SAMBA Fellowship Taskforce

A Taskforce was established by then SAMBA president, Dr. W. Maurer in 2006, chaired by Dr. Shireen Ahmad, with Dr. Lydia Conlay as Vice-Chair, to coordinate the efforts of SAMBA to obtain accreditation of fellowship training in ambulatory anesthesiology from the Accreditation Council on Graduate Medical Education (ACGME). Taskforce members included:

BobbieJean Sweitzer, MD Peter S. Glass, M.D.
Leopoldo V. Rodriguez, MD, MBA, FAAP, FASA Barbara S. Gold, M.D.
Jeffrey L. Apfelbaum, M.D. Raafat S. Hannallah, M.D.
Kumar G. Belani, M.D. Girish P. Joshi, M.D.
Jeffry B. Brand, M.D. Patricia A. Kapur, M.D.
Frances Chung, M.D. Walter G. Maurer, M.D.
Thomas W. Cutter, M.D. Kathryn E. McGoldrick, M.D.
Meena S. Desai, M.D. Douglas G. Merrill, M.D.
John A. Dilger, M.D. Burton S. Epstein, M.D.D.

Dr. W. Maurer convened a meeting of the Taskforce members in San Diego in May 2007, to discuss the implications of accreditation of the ambulatory anesthesia fellowship program and determine whether there was a consensus support to warrant proceeding with the application for accreditation of the ambulatory fellowship.

It was agreed that the educational goal of the fellowship would be to increase the depth of knowledge in ambulatory anesthesia and facilitate successful careers for ambulatory anesthesiologists in either academic or private practice situations. There was universal agreement that anesthesiologists involved in the practice of ambulatory anesthesia are the true “perioperative physicians” involved in the total medical encounter, from preoperative screening and preparation, to intra-operative anesthetic care and postoperative management to facilitate the recovery process.

Many ambulatory facilities are administered by anesthesiologists who have little or no formal training in the management and organizational skills necessary for the role. Fellowship training would include provision for this type of training. Fellowship training would also result in increased research in ambulatory anesthesia since it would be a requirement of the program. Special emphasis on outcomes research and patient safety issues was considered desirable.

There are unique features of the various off –site anesthetizing locations involved in the practice of ambulatory anesthesia and trainees do not get sufficient exposure to the aspects of ambulatory anesthesia practice in these locations during residency. This knowledge deficit could be addressed during the fellowship and would result in improved care of the patients managed in these locations.

At the conclusion of the meeting the decision was made to postpone the application for an ACGME fellowship, but for SAMBA to undertake the establishment of program requirements  and curriculum guidelines  for fellowship in ambulatory and office –based anesthesia based on the existing ACGME template.These guidelines were approved by the SAMBA Board of Directors in May 2008 and a competency based curriculum for education in ambulatory and office –based anesthesia that was approved in October 2009. The taskforce also developed a resident curriculum for office based anesthesia that was approved by the Board in May 2010.The intent of the guidelines is to improve the quality and consistency of resident and fellow training in ambulatory and office-based anesthesia and may be altered to conform to the needs and resources of the individual institution.