Perioperative Quality & Safety Fellowship

Overview and Goals

This unique 2-year clinical non-ACGME post-graduate fellowship program in Perioperative Quality and Safety combines formal training through Harvard Medical School, deep immersion in organizational operations at BIDMC, and a highly productive research program.

Successful candidates will be enrolled in a fully funded 2-year integrated program, culminating in a Master of Healthcare Quality and Safety (MHQS) degree from Harvard University.

The program is designed to help clinicians improve patient safety and health care quality in an increasingly complex and evolving health care environment.

On completion of the fellowship program, graduates will be able to:

  • Drive strategic change and foster a culture of quality and safety
  • Generate data-driven solutions to address operational challenges
  • Measure, interpret and communicate meaningful health care outcomes
  • Identify quality and safety gaps and develop strategies to address them
  • Use data to support rational and evidence-based improvements
  • Develop and implement quality improvement initiatives within a tight budget
  • Assess and improve health care processes through evidence-based best practices
  • Identify, design, and implement malpractice prevention and intervention strategies

OSI Year 2

Eligibility/How to Apply/Contact Information

The fellowship program accepts up to two fellows a year, including physicians trained both in the US and overseas. Additionally, we also welcome attending (consultant) anesthesiologists who wish to pursue the MHQS program while employed as faculty at BIDMC.

All prospective candidates are strongly encouraged to directly contact the Program Director Dr. Satya Krishna Ramachandran for more information.

Essential criteria for all applicants:

  • Successful completion of postgraduate training in Anesthesiology, including evidence of successful board eligibility or certification
  • Full registration on the State or National Medical Register (including entry on the specialist register or eligibility for state medical licensure)
  • Confirmation of current and ongoing employment
  • At least 5 years of post-MD anesthesia training or higher
  • ECFMG certification: The Step 1, Step 2 CK&CS must be mandatorily completed for limited licensing
  • Submit your application through our Fellowship Application Form for July start. International applicants are instructed to send in their applications as early as possible

Desirable criteria:

  • All three USMLE steps completed
  • A track record of excellent clinical care attributes and organizational citizenship
  • Evidence of interest in quality and safety
  • Higher academic degrees that indicate intent and ability to excel in academically rigorous environments

Candidates from England who wish to apply through the Royal College of Anaesthetists, please visit the SALG-BIDMC page to learn more about the Scholar program.

Rotations and Schedules

The clinical rotations are fully coordinated with the academic schedule of the 2-year MHQS program:

  • On average, fellows can expect to work 20-25 clinical hours a week during the ‘term time' of their MHQS program.
  • Fellows will resume a complete clinical workload when the MHQS course is in recess
  • Clinical responsibilities for the fellow include late call once a week and weekend day call six to twelve times a year.
  • The appointment does not stipulate specific anesthesia or surgical specialty case-mix, and it is anticipated that the successful applicants will be exposed to a wide variety of anesthetic care within BIDMC.

Curriculum and Didactics

The curriculum for the fellowship follows the two-year MHQS program from Harvard University. Successful candidates will have protected time to participate in didactics at Harvard Medical School, which is walking distance from BIDMC.

The key benefits of this program are:

  • The curriculum is designed to accelerate your ascent to a leadership role focused on health care quality and safety
  • Distinguished faculty who are recognized leaders in some of the nation's most prestigious health care systems
  • A learning model that combines concrete theory with applied learning
  • An accomplished community of professional peers that you can call upon long after the program ends
  • A capstone project that is aligned with your goals and interests plus one-on-one mentoring
  • The carefully designed curriculum that focuses on all operational aspects of health care quality and safety
  • Exposure to best practices within the Harvard network of hospitals, including Massachusetts General Hospital, Brigham and Women's Hospital, Boston Children's Hospital, Beth Israel Deaconess Medical Center and Dana-Farber Cancer Institute.

Fellows will be trained as a Simulation Instructor through the world-renowned Center for Medical Simulation. Fellows are also coached and mentored to apply these skills operationally and engage in various implementation projects. Our aim is to maximize your ability to execute change in healthcare quality and safety from the day you complete your fellowship training.

Examples of projects and programs are:

  • M&M review: fellows help guide faculty and residents in delivering their presentations
  • Resident RCA faculty: help guide residents in learning and performing an RCA
  • Implementation of a debriefing framework after major adverse events in the OR
  • OR efficiency
  • In-situ team training for emergency manual implementation
  • Running large multidisciplinary team training events
  • Greening the OR

Research and Other Opportunities

Fellows are fully integrated into the Quality & Safety and Outcomes Research Labs that leverage the rich data resources in an academic environment that sets them up for success. Under the mentorship of Dr. Krish Ramachandran, you will be engaged in operationally relevant investigations using high-end research methodology. See more information about our Department's Research at their website.

Publications in 2020

(fellows names bolded)

  • Li Y, Ciampa EJ, Zucco L, Levy N, et al. Adaptation of an obstetric anesthesia service for the SARS-CoV-2 pandemic: description of checklists, workflows, and development tools. Anesth Analg. 2020 Epub ahead of print
  • Levy N, Zucco L, Ehrlichman RJ, et al. Development of Rapid Response Capabilities in a Large COVID-19 Alternate Care Site Using Failure Modes and Effect Analysis with In-Situ Simulation. Anesthesiology. 2020 Epub ahead of print
  • Zucco L, Santer P, Levy N, et al. A comparison of postoperative respiratory complications associated with the use of desflurane and sevoflurane: a single centre cohort study. Anaesthesia. 2020 Epub ahead of print
  • Feuerstein JD, Levy N, Zucco L, et al. Management of a COVID-19 patient in the endoscopy suite. VideoGIE. 2020 May 8;5:327-330
  • Zucco L, Levy N, Ketchandji D, Aziz M, Ramachandran SK. Perioperative Considerations for COVID-19 Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Anesthesia Patient Safety Foundation Online Article

Education materials

Our fellows developed and published the training materials our hospital uses for COVID preparedness, including the simulated videos. These are available for free-online-access.

Awards in 2020

  • Oral and ePoster Presentation: SALG Patient Safety Conference, UK 2020, Joint 1st prize
  • "Concise Out of operating room Interprofessional in-Situ Exercises (CONcISE)": Implementation of a Novel Program and Impact of Drill Frequency on Critical Measures of Patient Safety. CRICO RMF Grant $200,000