Structure of an Anesthesiology Residency  - New Jersey Anesthesia Professionals
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Structure of an Anesthesiology Residency 

After graduating medical school, aspiring physicians have the opportunity to enter a residency program, which will provide the training and clinical knowledge necessary to specialize in a subfield of medicine. Each specialty has its own needs in terms of clinical training and experience. Future anesthesiologists might undergo their training at different institutions, but the basic structure of an anesthesiology residency is typically similar across programs. The four-year residency can typically be split into the following “blocks”: 

  1. Clinical year: The “intern year” of an anesthesiology residency provides the structure for basic training and broad exposure to that will help residents become well-rounded anesthesiologists. More specifically, during the clinical year, residents gain broad clinical exposure to different fields of medicine, including anesthesiology, general surgery, orthopedic surgery, pediatrics, ambulatory surgery, acute pain medicine, and trauma care.1 Rotations through these different modules ensure that the resident is familiar with different types of medicine and has a broad spectrum of medical knowledge. These modules can be taught in a combination of classroom, simulation, and OR settings.2,3 
  1. CA-1: While all interns gain exposure to the field of anesthesia during the clinical year, CA-1 represents the first deep dive into the specialty. During this period, anesthesia residents might begin to receive specialized training with the help of faculty mentorship.1 

The structure of CA-1 also typically incorporates some continued classwork into residency to help residents prepare for the nationwide In-Training Examination (ITE), which will be taken in the spring to evaluate and standardize the progress of each anesthesiology candidate.4 The exam covers four categories: basic sciences, clinical services, organ-based basic and clinical sciences, and special problems or issues in anesthesiology. Each of the 200 questions is ranked and distributed by difficulty level; residents are given four hours to complete the exam. 

  1. CA-2: The second year of residency training offers an in-depth look at anesthesiology within the context of more complex subspecialties, like neurosurgery. Clinical training intensifies around this time, although some classroom learning may continue to be integrated. Residents become more involved as part of the team of anesthesiologists; for example, participating in grand rounds.1 This is also around the time where some residents start applying for fellowships to help them advance within a specific subfield of anesthesiology or participate in research. 
  1. CA-3: Senior residents are in their final year of residency and are therefore able to practice anesthesia in the OR under less supervision and with more autonomy. The structure of this final year of anesthesiology residency focuses on fine-tuning skills and preparing the resident to be able to practice independently.1,2 

There are many opportunities for interns/residents to personalize their residency training according to their unique interests. For example, some residency programs offer the option to participate in additional focus programs, attend anesthesia conferences, or even condense clinical residency and spend several months doing research.1,2 Post-residency fellowships, which are available for those who want to deepen their understanding of a subject or continue to specialize, are another common option. Such opportunities might vary depending on the resources and aims of each unique institution. 


1 The CA-1 Year. The CA-1 Year | UCSF Dept of Anesthesia. (n.d.). Retrieved from  

2 Residency. Cleveland Clinic. (n.d.). Retrieved from  

3 Anesthesiology residency: Anesthesiology: Michigan medicine. Anesthesiology. (2023, January 31). Retrieved from  

4 The American Board of Anesthesiology. (n.d.). In-training examination (ITE) blueprint – the aba. Retrieved from