Inside Yale's Thoracic Anesthesiology Fellowship

Popescu: As a fellow, you typically complete three clinical days each week, delivering care in thoracic surgery cases. Additionally, you are required to complete one clinical day a week as an attending, administering anesthesia to non-thoracic cases.

This is a huge advantage of our program. It helps new graduates build skills as independent anesthesiology attendings. They can do this while knowing they have a strong safety net, consisting of colleagues and mentors from the fellowship, who are always there to support fellows in case they need help.

Two days each month, the fellow works in the interventional pulmonology lab. They learn more bronchoscopy skills and sometimes other procedures, which may include percutaneous tracheostomies, rigid bronchoscopy, etc.

The fellow has dedicated time to work on academic projects, which may include a small research project, writing a review article, a book chapter, or a case presentation.

Our fellows are expected to participate in the Thoracic Anesthesia Symposium that takes place in the spring under the auspices of the Society of Cardiovascular Anesthesiologists annual meeting. We’ve always supported the travel expenses for the fellows to participate in this one day and a half event.

Popescu: Lower airway management can take many different forms and encompasses a broad range of skills. Our fellows receive extensive bronchoscopy training, an experience that also helps them become better and more versatile upper airway management specialists.

We also emphasize invasive procedural skills, including the placement and management of central venous and arterial lines. Regional anesthesia and acute pain management are also important components of the fellowship.

Our former fellows have told us that, by the end of their fellowship year, they feel extremely confident and well equipped to manage virtually any airway situation and a wide variety of challenging cases. They are prepared to practice successfully in both private practice and academic environments. I believe that this additional year of focused training in thoracic anesthesiology after residency provides an important extra layer of knowledge, technical expertise, and confidence that stays with them throughout their careers.

Popescu: As our fellows become more knowledgeable and comfortable managing cases, they gradually gain greater independence. Their independence is further reinforced by the dedicated clinical attending day, where they have complete autonomy in managing their cases.

It really is the best of both worlds: fellows can experience 100% independence while still having a strong safety network and knowing that they can ask for help at any point.

This is particularly valuable as fellows transition to their first job after graduation. When you start a new position and you need help you may hesitate to ask for it right away because you worry that it could affect how you are perceived by your new colleagues. Our program offers a very different environment. The people you are working with are your former attendings, current mentors, and colleagues, and they are genuinely eager to help whenever you need it.

Many of our graduates have told us that having this dedicated day of independent practice was an extremely valuable experience, giving them confidence and making them feel better prepared as they transitioned to independent practice.

Popescu: Our graduates have gone on to very successful careers, with some working in private practice and others pursuing academic careers. All our graduates have remained in Connecticut, which speaks to the strong professional relationships and opportunities they have found here.

One of our former fellows initially went into private practice but later returned to academia and is now completing her cardiac anesthesiology fellowship. She will join our department as a faculty member, practicing as a hybrid cardiac and thoracic anesthesiologist. We are extremely excited to welcome her back to the department.

We are very proud of what our graduates have accomplished, and it is particularly rewarding to see them continue to grow professionally and, in some cases, return to academic medicine and become part of our faculty.