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The BWH Day Surgery Unit performs approximately 6,500 adult ambulatory surgical procedures per year. Both private and house staff physicians of most surgical specialties utilize the unit, including gynecology (the largest), plastics, orthopedics, urology, ophthalmology and general surgery. All forms of anesthesia are offered, with a special interest in ambulatory regional anesthesia: spinal, epidural, nerve block and intravenous regional. Patient population encompasses ASA I, II and III. The CA-3 or fellow subspecialty year in Ambulatory Anesthesia includes clinical practice, teaching, administration and research. The residents and fellows take night and weekend call in the general operating room pool with other residents, an opportunity to keep all of their anesthesia skills current. The trainee is given the opportunity to function as a "solo practitioner", to develop increased proficiency in administering anesthesia to ambulatory surgery patients. Experience in clinical skills includes pre-operative, intra-operative, and post-operative care of ambulatory patients. Opportunity is given to administer anesthesia in non-operating room settings. The trainee is central to the clinical teaching program for junior residents rotating on the service, to develop experience as a teacher of ambulatory anesthesia. The CA-3 or fellow is expected to teach the pharmacology of appropriate anesthetic agents, as well as personal (interactive) and technical skills. The trainee also acquires experience teaching and supervising CRNA's in their practice of ambulatory anesthesia. The trainee develops experience in the administration of an active ambulatory surgery unit, and in the role of the anesthesiologist as Medical Director. Administrative experience includes the application of unit policies to specific situations in the daily functioning of the unit, such as patient suitability for anesthesia or readiness for discharge. The trainee participates in development and revision of the unit's medical policies and is given tutorial and reading material on the establishment of this and other ambulatory surgery units. The trainee is involved in clinical research. Areas of current interest include evaluation of established and novel general and regional anesthetics, antiemetic agents, the identification of appropriate monitoring and anesthetic follow-up (quality assurance). Beverly K. Philip, MD Director of Ambulatory Anesthesia