The Case for Modernizing the Third-Year Clinical Anesthesiology Residency Curriculum.

Advances in anesthesiology over 50 years contributed to the decision to add a required third year of clinical anesthesia (CA) residency training in 1989. Cardiac anesthesiologists with expertise in transesophageal echocardiography (TEE) provide improved monitoring, including surgical guidance. Increased survival of very low birth weight infants increased the need for anesthesiologists who are skilled with these fragile patients. Older, high-risk obstetric patients and complex neurointerventional procedures increased the need for anesthesiologists with special expertise to care for obstetrical and neurosurgical patients. This increased subspecialty knowledge could not be imparted to trainees in 1 rotation; 2 rotations became necessary for generalist anesthesiologists to learn the skills of each subspecialty.