Although the Accreditation Council for Graduate Medical Education (ACGME) Program Requirements for Graduate Medical Education in Anesthesiology emphasizes that resident must obtain significant experience with a broad spectrum of airway management techniques (e.g., performance of fiberoptic intubation, double lumen endotracheal tube, endobronchial blockers) [43
], there is no specific information on what constitutes the minimum clinical experience that should be obtained in order to ensure competency with the specific airway management technique. A rotation in advanced airway management should be part of the required curricula in anesthesiology residency programs. Standardization of resident training in advanced airway management can be achieved by a clinical certification process and established competencies for the training in advanced airway management techniques and devices. A survey concerning formal training in advanced airway management techniques was performed twice [3
]. In 1995, only 27% of the anesthesiology programs reported to have a formal advanced airway rotation in their curriculum [44
]. The majority of these airway rotations (60%) were less than two weeks in duration. The other survey conducted in 2002 demonstrated that only 33% of the anesthesiology programs had a dedicated airway rotation [3
]. Of these, more than 61% of the rotations were only one week in duration [3
]. A well-designed survey would be valuable in assessing current practices within US anesthesiology residency programs.
We believe that a comprehensive airway management educational program is necessary to help anesthesiology residents earn “expert” status in difficult airway management. Three years ago, we instituted in our institution a formal educational program in advanced airway management for senior residents in anesthesiology which consist of a two-to-four-week clinical rotation together with a semiannual difficult airway workshop. Although offered as an elective rotation, all CA-3 residents have elected to do the rotation during the past three years. In a survey of departmental educational activities, both the AAT rotation and the Difficult Airway Workshop have been voted by the residents as the best educational activities for the past two consecutive years. We believe that this program has resulted in improved technical skills of our residents, and improved patient safety and patient care during the difficult airway management. Future studies should focus on determining if education in advanced airway management can result in decrease in airway related morbidity and mortality and overall better patients' outcome during difficult airway management.