History and Evolution of Anesthesia Education in United States Mian Ahmad * and Rayhan Tariq Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, Philadelphia, PA, USA *Corresponding author: Mian Ahmad MD, Vice-Chair Education, Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, 245 N. 15th Street, MS 310, Philadelphia, PA 19102, USA, Tel: 215-762-8936; Fax: 215-762-8656; E-mail: mian.ahmad@drexelmed.edu Received date: Jun 11, 2017; Accepted date: Jun 19, 2017; Published date: Jun 22, 2017 Copyright: © 2017 Ahmad M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Resident education is both, a science and an art. Quality and homogeneity of resident education has a considerable correlation with patient safety. This article appraises how formal training in anesthesiology was started in United States and how it has evolved over the years. A comprehensive literature search was performed to identify journal articles, periodicals and historic documents that detailed the development and progression of academic anesthesiology. Various Anesthesiology Departments were also consulted. In 1927 Dr. Waters established the first ever academic department of Anesthesiology at the University of Wisconsin, Madison. The graduates from that residency programs, the so called “Aqualumni” went on to establish residency programs throughout the country. In 1938 American Board of Anesthesiology was formed, elevating the level of anesthesiology to a distinct specialty. World War II and post war era was a period of rapid growth in anesthesiology in general and academic anesthesiology in particular. In late 1970’s and early 80’s American College of Graduate Medical Education (ACGME) closely regulated the anesthesiology residency programs by recommending minimum program requirements. Over the years the training model has transformed from a relatively heterogeneous one to a uniform outcome based model with focus on learning and teaching of 6 core competencies. This article explores how the anesthesiology education evolved throughout 20 th century to its present form. Keywords: Academic; Education; Residency; Internship; Anesthesiology history; Training; ABA; ACGME Introduction Today residency is considered to be the essential dimension that ensures the transformation of a graduating medical student into an independently practicing physician. Te training model was not as clear in early days of medical education. Medicine had utilized the same apprentice based model that other trades were using to train the artisan of the next generation. An interested individual would get attached to a practicing physician, observe him dealing with patients and over time learn the knowledge and skills which enabled him to diagnose and treat conditions that patients presented with. Very slowly this model evolved into a structured and process based training. Anesthesia training however, never really followed that pattern. Initially, surgeons administered anesthetics to their patients and then directed nurses to do the same. Physicians interested in this branch of medicine had to teach themselves and soon felt the need to improve upon the technical and cerebral part of anesthetic administration. Tis article is meant to review the diferences between these early anesthetists and the physicians certifed by American Board of Anesthesiology to be the anesthesiologists practicing this specialty of medicine today. Even more importantly, it is going to examine the content and structure of education as it has evolved overtime. Te Early Years: 1900-1920 Surgery has existed long before anesthesiology, but before anesthesia, surgery was a means of last resort. Te notion of undergoing surgery was so painful that many would prefer to allow a disease to run its natural course than going under the knife. Te greatest development in history of medicine no doubt is the ability to alleviate pain during surgery and essentially making modern surgical practice possible. Although the frst public demonstration of General Anesthesia was in 1846 by a dentist at Massachusetts General Hospital, the growth of anesthesiology as a specialty was slow [1]. For most of the early 20 th century Anesthesiology remained a neglected feld because of the general perception that very little training was needed to administer anesthetics. During most of the early part of the 20 th century instructions in anesthesia were nonexistent and the specialty was being practiced only by a few self-taught individuals [2]. Among them was James T. Gwathmey who authored the frst authoritative text on the subject in 1914. His book “Anesthesia” would remain a valuable educational resource over the next few decades [3]. He was the frst president of the American Society of Anesthetists, later renamed American Society of Anesthesiologists (ASA) [4]. He, along with other regional anesthesiology societies emphasized the need to give organized instructions and training in Anesthesia. In 1924, McMechan started the frst journal in the specialty; Anesthesia and Analgesia [5]. Previously American Journal of Surgery used to publish quarterly supplements on anesthesia and analgesia. In 1940 Henry Ruth started Anesthesiology, the ofcial journal of ASA. During these early years there was a gradual movement towards establishment of Anesthesia as distinct medical specialty that should be practiced by physicians. History of Anesthesiology residency training was interlinked with the push for specialty status for Anesthesiology in the late 1920's and 1930's. Ahmad and Tariq, J Anesth Clin Res 2017, 8:6 DOI: 10.4172/2155-6148.1000734 Research Article Open Access J Anesth Clin Res, an open access journal ISSN:2155-6148 Volume 8 • Issue 6 • 1000734 J o u r n a l o f A n e s t h e s i a & C l i n i c a l R e s e a r c h ISSN: 2155-6148 Journal of Anesthesia & Clinical Research