CA-1/PGY 2 - Cementing the fundamentals of operating room anesthesiology: two months of tutorial one to one with an attending or senior resident, six months in the main operating room (Neurosurgery, Orthopedic Surgery, General Surgery, ENT, Urology), one month in the Cardiac ORs, one month in the Thoracic ORs, one month in the ICU, one month in obstetric anesthesiology.
CA-2/PGY 3 - Exploring subspecialties in anesthesiology and complex operating room anesthesiology: three months at Boston Children's Hospital for pediatric anesthesiology, one month acute pain, one month chronic pain, one month ICU, one month obstetric anesthesiology, one month cardiac, one month thoracic, two weeks in regional anesthesiology, two and a half month in the main operating room.
CA-3/PGY 4 - Cementing Practice of Anesthesiology and Transition to Attending: three months of electives (liver transplants, research, TEE, advanced regional, education, international rotations, etc.), six to nine months of selective rotations in the main operating room.
Residents receive graduated autonomy throughout this process and eventually are expected to run the operating rooms during "OC-1" call shifts as a CA-3: staffing cases with junior residents, prioritizing competing surgical demands, responding to and resolving perioperative issues as the OR manager.