The objective of the residency program in Anesthesiology at JHSH of Cook County is not only to provide residents with the broadest possible clinical experience in Anesthesiology and all of its subspecialties, but also to provide them with a firm grasp of the principles and concepts upon which the practice of Anesthesiology is based. To accomplish this, complementary didactic and clinical programs provide a unique opportunity to develop the clinical judgment and expertise that is essential if a resident is to emerge from the program as a Consultant in Anesthesiology who is knowledgeable in all of the many facets of the Specialty.

CLINICAL BASE YEAR
The Clinical Base Year (CBY) is divided into thirteen (13) rotations. All of the rotations are at JHSH of Cook County and take place during the first year of the Continuum of Education in Anesthesiology. The rotations are arranged through the Program Directors of the responsible departments by Dr. Carlo D. Franco, Director, Clinical Base Year, Department of Anesthesiology and Pain Management. However, Dr. Franco deals directly with the appropriate rotation coordinator within each of the subspecialties on which the Clinical Base Year residents rotate. Rotations include Internal Medicine, Pulmonary Medicine, Neurology, Emergency Medicine, Surgery, Family Practice, Medical Intensive Care, Coronary Care, Radiology (elective), Nephrology (elective), and Anesthesiology. Except for the General Medicine rotation, which is three months, each of the rotations is one lunar month (28 days) in duration. All of the rotations are required except for two electives, which can be selected by the resident. The resident is allowed one lunar month of vacation time during the Clinical Base Year.

CLINICAL ANESTHESIA YEARS (CA-1 CA-2, CA-3)
The Clinical Anesthesia Years are divided sequentially into Basic Anesthesia Training, Subspecialty Anesthesia Training, and Advanced Anesthesia Training. This represents a graded curriculum which increases in difficulty and progressively challenges the resident's intellect and technical skills. The Basic Training occupies most of the CA-1 year, but obviously, from a logical point of view, it overflows into the beginning of the CA-2 year. Similarly, while the Subspecialty Training occupies most of the CA-2 year, some of the subspecialty rotations, e.g., pediatric and obstetrical anesthesia, are begun (by those residents who are progressing more rapidly) during the second half of the CA-1 year and continue into the CA-2 year. While this occurs in part for logistical reasons, it does allow the transition from basic to subspecialty training to vary from individual to individual, depending on the rate at which he/she is progressing. Experience in the Advanced Anesthesia Training constitutes the CA-3 year. In keeping with the Continuum of Education outlined by the American Board of Anesthesiology, following satisfactory completion of the Clinical Base and the CA-1 and CA-2 years, the resident will in collaboration with the Program Director, proceed to Advanced Anesthesia Training, which constitutes the CA-3 year. The resident and the Program Director will select one of two tracks designated as the Advanced Clinical Track and the Clinical Scientist Track.
The goals and objectives of the Advanced Clinical Track, as with the Subspecialty Clinical Track, are to expand the knowledge and augment the clinical experience of the residents in each of the selected subspecialties, but allows the resident to gain further knowledge and experience in a broader spectrum of subspecialties. Residents in the Advanced Clinical Track are required to complete a minimum of six months experience in advanced and complex clinical anesthesia assignment. The remaining six months may be spent in one to three selected subspecialty rotations, or alternatively, additional
complex clinical anesthesia assignments may be selected. The goal of this track, which takes place primarily at the Parent Institution, JHSH of Cook County, is to provide the residents with the opportunity to gain more experience and confidence in the more difficult and/or complex anesthetic procedures, in the management of anesthesia for more complicated and extensive surgical procedures, and in the anesthetic management of the most seriously ill patients, particularly those with multiple organ system disease and/or failure. Thus, the resident in this track is assigned to manage cases that, for the most part, have unstable hemodynamic and ventilatory parameters which warrant extensive invasive monitoring procedures.
The goals and objectives of the Subspecialty Clinical Track are, in general, to expand the knowledge and augment the clinical experience of the residents in each of the selected subspecialties. Whatever the Subspecialty Clinical Track, the CA-3 resident is assigned to care for the more difficult or complex procedures utilized in that subspecialty and care for the most seriously ill patients. Residents in the Subspecialty Clinical Track may complete nine to twelve months of experience in one subspecialty rotation along with up to three months of advanced experience in complex clinical anesthesia assignments or, alternatively, six months experience in each of two subspecialty rotations may be selected. Instruction and supervision in each of the subspecialties are provided by the faculty in that Division and/or Section.
The goals of the Clinical Scientist Track are as follows: (1) To introduce and motivate the resident to learn the basic principles and practices of clinical research, animal research, and biochemical research, including experimental design and statistical analysis. (2) To learn to conduct a guided literature search in order to develop and support an experimental project. (3) To teach the resident how to design a research protocol and, in addition, to learn the process by which administrative and scientific approval is gained for research, particularly research involving human and/or animals. (4) To teach the resident to perceive and analyze clinical problems and to determine the best experimental approach to their solution. (5) To allow residents to participate directly in the technical aspects of research, including the choice of a correct species for animal research, and the surgical techniques necessary to carry out a project utilizing that species, the techniques of analysis of biological samples, and the special research techniques required for human experimentation. (6) To introduce the resident to the appropriate format of a scientific paper and to its verbal presentation at local, regional, or national meetings.

The Didactic Program
The Clinical Curriculum is accompanied by a series of didactic lectures by the Faculty which presents to the residents and fellows the scientific concepts and principles upon which the clinical practice of Anesthesiology is based. Grand Rounds by distinguished Visiting Professors augment this lecture series, as does the weekly Morbidity and Mortality Conference. In addition, daily Key Word discussions, Problem-Based Learning discussions, Literature Seminars, and didactic videos complement the didactic program.