Anesthesiology, Perioperative Care & Pain Medicine Residency Rotations
NYU Grossman School of Medicine’s Anesthesiology, Perioperative Care, and Pain Medicine Residency provides clinical training in a wide array of subspecialties and enables trainees to care for a diverse population of patients.
Our residency program features two clinical training tracks:
- The Manhattan track, with rotations in ambulatory, cardiothoracic, critical care, pediatric, regional, neurosurgical, and obstetric anesthesiology, as well as pain medicine. Training occurs at NYU Langone’s Tisch Hospital and Kimmel Pavilion, NYC Health + Hospitals/Bellevue, and the VA NY Harbor Healthcare System.
- The Brooklyn Track, with rotations in ambulatory, cardiothoracic, critical care, pediatric, and regional anesthesiology at the same sites as residents on the Manhattan track. Brooklyn trainees also rotate at NYU Langone Hospital—Brooklyn in obstetric anesthesiology, neurosurgical anesthesiology, and pain medicine.
Ambulatory Anesthesiology: Manhattan and Brooklyn Tracks
The Day Surgery Center at Tisch Hospital is an outpatient unit with 10 operating rooms and its own 30-bed recovery room. This environment allows the entire staff to concentrate on ambulatory patient needs with access to the full services of Tisch Hospital.
Because an ever-increasing proportion of surgery is being done on an ambulatory basis, the training in this unit is extremely relevant. Residents can elect to rotate in the ambulatory service to gain experience in the management of both pediatric and adult patients under the supervision of faculty with special expertise in ambulatory anesthesiology. Trainees learn a multitude of sedation techniques and the laryngeal mask airway.
In addition, residents have the opportunity to elect an ambulatory regional rotation at NYU Langone Orthopedic Hospital. During this ambulatory elective, residents become proficient in ultrasound-guided blocks of both the upper and lower extremities.
Cardiothoracic Anesthesiology: Manhattan and Brooklyn Tracks
NYU Langone is a major cardiac referral center, with the fifth floor of the Kimmel Pavilion dedicated to cardiothoracic procedures. Kimmel 5 has eight operating rooms and four catheterization suites. Cases include coronary artery bypass grafting, valve repair and replacement, minimally invasive cardiac surgery, robotic-assisted cardiac surgery, ventricular assist device placement, transcutaneous valve replacement, and aortic surgery. Physicians also perform a wide variety of thoracic surgeries and pediatric cardiac surgeries. Faculty in our Division of Cardiothoracic Anesthesiology provide care not only for these surgical procedures, but also for pediatric electrophysiology and pediatric cardiac catheterization procedures.
Our formal teaching program includes reading and topical reviews, formal case discussions, case presentations, and lectures by visiting professors. Residents are also encouraged to participate in the Division of Cardiothoracic Anesthesiology’s research program.
Clinical teaching in the program encompasses preoperative patient assessment, including evaluation of myocardial functional status, interpretation of cardiac catheterization, echocardiographic and angiographic data, and reading and evaluating other diagnostic information. Strong emphasis is placed on complete preoperative evaluation and the preparation and development of anesthesiology plans to address intraoperative or postoperative problems. The resident closely collaborates with echocardiographers and electrophysiologists.
Our faculty emphasize intraoperative care, which includes transesophageal echocardiography, and all major types of vascular monitoring. Residents master perioperative management, including vasoactive infusions, pacemakers, intra-aortic balloon pumps, and other interventions needed to maintain optimal hemodynamic status before, during, and after bypass.
Critical Care Anesthesiology: Manhattan and Brooklyn Tracks
The domain of the anesthesiologist extends beyond the operating room to include the practice of critical care medicine. Perhaps nowhere in the hospital is the application of basic science principles to clinical therapy as important as in the intensive care unit (ICU). Here, residents encounter a varied mix of medical, surgical, cardiovascular surgical, and neurosurgical patients. The care of these patients requires fast-paced teamwork among anesthesiologists, surgeons, and many other specialists.
Trauma Anesthesiology and Critical Care
Every resident spends eight weeks in critical care medicine as a member of the Bellevue Trauma Anesthesia and Critical Care (TRACC) team. The TRACC program integrates the care of injured or critically ill patients outside the operating room and expands the training experience for residents and fellows.
The TRACC team provides immediate and continuous patient care in the trauma treatment area, post-anesthesia care unit, and ICU. Residents encounter a diverse population of surgical, neurosurgical, and trauma patients.
The TRACC resident is part of a multidisciplinary trauma and critical care team directed by anesthesiology critical care attendings. The TRACC resident is on call in-house, supervised by full-time critical care attendings. Critical care rounds with attendings and the surgical teams are held twice daily. Afternoon lectures and patient management conferences are held daily. The TRACC team is separate from the anesthesiology team on call for the operating room.
The TRACC team is directly and primarily involved in administering bedside care to all critically ill patients in the surgical ICU and the recovery room. The team is available at all times for patient consultation in the neurosurgical, pediatric, and medical ICUs, and the adult and pediatric emergency department. The TRACC resident actively participates in all aspects of ICU patient care and management (e.g., ventilation, circulation, electrolytes, fluid balance, nutrition, and infectious problems) and is responsible for writing orders and progress notes.
In addition to primary patient responsibility, the TRACC team offers the following services:
- emergency airway management such as fiber-optic intubation and difficult tracheal intubation
- ventilator management, especially for patients with special needs such as double lumen endobronchial tube, acute respiratory distress syndrome, asthma, or bronchopleural fistula
- pain management in the ICU, including insertion of epidural and brachial plexus catheters
- diagnostic and therapeutic fiber-optic bronchoscopy
- insertion of arterial, central venous, and other vascular access lines
- use of ultrasonography for diagnosis, vascular access, and cardiovascular assessment
- daily lectures for house staff
- nutritional support
Pediatric Anesthesiology: Manhattan and Brooklyn Tracks
At Hassenfeld Children’s Hospital at NYU Langone, and other NYU Langone–affiliated hospitals, we treat a broad range of pediatric illnesses that require surgery. This provides residents with abundant clinical opportunities in pediatric anesthesiology. About halfway through the first year of training, residents rotate through the Division of Pediatric Anesthesiology, whose physicians provide care for nearly 8,000 children annually.
All pediatric surgical subspecialties are represented, including pediatric open heart surgery. Strong teaching of the fundamentals during the eight-week pediatric rotation is supplemented by pediatric anesthesiology in the ambulatory care suite at Tisch Hospital. Emphasis is placed on total perioperative care.
During the CA-3 year, residents are assigned to more challenging pediatric cases, including neurosurgical, plastic, and cardiac procedures. Hassenfeld Children’s Hospital is one of the largest centers for pediatric craniofacial surgery in North America.
We conduct weekly pediatric conferences and board review seminars. As a result of the case diversity and strong pediatric educational focus, our residents are extremely confident in their ability to provide anesthesiology care for any pediatric procedure.
Regional Anesthesiology: Manhattan and Brooklyn Tracks
During the CA-1 and CA-2 years, residents spend four to eight weeks training in regional anesthesiology at NYU Langone Orthopedic Hospital and Bellevue. Residents perform a wide variety of regional techniques to block nerves of the upper and lower extremities, trunk, lumbar, and thoracic areas. During their CA-3 year, residents can opt for an elective rotation at the outpatient NYU Langone Orthopedic Center to get more experience in regional anesthesiology.
Our faculty emphasize the understanding of relevant anatomy, use of ultrasound, local anesthetic mechanisms and toxicity, and management of postoperative analgesia.
Neurosurgical Anesthesiology: Manhattan Track
The Division of Neurosurgical Anesthesiology is active at both Kimmel Pavilion and Bellevue. Kimmel Pavilion has a dedicated second floor with six operating rooms (including two intra-operative MRI rooms) and two interventional neuroradiology suites for neurosurgical procedures.
With more than 3,000 procedures performed annually at the combined institutions, residents have the opportunity to evaluate and manage adult and pediatric patients with a wide array of pathologies, including brain and spinal cord lesions and intracerebral vascular anomalies. Trainees also have extensive exposure to all modalities of neurophysiologic monitoring.
As a resident, you are encouraged to participate in ongoing research projects conducted by division faculty in areas such as clinical pharmacology, perioperative pain control, and neurophysiology.
Stereotactic and Minimally Invasive Neurosurgery
NYU Langone’s Department of Neurosurgery is at the forefront of stereotactic and minimally invasive neurosurgery. Procedures performed include deep brain stimulation, functional neurosurgeries, biopsies, and tumor resection using computer-guided navigation. The neurosurgical anesthesiology team is closely involved in the management of these procedures. Our experts use a variety of special airway management techniques for patients in headframes.
A dedicated epilepsy and movement disorder surgical service further expands the experiential base for our residents. Because a large number of these patients undergo “awake” surgery, residents have opportunities to use fiber-optic intubation, laryngeal mask airway, and other special techniques. We regularly perform operative treatment of epilepsy at Kimmel Pavilion. These procedures often involve pediatric and young adult patients who undergo multiple procedures during their stay for seizure monitoring and for resection of epileptic foci.
Tisch Hospital is certified as a Comprehensive Stroke Center, where doctors treat cerebral aneurysms and arteriovenous malformations (AVMs) in a state-of-the-art hybrid operating room or in a radiology suite. Interventional radiology procedures include embolization of AVMs, placement of coils within aneurysms, and angiographic procedures for pediatric patients.
Spine and cranial base surgery is another active area of care at Tisch Hospital, Kimmel Pavilion, and Bellevue. Trainees gain exposure to simple lumbar discectomies and thoracic spine and skull base procedures with double lumen intubation and invasive monitoring or evoked potential monitoring.
Treatment for Head Trauma
Bellevue, with its well-known trauma service, treats many patients with head injury and is a regional center for the treatment of spinal cord injuries. Bellevue offers residents additional experience in physiologic and cerebrovascular monitoring.
Residents at Bellevue have the opportunity to work with specialists from neuroradiology, neurophysiology, and neurology. We encourage attendance at weekly anesthesiology conferences and at the weekly neurosurgical conference. Residents are also exposed to the most modern technology for neurosurgical practice, with hands-on opportunities to provide care.
Obstetric Anesthesiology: Manhattan Track
Residents receive extensive training in obstetric anesthesiology at Tisch Hospital and Bellevue where together doctors deliver more than 8,000 babies per year. This caseload affords residents excellent opportunities to be exposed to all facets of obstetric anesthesiology practice.
Residents receive training in advanced techniques for labor analgesia and cesarean birth. Because the rate of regional analgesia in labor is high, residents gain experience with epidurals, spinals, and combined spinal–epidural techniques.
Bellevue, a major facility for the care of high-risk pregnancy, provides outstanding opportunities to participate in the management of pregnant patients with conditions such as preeclampsia, asthma, cardiac disease, and sickle cell disease. In addition, a high-risk obstetric service at Tisch Hospital gives residents access to many obstetric anesthesiology challenges.
For interested residents, research opportunities are available in obstetric anesthesiology during the third year.
Pain Management: Manhattan Track
Faculty in the Center for Study and Treatment of Pain, a part of the Division of Pain Medicine, train residents in the diagnosis and treatment of patients with acute and chronic pain, including discomfort caused by cancer. Training is patient-centered, evidence-based, and multidisciplinary. The center’s goal is to optimize patients’ physical function by coordinating pharmacological, physical, nursing, interventional, and alternative care modalities.
Trainees gain experience in a wide range of diagnostic and therapeutic approaches to relieve pain, including spinal cord stimulators, radiofrequency ablation, and intrathecal drug delivery systems. Under supervision, residents also perform interventional procedures, many of which employ image guidance.
Residents spend eight weeks on the pain medicine service during their CA-1 and CA-2 years and can elect to participate in a third-year rotation. Training sites include Tisch Hospital, NYU Langone Orthopedic Hospital, Bellevue, and the VA NY Harbor Healthcare System.
Residents attend and present at pain medicine morning lectures, case conferences, journal clubs and meetings of quality assurance, and morbidity and mortality. Biweekly Pain Medicine Grand Rounds enhance the educational experience. Many research projects are available for resident participation and afford ample publication opportunities.
Outpatient Pain Medicine
In the outpatient pain program, residents see an array of complex and refractory pain cases. Trainees learn to apply medical and psychosocial analysis for the assessment and management of each stage of the injury–pain–suffering cycle.
Inpatient Pain Management
All NYU Langone–affiliated hospitals have an inpatient pain service that collaborates with primary care physicians, neurologists, physiatrists, psychiatrists, and other specialists to optimize treatment. A postoperative epidural analgesia service supports patient rehabilitation and reduces the amount of time in the hospital.
Neurosurgical Anesthesiology: Brooklyn Track
NYU Langone Hospital—Brooklyn’s Division of Neuroanesthesiology offers residents a wealth of experience in neurosurgical anesthesia, with opportunities to assess and provide care for adults with brain and spinal cord lesions and intracerebral vascular anomalies. All modalities of neurophysiologic monitoring are also represented on rotation.
As NYU Langone Hospital—Brooklyn is a Comprehensive Stroke Center, we treat a large number of patients with cerebral aneurysms and AVMs. Some patients undergo operative procedures in our advanced hybrid operating room, while many are treated using interventional neuroradiology. Procedures performed in the radiology suite include embolization of AVMs, endovascular treatment for aneurysms, and angiographic procedures.
Faculty at NYU Langone Hospital—Brooklyn perform spine and cranial base surgeries such as simple lumbar discectomies and thoracic spine and skull base procedures. Residents gain experience in double lumen intubation and invasive monitoring, as well as evoked potential monitoring.
NYU Langone Hospital—Brooklyn is a Level 1 Trauma Center. We treat many patients with acute head and spinal cord trauma. This offers a unique experience in managing complex multiple trauma patients with significant comorbidities.
Obstetric Anesthesiology: Brooklyn Track
Residents at NYU Langone Hospital—Brooklyn receive comprehensive training in obstetric anesthesiology, including preeclamptic and high-risk patients. As more than 5,000 babies are born here each year, residents are exposed to the full range of obstetric anesthesiology practice. Residents receive training in labor analgesia, including epidural, spinal, and combined spinal–epidural techniques, and cesarean birth. In addition, third-year residents can pursue research opportunities.
Pain Medicine: Brooklyn Track
NYU Langone Hospital—Brooklyn provides comprehensive training in the diagnosis and treatment of patients with acute, chronic, and cancer pain. Training is patient-centered, evidence-based, and multidisciplinary. Our goal is to optimize patients’ physical and psychosocial function by coordinating pharmacological, physical, nursing, psychological, interventional, and alternative care modalities. When necessary, inpatient care is available.
Under supervision, residents perform interventional procedures, many of which employ image guidance. While on rotation, residents gain experience in a wide range of diagnostic and therapeutic approaches for treatment of acute, chronic and cancer pain, including spinal cord stimulators, radiofrequency ablation, and intrathecal drug delivery systems.
Residents spend eight weeks on the pain medicine service during their CA-1 and CA-2 years of study and can elect a rotation in their third year. Rotations encompass clinical experience in pain medicine not only at NYU Langone Hospital—Brooklyn but also as an elective at NYU Langone’s Center for the Study and Treatment of Pain, Bellevue, and the VA NY Harbor Healthcare System. Many research projects are available for resident participation and afford ample publication opportunities.
Outpatient Pain Medicine
Patients referred to the outpatient pain program present with a wide array of complex and refractory pain problems. Thorough medical and psychosocial analysis helps to optimize the assessment and management during each stage of the injury–pain–suffering cycle.
Residents attend and present at pain medicine morning lectures, case conferences, journal clubs and meetings of quality assurance and morbidity and mortality. Biweekly Pain Medicine Grand Rounds enhance experience for the house staff.
Inpatient Pain Medicine
A comprehensive inpatient pain service is available at all NYU Langone–affiliated hospitals. The inpatient pain service works with the primary service, as well as neurologists, physiatrists, psychiatrists, and other specialists, to optimize treatment for each patient. A postoperative epidural analgesia service enhances patient satisfaction and recovery, facilitates early rehabilitation, and helps to reduce the time spent in the hospital.