsch, holds a mock-oral boards style lecture for all residents.  This is a unique opportunity to practice oral boards style questions weekly and discuss management of challenging cases.  In addition to our weekly "Kirsch Rounds" we also offer biannual official mock oral board exams which simulate the actual exam and allow our residents practice so they feel prepared to take their formal Oral Boards.  Journal club is held once a month and includes the APOM clinical and research faculty.  Simulation has become an integrated and popular part of our curriculum.  Residents attend sessions at our state-of-the-art SIM Center two to three times per year.  This opportunity allows residents to practice managing patients through common and rare anesthetic issues and emergencies. 

As mentioned previously, an important and recent addition to our didactic curriculum is the addition of the ASPIRE program.  The goal of the ASPIRE program is to have additional training in specialty areas such as TEE, pacemaker, global health, acupuncture and regional anesthesia.  These programs are typically hour long lectures and hands-on learning experiences for interested learners 6-12 times per year in the evenings.   Each year, several residents became certified in basic TEE training, passing the national exam.  This new program has so far been extremely popular and successful and is still growing to fulfill other resident interests.

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Unique Opportunities

A unique strength of the OHSU residency program as highlighted by the ASPIRE program, is the academic support and encouragement for residents to individualize their clinical experience.  The additional training provided by the ASPIRE programs is just one example.  As an elective, many residents do a senior cardiac rotation at Kaiser Permanente in Portland.  This gives residents the opportunity to practice in a private practice setting as well as to learn from additional cardiac anesthesiologists.  Those interested in global health have the opportunity to work/serve internationally, where together with OHSU faculty, they administer anesthesia to children and adults in need of surgical care throughout the world.  Previous residents have traveled to Ethiopia, Kenya, Guatemala, Peru and India.  OHSU is fortunate to have several faculty involved in the ASA delegation and interested in advocacy.  In addition to sponsoring residents to the ASA House of Delegates and Oregon Society of Anesthesia executive committee, our residents have completed domestic rotations and fellowships in Public Policy and Legislative development in Washington D.C.  Many of our residents are active in research projects throughout residency.  OHSU APOM has a supportive research team to help get residents involved in both clinical and laboratory research.  Research electives are available during residency for residents who submit projects.   Most of our residents have authored book chapters and/or articles in peer-reviewed journals.  Our CA-1 residents attend the Western Anesthesia Residency Conference in the spring where they present research or a case presentation.  Many of our residents have gone on to present at national conferences gaining great recognition and experience for their efforts.                 

The OHSU Anesthesiology and Perioperative Medicine Department has remained at the forefront in the development of dedicated research and critical care tracks.  The Oregon Scholars Program includes 3 residents per class and is a 48 month program during the CA-3 and CA-4 years in which residents either complete a Critical Care Fellowship or focus on Research during their training at OHSU.  The Scholars split rotations in their final two years between research or ICU and their general and subspecialty anesthetic experiences.

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Living in Portland

Many of the residents, and fellow Portlanders, are transplants from other parts of the country, and find living in Portland another advantage to training OHSU.  I feel lucky to have a comprehensive, supportive and progressive program in such a beautiful area of the country.  Portland has many of the benefits of a large metropolitan area; such as great food, music, theater and entertainment.   However, within the city are many family friendly neighborhoods with fun restaurants and shops.  Portland prides itself as one of the most walkable and bikable cities in the country.  Many of our residents and staff bike to work year round.  In addition, Portland is extremely dog friendly with dogs welcome in nearly every business and dog parks throughout the city.   

During residency you'll be busy training for your career as an Anesthesiologist, however, there is still plenty of time to take advantage of all Portland and the NW has to offer.  It's not a secret that Portland is known for its food and beer.  Portland is unique in its ability to offer incredible vegan dining as well as restaurants that utilize every part of the pig.  In your free time you'll be able to take advantage of what Portland has to offer from nationally recognized food carts, outside happy hours, and >30 microbrews.  In the Northwest we pride ourselves on a great selection of organic and local foods, with an amazing Farmer's Markets open nearly year-round. 

One of the advantages of Portland is that you are <90 miles from the beautiful Oregon Coast as well as the Columbia Gorge and Mount Hood.  This allows amazing day trips outside the city that help you feel that you are really able to get away during your free time.  The Willamette Valley prides itself in its Pinot Noirs with a handful of cute towns in wine country to explore and wine tastings to partake.  As for activities, the running and cycling within the city seems to be an addictive epidemic.  In the winter the skiing on Mount Hood is incredible from those who are learning for the first time to back country ski touring.  For the less intense, the day hikes available in the Columbia Gorge and along the Coast are incredible and sometimes it's hard to believe you live so close to such a beautiful area of the country.   We all here at OHSU department of Anesthesia are excited to share with you all the wonderful things we have to offer.  Thank you for your interest in our program.  Please feel free to contact me or anyone in the admission department with any questions you may have.  Good luck during this exciting time in your career and in your journey finding the program that fits you the best.

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Sincerely,

Beth Raecker, MD
raecker@ohsu.edu
Chief Resident