Cedars Sinai Anesthesia Residency

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CedarsAnesthes

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Hello Anesthesia Applicants,

I'm one of the Cedars Sinai Anesthesia residents and wanted to provide some current information about our program. I was looking around on SDN, and noticed the vast majority of the info about the program is really outdated (back from 2007-2008). I'll try to break it down in an organized fashion, but feel free to PM me if you have any questions.

Cedars Sinai Medical Center: The medical center is located in one of the most desireable locations in Los Angeles, right next to Beverly Hills and West Hollywood. There are tons of fun bars/restaurants/shops right around the hospital and the ocean is around a 20-25 min drive away. Lots of the residents live close to the hospital but others choose to live a little farther away to have walking access to the Pacific Ocean (Santa Monica, Venice, Marina del Rey). The medical center is a hybrid hospital in terms of having a large academic feel as well many private practice physicians. This provides a unique perspective into academic v. private practice medicine that I was never able to experience during medical school. There is also a "business in medicine" lecture series year-round to teach the residents how to negotiate their first job contract, find jobs, start a practice, etc. Another huge perk is the Starbucks in the lobby that opens up at 4am every day. While Cedars used to be a completely private hospital many years ago, it has transitioned into an academic medical center with many different resideny programs, UCLA M3/4 medical students, and visiting medical students/residents. There is also a brand new combined clinical/research building set to open in early 2013 with state-of-the-art research labs and more hospital beds/ORs. I interviewed at 13 different anesthesia programs when I applied (in retrospect, far too many. 5-6 is probably adequate), and Cedars was by far the nicest medical center I visited. Did I mention the weather is amazing?

Intern Year: The intern year was recently reformated to be a true transition year, as opposed to mostly medicine. Rotations include 2-3 months of surgical subspecialties (colorrectal, thoracic, hepatobiliary, peds, urology, trauma, outpatient), 2 months of SICU, Anesthesia, and Medicine (1 month wards, 1 month MICU/RICU, Free Clinic, Consults). From my experience, 2-3 of those months will be extremely challenging in terms of hours 60-70/week; while others are much more modest 45-55/week. Its a nice blend of medicine and surgery. If you like to operate, you will have a lot of opportunities to be one-on-one with the attendings. I can't speak for my co-residents, but as an intern, I did 16 pediatric surgerys (hernias, gastroschiesis closures, skin lesions, etc), 22 general cases (appys, choles, mastectomy/lumpectomy, cyst removals, LARs, SBR and ostomys) in my 3 months. Essentially, I was doing 4-5 cases per week during my 3 months of surgery which was more than enough given the fact that I still needed to handle the floor work. If you get assigned to an outpatient surgery rotation, you do 3-4 cases per day for a month (no clinic, no notes, no rounds.... amazing month). I would say the biggest pro to the intern year is the teaching..... the attendings and residents do enough teaching during rounds/conferences to cover all the bases and reading outside the hospital isn't really needed unless you need to present on a topic the following day. In terms of intensity, its not super cushy like a lot of TY programs but its much nicer than most prelim medicine/surgery internships. Perks include a ton of meal card money (can use at starbucks, caf, and any of the restaurants in the hospital), book fund that most use on Step 3, free catered lunches everyday on medicine, and free parking in the lot that connects to the hospital.

Anesthesia Program: The attendings are all part of a private anesthesia group called GASP (there are about 120-130 attendings, I believe). Of that group, about 40-50 are part of the teaching faculty that you will work with directly in the OR. The Cedars anesthesia group is an MD-only group so each room is staffed by an attending.... no CRNAs. Because we are a small/medium sized anesthesia program with 8 residents per year, we get paired one-to-one with the attendings. Once the case gets going, there is typically a teaching session in the OR while you manage the case, and then you give each other breaks, followed by more intraoperative teaching. Typically, the attendings will stay in the OR with you during your first few weeks of anesthesia until you "prove yourself," but after that, you typically get to fly solo and have the right amount of autonomy. Because its one-on-one, you always get released for lectures/didactics (usually with a 15 min buffer to allow you to grab a coffee)..... looking back, I didn't realize how important it was to be able to actually get released to go to lectures (lectures are really good and high yield). There is typically a brief AM lecture for 20 min and then a more formal teaching conference in the afternoon. I would say the two greatest rotations are OB and Cardiovascular. Cedars is one of the busiest labor and deliveries in the country and you will do so many epidurals that you'll be a pro in a week (also, once you finish your OB anesthesia rotation, you can moonlight within the OB anesthesia department to supplement your income.... I think its around $85-90/hr). Regarding CV, Cedars does more heart transplants than any other medical center in the nation, in part to a huge expansion in the last few years (there are currently 5 CV anesthesia fellows as well). The only weakness I've seen in terms of rotations is that the residents wish they could do more regional blocks. Everyone gets a ton of blocks in, but we have a huge orthopedics department and would love to work with them more in terms of regional anesthesia (this will be expanded in the next year or so). To end of a positive, the Drs. Wender and Yumul (chair and PD) are two of the nicest people on earth. They work so hard to teach us and turn us into great anesthesiologists. The program is a family, and they are really like mom and dad.

After Residency: For the last several years, all of the residents have pursued fellowships. The most recent graducating class did Critical Care at Northwestern, Regional at HSS, OB Anesthesia x2 at Cedars, Peds at CHOP, and Pain x2 at Cedars. At Cedars, we have fellowships for OB, Cardiovascular, Pain, and Liver. Many past residents/fellows have joined the Cedars Anesthesia group while others stayed in LA at different hospitals or moved elsewhere. No one has had difficulties in finding great jobs despite all the rumors of "saturated markets in most big cities". The program director and chair are both very well connected and always helping people find jobs.

Overall: I couldn't be happier at Cedars and am so glad I matched here for residency. I interviewed at a lot of big name anesthesia programs, and my advice is to pick a program that best fits your personality and goals; don't just pick a program for name. Be in a place where you want to live and have ties because residency is tough, and having a solid support system is important.

From what I understand, anesthesia applicants are allowed to come spend a day in the OR with the residents and attendings to get a better feel for the program. Also, feel free to contact our medical student coordinator (all info is available from the anesthesia website) to set up a rotation for 1-4 weeks depending on your schedule. I rotated here and was scheduled for 3 weeks, ended up staying 5 weeks because I liked it so much. Also, feel free to PM me if you have any more specific questions. Thanks and I hope this info was helpful!

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Thanks for this great review! I interviewed at Cedars last year for anesthesia and loved the program. Unfortunately, I didn't match there but am hoping to do a CV fellowship at Cedars once I finish my anesthesia residency (long ways to go, still just an intern). Thanks again for such a thorough perspective. Perhaps if I get a day off as a surgical resident, I'll post about my program haha
Cheers!
 
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Hello Anesthesia Applicants,

I'm one of the Cedars Sinai Anesthesia residents and wanted to provide some current information about our program. I was looking around on SDN, and noticed the vast majority of the info about the program is really outdated (back from 2007-2008). I'll try to break it down in an organized fashion, but feel free to PM me if you have any questions.

Cedars Sinai Medical Center: The medical center is located in one of the most desireable locations in Los Angeles, right next to Beverly Hills and West Hollywood. There are tons of fun bars/restaurants/shops right around the hospital and the ocean is around a 20-25 min drive away. Lots of the residents live close to the hospital but others choose to live a little farther away to have walking access to the Pacific Ocean (Santa Monica, Venice, Marina del Rey). The medical center is a hybrid hospital in terms of having a large academic feel as well many private practice physicians. This provides a unique perspective into academic v. private practice medicine that I was never able to experience during medical school. There is also a "business in medicine" lecture series year-round to teach the residents how to negotiate their first job contract, find jobs, start a practice, etc. Another huge perk is the Starbucks in the lobby that opens up at 4am every day. While Cedars used to be a completely private hospital many years ago, it has transitioned into an academic medical center with many different resideny programs, UCLA M3/4 medical students, and visiting medical students/residents. There is also a brand new combined clinical/research building set to open in early 2013 with state-of-the-art research labs and more hospital beds/ORs. I interviewed at 13 different anesthesia programs when I applied (in retrospect, far too many. 5-6 is probably adequate), and Cedars was by far the nicest medical center I visited. Did I mention the weather is amazing?

Intern Year: The intern year was recently reformated to be a true transition year, as opposed to mostly medicine. Rotations include 2-3 months of surgical subspecialties (colorrectal, thoracic, hepatobiliary, peds, urology, trauma, outpatient), 2 months of SICU, Anesthesia, and Medicine (1 month wards, 1 month MICU/RICU, Free Clinic, Consults). From my experience, 2-3 of those months will be extremely challenging in terms of hours 60-70/week; while others are much more modest 45-55/week. Its a nice blend of medicine and surgery. If you like to operate, you will have a lot of opportunities to be one-on-one with the attendings. I can't speak for my co-residents, but as an intern, I did 16 pediatric surgerys (hernias, gastroschiesis closures, skin lesions, etc), 22 general cases (appys, choles, mastectomy/lumpectomy, cyst removals, LARs, SBR and ostomys) in my 3 months. Essentially, I was doing 4-5 cases per week during my 3 months of surgery which was more than enough given the fact that I still needed to handle the floor work. If you get assigned to an outpatient surgery rotation, you do 3-4 cases per day for a month (no clinic, no notes, no rounds.... amazing month). I would say the biggest pro to the intern year is the teaching..... the attendings and residents do enough teaching during rounds/conferences to cover all the bases and reading outside the hospital isn't really needed unless you need to present on a topic the following day. In terms of intensity, its not super cushy like a lot of TY programs but its much nicer than most prelim medicine/surgery internships. Perks include a ton of meal card money (can use at starbucks, caf, and any of the restaurants in the hospital), book fund that most use on Step 3, free catered lunches everyday on medicine, and free parking in the lot that connects to the hospital.

Anesthesia Program: The attendings are all part of a private anesthesia group called GASP (there are about 120-130 attendings, I believe). Of that group, about 40-50 are part of the teaching faculty that you will work with directly in the OR. The Cedars anesthesia group is an MD-only group so each room is staffed by an attending.... no CRNAs. Because we are a small/medium sized anesthesia program with 8 residents per year, we get paired one-to-one with the attendings. Once the case gets going, there is typically a teaching session in the OR while you manage the case, and then you give each other breaks, followed by more intraoperative teaching. Typically, the attendings will stay in the OR with you during your first few weeks of anesthesia until you "prove yourself," but after that, you typically get to fly solo and have the right amount of autonomy. Because its one-on-one, you always get released for lectures/didactics (usually with a 15 min buffer to allow you to grab a coffee)..... looking back, I didn't realize how important it was to be able to actually get released to go to lectures (lectures are really good and high yield). There is typically a brief AM lecture for 20 min and then a more formal teaching conference in the afternoon. I would say the two greatest rotations are OB and Cardiovascular. Cedars is one of the busiest labor and deliveries in the country and you will do so many epidurals that you'll be a pro in a week (also, once you finish your OB anesthesia rotation, you can moonlight within the OB anesthesia department to supplement your income.... I think its around $85-90/hr). Regarding CV, Cedars does more heart transplants than any other medical center in the nation, in part to a huge expansion in the last few years (there are currently 5 CV anesthesia fellows as well). The only weakness I've seen in terms of rotations is that the residents wish they could do more regional blocks. Everyone gets a ton of blocks in, but we have a huge orthopedics department and would love to work with them more in terms of regional anesthesia (this will be expanded in the next year or so). To end of a positive, the Drs. Wender and Yumul (chair and PD) are two of the nicest people on earth. They work so hard to teach us and turn us into great anesthesiologists. The program is a family, and they are really like mom and dad.

After Residency: For the last several years, all of the residents have pursued fellowships. The most recent graducating class did Critical Care at Northwestern, Regional at HSS, OB Anesthesia x2 at Cedars, Peds at CHOP, and Pain x2 at Cedars. At Cedars, we have fellowships for OB, Cardiovascular, Pain, and Liver. Many past residents/fellows have joined the Cedars Anesthesia group while others stayed in LA at different hospitals or moved elsewhere. No one has had difficulties in finding great jobs despite all the rumors of "saturated markets in most big cities". The program director and chair are both very well connected and always helping people find jobs.

Overall: I couldn't be happier at Cedars and am so glad I matched here for residency. I interviewed at a lot of big name anesthesia programs, and my advice is to pick a program that best fits your personality and goals; don't just pick a program for name. Be in a place where you want to live and have ties because residency is tough, and having a solid support system is important.

From what I understand, anesthesia applicants are allowed to come spend a day in the OR with the residents and attendings to get a better feel for the program. Also, feel free to contact our medical student coordinator (all info is available from the anesthesia website) to set up a rotation for 1-4 weeks depending on your schedule. I rotated here and was scheduled for 3 weeks, ended up staying 5 weeks because I liked it so much. Also, feel free to PM me if you have any more specific questions. Thanks and I hope this info was helpful!

This is amazing! Thanks so much for the rundown. Recently got an interview and hail from the east coast with no ties/experience with the west so this was really useful!
 
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The most recent graduating class did Critical Care at Northwestern, Regional at HSS, OB Anesthesia x2 at Cedars, Peds at CHOP, and Pain x2 at Cedars. At Cedars, we have fellowships for OB, Cardiovascular, Pain, and Liver. Many past residents/fellows have joined the Cedars Anesthesia group while others stayed in LA at different hospitals or moved elsewhere. No one has had difficulties in finding great jobs despite all the rumors of "saturated markets in most big cities". The program director and chair are both very well connected and always helping people find jobs.

You have by FAR the busiest heart transplant program in the country (if not the world?). Why do you think nobody in your most recent graduating class did the Cardiothoracic fellowship at Cedars?
 
One thing I've heard about Cedars from someone who rotated through there was that autonomy is an issue given you're always one-to-one with an attending.
 
If you do a search you can see some strong opinions from presumably an (ex) attending anesthesiologist. Primarily regarding lack of autonomy and lack of preparededness for attending hood. I do believe they had to soap a spot. I'm sure in the long run you'll be fine esp if you want to work in socal.
 
If you do a search you can see some strong opinions from presumably an (ex) attending anesthesiologist. Primarily regarding lack of autonomy and lack of preparededness for attending hood. I do believe they had to soap a spot. I'm sure in the long run you'll be fine esp if you want to work in socal.

true, though to be fair, last year was bizarre, with UW, Emory, and Dartmouth all filling in SOAP.
 
Autonomy is not an issue at Cedars. Residents are paired with a CA3 for the first few weeks and then released on their own. CA1s are then paired with attendings 1:1 and are routinely left alone in the room on big cases including craniotomies, whipples, etc. very early on (as early as the first month). Basically, it is up to the CA1 to show the attending that they are capable - that governs who gets left alone and who needs to be babysat. CA1s get assigned to liver transplants, kidney transplants, etc. They take airway call the second month. There's no shortage of case variety. Many are already aware that Cedars does the most heart transplants in the country. It has a super busy OB service. Acute pain service. Regional service. Anesthesia preoperative clinic. Everything a good program should have.

The group of anesthesiologists is large (at least 150). The best rooms (most opportunity for learning) are assigned to teaching attendings (of which there are probably 50 or so) and then the residents are assigned to the attendings.

Every resident (who has a desire to go) has been sent to the ASA conference every year (this year to Chicago) - fully paid trip. Not aware of another program which does this. Every resident can be released at a moments notice for lecture (huge benefit to 1:1).

Interns do a surgical internship; they meet a lot of the surgery residents and attendings. They do 3 months of ICU (neuro, surgical, medical).

CA2s spend time and take call in the CSICU (as do CA3s). Just about every CA3 took and passed the Basic PTEexam.

Cedars has one of the best simulation centers in the country (a MOCA endorsed sim center).

And of course it's in between beverly hills and west hollywood.
 
@IAmTheOne1 I'm interested in the Cedars CCM fellowship. There was a time somewhere I saw they also get TEE certification with CCM. Is that the case? Since you say that most residents take the basic exam. I don't hear many residencies that I know of that most of their residents do that.
 
No strong opinion about cedars in any way. Just wanted to say that taking the basic PTEexam as a CA3 should not have much weight as a positive for this program. There are plenty of programs around the country that prepare residents for the advanced exam. And if they have such a robust cardiac experience and a CT fellowship as alluded to above, this is what should be happening.
 
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Several of our residents looked into the Basic TEE exam - seems like it's offered around the same time as the Advanced Anesthesia boards, and without much crossover it's pretty tough to study for both (otherwise you would need to wait a while). So most have decided against taking it. If you do a search on the NBE website, there simply aren't very many people with the basic certification - unclear how useful it is in clinical practice, any insight from the gallery?
 
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Any recent updates on this residency program and the state of the anesthesia department at Cedars?
 
I was a fellow there a few years back. Lots of internal politics causing rifts between different divisions. Training is not great; you will get good bread/butter but unless you're a self-directed learner you will be weak with complicated cases. What makes no sense is how the faculty call themselves Professors and Associate/Assistant Professors when there's no link or association to any University??
 
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What makes no sense is how the faculty call themselves Professors and Associate/Assistant Professors when there's no link or association to any University??
I thought they were affiliated with Geffen-UCLA. Wikipedia agrees.
 
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There’s a big rivalry with UCLA for business. So it’s actually strange faculty would associate themselves with their main competitor. University is a university at the end of the day.
 
there’s a lot of drama/politics. lots of attendings didn’t seem all that happy. good cardiac though.
Could you elaborate more on this, I'm an applicant thinking of ranking Cedars high but this has me second guessing my decision. Were there any specific events or people? You could DM privately if that's more comfortable for you
 
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