Subspecialty Training

Cardiothoracic Anesthesia

Residents at the University of Cincinnati begin developing expertise in cardiothoracic anesthesia beginning in November of their CA1 year through a longitudinal curriculum that emphasizes progressive responsibility, clinical decision-making, and mastery of complex perioperative physiology.

Training encompasses the full spectrum of contemporary adult cardiac surgery, including coronary artery bypass grafting, valve repair and replacement, minimally invasive cardiac surgery, complex aortic reconstruction, durable left ventricular assist device (LVAD) implantation, and extracorporeal membrane oxygenation (ECMO). Residents gain extensive experience caring for critically ill patients whose physiology demands thoughtful anesthetic planning, advanced monitoring, and real-time clinical judgment.

Working alongside fellowship-trained cardiac anesthesiologists, residents develop proficiency in preoperative assessment, anesthetic management, hemodynamic optimization, and postoperative critical care. Emphasis is placed on understanding the physiologic principles that guide complex cardiovascular anesthesia, allowing residents to anticipate problems, manage rapidly evolving situations, and function as leaders of the perioperative team.

As residents demonstrate increasing clinical maturity, they are entrusted with progressively more challenging cases under close faculty mentorship, ensuring that each graduate develops the confidence and judgment expected of a consultant anesthesiologist.

To further broaden their experience, CA2 residents also rotate at Bethesda North Hospital, a high-volume regional cardiac surgery center that complements the advanced pathology encountered at University of Cincinnati Medical Center. For residents wishing to pursue additional subspecialty training, the department also offers an ACGME-accredited Adult Cardiothoracic Anesthesiology Fellowship.  fellowship in cardiac anesthesia .

Pediatric Anesthesia

Under the leadership of Joseph Weethee, MD, Director of Resident Education, our pediatric anesthesiology curriculum has been intentionally redesigned to provide a progressive, longitudinal educational experience that develops confidence in every resident while allowing individualized opportunities for those pursuing advanced pediatric training.

Rather than concentrating pediatric anesthesia into a single stage of residency, residents now rotate at Cincinnati Children's Hospital Medical Center—the nation's premier pediatric hospital—during their CA1, CA2, and CA3 years. This longitudinal model introduces pediatric anesthesia early in training and allows residents to continually build upon their knowledge, technical skills, and clinical judgment as their experience matures.

The curriculum emphasizes mastery of the care of infants and children younger than 12 years of age, ensuring graduates develop the knowledge and confidence expected of contemporary general anesthesiologists entering private or academic practice. As residents progress, clinical experiences become increasingly individualized based on demonstrated competency and career aspirations.

Residents considering pediatric anesthesiology fellowship training have opportunities to participate in some of the most surgically and medically complex pediatric cases in the country. Working alongside nationally recognized pediatric anesthesiologists, they gain additional exposure to advanced neonatal surgery, congenital anomalies, solid organ transplantation, complex airway management, congenital cardiac disease, and other highly specialized procedures. Elective experiences during the CA3 year allow interested residents to further tailor their training in preparation for fellowship.

This individualized approach ensures that every graduate develops a strong foundation in pediatric anesthesiology while providing an exceptional pathway for residents seeking careers in pediatric subspecialty practice.

An ACGME-accredited Pediatric Anesthesiology Fellowship is also offered at Cincinnati Children's Hospital Medical Center, further enriching the educational environment through close interaction with pediatric anesthesia fellows and nationally recognized faculty.

An ACGME accredited pediatric anesthesia fellowship is also offered.

Obstetrical Anesthesia

Our obstetric anesthesiology curriculum is intentionally designed as a progressive three-year educational experience, with each stage of training building upon the last to develop residents into confident consultants, procedural experts, and future educators.

CA1: Building the Foundation

Residents begin their obstetric anesthesia training at University of Cincinnati Medical Center, where they care for medically and obstetrically complex patients under the close mentorship of dedicated obstetric anesthesia faculty and senior CA3 residents. During this foundational rotation, emphasis is placed on developing a deep understanding of maternal physiology, fetal considerations, labor analgesia, cesarean delivery, obstetric emergencies, and evidence-based decision-making. Daily bedside teaching, structured didactics, simulation, and case-based discussions establish the knowledge framework upon which future clinical expertise is built.

CA2: Developing Procedural Mastery

During the CA2 year, residents rotate at Good Samaritan Hospital, the highest-volume obstetric center in the Cincinnati region. This fast-paced community practice exposes residents to a different model of obstetric anesthesia while providing exceptional procedural volume. Through repeated experience with labor epidurals, spinal anesthesia, combined spinal-epidural techniques, cesarean delivery, and obstetric emergencies, residents rapidly develop procedural efficiency, clinical confidence, and independent decision-making. Equally valuable is the opportunity to work alongside experienced private practice anesthesiologists, gaining insight into a distinct style of clinical practice and patient care.

CA3: Learning to Lead and Teach

By the CA3 year, the educational focus shifts from learning obstetric anesthesia to leading its delivery. Senior residents serve as near-peer mentors for incoming CA1 residents, working alongside faculty to teach clinical reasoning, procedural techniques, and perioperative decision-making while helping guide junior residents through their first obstetric experiences. This deliberate emphasis on teaching reinforces advanced clinical knowledge while cultivating the leadership and educational skills expected of future anesthesia care team leaders. Residents with a particular interest in obstetric anesthesiology may further individualize their training through additional elective rotations at University of Cincinnati Medical Center.

Across all three years, residents participate in a comprehensive educational program that includes simulation, cadaver workshops, ultrasound-guided regional anesthesia, daily faculty-led teaching, quality improvement initiatives, and multidisciplinary collaboration. 

Neuroanesthesiology

University of Cincinnati Medical Center serves as a regional referral center for complex neurosurgical and neurointerventional care, providing residents with broad exposure to some of the most challenging neurologic patients encountered in anesthesiology.

Based on resident feedback and our philosophy of longitudinal learning, our neuroanesthesiology curriculum has been intentionally redesigned into two separate two-week rotations during the CA1 and CA2 years. Rather than concentrating all neuroanesthesia training into a single month, this approach allows residents to establish a strong foundation early in residency and then return with greater clinical maturity to refine their knowledge, technical skills, and perioperative decision-making.

Residents care for patients undergoing complex intracranial tumor resection, cerebrovascular surgery, aneurysm clipping, carotid endarterectomy, acute stroke intervention, advanced neurointerventional procedures, and complex spine surgery. Throughout the rotation, emphasis is placed on cerebral physiology, neuroprotection, advanced monitoring, hemodynamic management, and the anesthetic considerations unique to neurologic disease.

The rotation is supported by a comprehensive educational curriculum that integrates structured didactics, problem-based learning discussions (PBLDs), and bedside teaching to reinforce clinical decision-making in real time. Working closely with dedicated neuroanesthesiology faculty, residents progressively develop the knowledge, judgment, and confidence required to safely manage complex neurosurgical patients.

Critical Care

At the University of Cincinnati, we believe exceptional anesthesiologists are exceptional critical care physicians. The same knowledge of physiology, resuscitation, hemodynamic management, mechanical ventilation, and perioperative decision-making that guides care in the operating room must also extend to the intensive care unit. For that reason, our critical care curriculum is intentionally designed as a longitudinal educational experience that spans all four years of residency.

Rather than concentrating critical care into a single stage of training, residents repeatedly return to the intensive care environment with increasing clinical maturity, allowing each experience to build upon the last while reinforcing the understanding that perioperative medicine extends far beyond the walls of the operating room.

PGY-1: Building the Foundation

Interns begin residency with two distinct critical care experiences that establish the physiologic framework for the remainder of their anesthesiology training.

During the Cardiovascular Intensive Care Unit rotation, residents work alongside critical care anesthesiologists caring for some of the hospital's most medically complex postoperative patients, including those recovering from cardiac and thoracic surgery, patients requiring extracorporeal membrane oxygenation (ECMO), advanced mechanical circulatory support, major head and neck surgery, and burn surgery. This early experience develops a deep understanding of cardiovascular physiology, mechanical ventilation, resuscitation, and multidisciplinary critical care.

Residents also complete a dedicated rotation in the Neuroscience Intensive Care Unit, where they care for patients with complex neurologic disease, traumatic brain injury, intracranial hemorrhage, stroke, and postoperative neurosurgical conditions. Working alongside neurointensivists, neurosurgeons, and neurosurgical residents provides an invaluable foundation that directly complements the progressive neuroanesthesiology curriculum encountered during the CA1 and CA2 years.

CA1: Advancing Perioperative Critical Care

Residents return to the Cardiovascular Intensive Care Unit during the CA1 year with a new perspective gained from months of operating room experience. As their understanding of anesthetic physiology and perioperative medicine expands, so does their ability to independently evaluate, resuscitate, and manage critically ill postoperative patients.

CA2: Managing Surgical Critical Illness

During the CA2 year, residents broaden their experience in the Surgical Trauma Intensive Care Unit, where they care for severely injured trauma patients as well as complex postoperative transplant, vascular, and emergency general surgery patients. Working alongside surgical intensivists, residents develop expertise in the management of multisystem organ failure, massive transfusion, complex resuscitation, and the critical illness unique to surgical patients.

CA3: Refining Clinical Judgment

The final required critical care experience returns residents to the Cardiovascular Intensive Care Unit during the CA3 year. This intentional return to a familiar environment allows senior residents to appreciate how far they have progressed while assuming greater clinical responsibility and applying the knowledge and judgment developed throughout residency. By revisiting complex cardiovascular critical care as senior residents, they refine the leadership, communication, and decision-making skills expected of consultant anesthesiologists.

Throughout residency, critical care principles are continually reinforced in the operating room, simulation center, didactic curriculum, and perioperative learning experiences. This longitudinal approach ensures our graduates are prepared not only to deliver exceptional anesthetic care, but also to lead multidisciplinary teams caring for the most critically ill surgical patients throughout the perioperative continuum.

For residents interested in advanced subspecialty training, the Department of Anesthesiology offers an ACGME-accredited Critical Care Medicine Fellowship.

 ACGME accredited fellowship in critical care medicine are available.

Chronic Pain and Regional Anesthesia

Pain management is one of the defining responsibilities of an anesthesiologist. Whether caring for patients with chronic pain in the outpatient setting or providing advanced regional anesthesia for postoperative recovery, our residents develop a comprehensive understanding of pain medicine through a thoughtfully designed longitudinal curriculum that spans the intern through CA2 years and continues throughout residency.

Building Expertise in Chronic and Interventional Pain Medicine

Residents complete six weeks of dedicated chronic pain education, intentionally divided into three two-week experiences distributed throughout the intern, CA1, and CA2 years. This progressive design allows residents to revisit pain medicine with increasing clinical maturity, reinforcing concepts as their understanding of anesthetic pharmacology, perioperative medicine, and regional anesthesia continues to evolve.

Early in training, residents develop a strong foundation in pain physiology, pain mechanisms, multimodal pharmacologic management, patient evaluation, and evidence-based treatment strategies. As they progress, they gain increasing exposure to the comprehensive care of patients with chronic pain while working alongside fellowship-trained pain medicine physicians in both medical and procedural clinics.

Residents participate in the evaluation and management of a broad spectrum of chronic pain conditions while developing experience with image-guided interventional procedures, including epidural steroid injections, facet interventions, radiofrequency ablation, sacroiliac joint procedures, spinal cord stimulation, peripheral nerve stimulation, and other contemporary techniques in interventional pain medicine. Residents pursuing fellowship training have additional opportunities to strengthen their clinical experience and mentorship in preparation for the ACGME Pain Medicine Match.

Recognizing that Advanced Track interns spend additional time in anesthesiology during their intern year, their chronic pain curriculum is thoughtfully redistributed to provide four weeks of dedicated pain medicine experience during the CA1 year while preserving the same educational objectives.

Excellence in Regional Anesthesia

Regional anesthesia is integrated throughout the CA1, CA2, and CA3 years, allowing residents to continually refine their procedural skills while developing a sophisticated understanding of anatomy, ultrasound imaging, local anesthetic pharmacology, and perioperative analgesic planning.

Working alongside fellowship-trained regional anesthesiologists, residents perform high volumes of ultrasound-guided peripheral nerve blocks and continuous peripheral nerve catheter placements for patients undergoing orthopedic, trauma, vascular, and other complex surgical procedures. This progressive clinical experience is complemented by dedicated bedside teaching, simulation, anatomy instruction, and procedural coaching from faculty recognized throughout the department for their commitment to resident education.

By graduation, University of Cincinnati residents routinely perform more than 350 ultrasound-guided regional anesthetic procedures, graduating with the technical confidence and clinical judgment necessary to incorporate regional anesthesia into virtually any contemporary anesthesia practice.

Preparing Leaders in Pain Management

Together, our chronic pain and regional anesthesia curricula prepare residents to thoughtfully evaluate pain, develop individualized treatment strategies, perform advanced image-guided procedures, and deliver exceptional perioperative analgesia. Whether entering private practice, academic medicine, or pursuing subspecialty fellowship training, our graduates leave residency with the knowledge, procedural expertise, and clinical judgment expected of leaders in modern pain management.

The Department of Anesthesiology also offers ACGME-accredited fellowships in both Regional Anesthesiology and Acute Pain Medicine and in Pain Medicine, providing additional opportunities for advanced training and mentorship.

Other Purposeful Clinical Experiences

The goal of residency is not simply to master individual anesthetic techniques—it is to develop the clinical judgment, communication skills, efficiency, and leadership required of a consultant anesthesiologist.

Throughout residency, our curriculum intentionally exposes residents to diverse practice environments and focused anesthesiology disciplines, allowing them to progressively integrate the knowledge and skills developed across each subspecialty. By graduation, our residents are prepared not only to care for patients independently, but also to lead operating room teams, coordinate perioperative care, and confidently navigate the complexities of modern anesthesiology practice.

CA1: Expanding Clinical Expertise

As CA1 residents transition from learning the fundamentals of anesthesia to developing procedural confidence, dedicated specialty experiences provide focused exposure to key areas of clinical practice.

Orthopedic and Neuraxial Anesthesia

During the CA1 year, residents complete a dedicated orthopedic and neuraxial anesthesia experience designed to accelerate proficiency with spinal anesthesia. Through concentrated exposure to high-volume orthopedic surgery, residents gain the repetition necessary to develop confidence with neuraxial techniques while refining patient selection, procedural efficiency, and management of neuraxial anesthetics in a variety of surgical settings.

Airway and Head & Neck Anesthesia

Residents also complete a focused airway and otolaryngology anesthesia experience that builds upon the four-week otolaryngology rotation completed during the intern year. Providing anesthetics for patient undergoing head and neck procedure and working collegially with otolaryngologists and trauma surgeons, residents learn the principles of shared airway management, advanced airway planning, anesthetic management for awake and asleep tracheostomy placement, laser airway surgery, jet ventilation, vocal cord surgery, and complex head and neck anesthesia.

Equally important, this rotation reinforces the communication, anticipation, and closed-loop teamwork required when multiple procedural teams share responsibility for a patient's airway—skills that continue to benefit residents throughout every stage of their training.

Community Practice Experience

CA1 residents also spend one month at West Chester Hospital, providing exposure to a high-functioning community practice environment while continuing to learn from many of the same University of Cincinnati faculty anesthesiologists. This experience complements the complexity of University of Cincinnati Medical Center by emphasizing efficient operating room workflow, ambulatory surgery, common surgical procedures, and practice management principles encountered in contemporary community anesthesiology.

CA3: Transitioning from Resident to Consultant

The CA3 year intentionally shifts the educational focus from technical proficiency to leadership. During these capstone experiences, residents begin functioning as junior attending anesthesiologists under the mentorship of experienced faculty, learning the responsibilities that extend beyond delivering a safe anesthetic.

Ambulatory Surgery Center Leadership

Residents gain experience directing efficient, patient-centered care within the ambulatory surgery environment, balancing patient flow, procedural efficiency, perioperative safety, and outstanding patient experiences.

Anesthesia Care Team Leadership

During advanced rotations at West Chester Hospital, senior residents begin functioning in the role of a consultant anesthesiologist within the Anesthesia Care Team model. Under faculty supervision, they learn to oversee multiple operating rooms while coordinating care with certified registered nurse anesthetists, anesthesiologist assistants, surgeons, nurses, and perioperative staff.

Residents refine the communication, professionalism, delegation, and situational awareness necessary to successfully lead multidisciplinary perioperative teams while maintaining the highest standards of patient safety.

Anesthesiologist of the Day (AOD)

One of the most distinctive educational experiences of the CA3 year is the Anesthesiologist of the Day (AOD) rotation—a resident favorite that brings together every aspect of residency training.

Working alongside experienced faculty, residents learn the operational responsibilities of directing a busy operating room schedule. They participate in case assignments, optimize operating room flow, coordinate staffing, manage unexpected schedule changes, balance competing clinical priorities, facilitate timely patient throughput, and oversee the safe transition of operating rooms as the surgical day progresses.

Throughout the day, residents continually integrate multiple responsibilities that define modern anesthesiology practice: performing regional anesthesia procedures between cases, completing preoperative evaluations, assisting with postoperative assessments, supporting colleagues, responding to urgent clinical issues, and ensuring appropriate relief for anesthesia team members while maintaining safe staffing across the department.

These experiences cultivate the multitasking, communication, adaptability, and systems-based thinking required of successful consultant anesthesiologists.

Research

The department has an active research program that emphasizes both the basic science and the clinical aspects of the neurotransmission of pain. Clinical research is also ongoing on techniques for airway management. Trainees are encouraged to take part in these projects and participate according to their interest. A specialized rotation in anesthesia research is available in the CA-3 year.