Page 66 - CASA Bulletin of Anesthesiology 2019 Issue 6

CASA Bulletin of Anesthesiology

Early in China, a few anesthesiologists were trained in a short term training program sponsored by sever-
al pioneers who received foreign anesthesia residency training in the United States or Europe . Most of them
studied anesthesia techniques under the guidance of their senior anesthesiologists who participated the short
term training program . At the same time, due to shortage of manpower, many nurses and technicians under-
took clinical anesthesia work . Until the end of 1980s, in order to improve the ability of clinical anesthesia and
alleviate the shortage of anesthesiologists, some medical colleges have established undergraduate major in
Anesthesiology one after another . In recent years, in order to improve the development of anesthesiology, it is
hoped that anesthesia residential trainees will be recruited through voluntary selection among all medical grad-
uates . Therefore, it is suggested that the undergraduate major of anesthesiology in China should be gradually
abolished . However, according to the survey in 2015, there are 75 233 anesthesiologists in China, with only 0 .5
anesthesiologists per 10,000 people . According to the requirement of 2 .4 anesthesiologists per 10,000 people in
Europe and the United States, it needs at least 330,000 anesthesiologists in China . The gap is huge in terms of
the number of anesthesiologists. The shortage of qualified anesthesiologists and the dramatic increase of surgic
operations make it more urgent to carry out residency training in anesthesiology .

Therefore, it is a challenge to ensure all the residents with different educational backgrounds to achieve the
desired standard quality in a limited period of three years .

2 . Introduction of residency culture in anesthesia department

Since 2012, the anesthesia department of Tongji Hospital has tried to recruit residents . In 2014, it was identi-
fied as the first national residentcy training base in Hubei Province, with a training capacity of 110 trainees. The
department is a key national discipline of the National Ministry of Education and a key clinical specialty of the
National Ministry of Health . In the past six years, more than 90 anesthesia residents have completed standard-
ized training in Tongji Hospital . At present, there are 91 resident trainees in anesthesia department (including 58
social trainees and 18 postgraduates) . Also, the department participated in the "One Belt and One Road" training
program organized by the Anesthesiology Branch of the Chinese Medical Association, and became one of the
first ten training bases in recruiting foreign trainees. We have accumulated some experience together with our
own characteristics and thoughts in the field of residency training as follows.

2 .1 Changes of the residency management system:

Since the residency program initiated in 2012, the residency program director has clearly defined the respon-
sibility of each member of the management team . A deputy director, designated by the departmentand assisted
by a teaching secretary, is in charge of residency training, teacher election and quality improvement . The attend-
ing anesthesiologist in OR is the tutor for trainees who rotate in the OR .

However, the diversity of education background and personal ability of residents is an objective fact that
cannot be ignored . Usually, an attending anesthesiologist is responsible for the anesthesia work in at least two
operating rooms every day . Their clinical task is already heavy . What’s more, as a result of scheduling, the col-
location of attending anesthesiologist and resident changes almost every day, and they do not know each other .
Therefore, most of the attending anesthesiologists have the phenomenon of "dare not let go" in their clinical
teaching, for the sake of safety responsibility, and to ensure the fast and safe anesthesia process . As a result,
many residents have less opportunities for clinical operation, but also there is not gradual process of clinical
learning for residents . Residents just passively accept the idea and instruction of anesthesia management from
their superior anesthesiologist, which results in frustration and lack of enthusiasm, weak sense of responsibility
and poor subjective initiative .

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