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The Neuroanesthesia Advanced Training Program at BWH is a rapidly expanding subspecialty section. We provide anesthesia for three operating suites four days per week. In addition, we are developing an intensive care facility dedicated to the special needs of the neurosurgical patient. The basic objective of a specialized rotation in neuroanesthesia is to provide the opportunity to manage patients with brain and spinal cord pathology. Many of these patients have intraoperative neurophysiologic monitoring as a routine portion of their care. The division also provides the opportunity for basic science and clinical research. The neurophysiologic monitoring provides training and experience with multichannel conventional and computerized EEG, auditory, visual and somatosensory evoked potentials. Intraoperative management also includes transcranial Doppler for carotid endarterectomy surgery and EMG monitoring for cranial nerve dysfunction. There is ample opportunity to participate in many other research projects which include motor evoked potentials and cerebral ischemia monitoring. Staff anesthesiologists are active in teaching both technical skills and the theoretical aspects of neuroanesthesia. The residents and fellows are encouraged to communicate their goals and objectives prior to beginning their rotation. The clinical case load is carefully assigned to assure that these goals are met. Each month the residents are presented a set of keyword based questions with answers and references as a means of self-assessment. In addition, a weekly seminar is available for those seeking comprehensive knowledge of neurophysiology. A senior resident or fellow is provided the opportunity to supervise and instruct junior anesthesia residents. The neurosurgical, anesthesia and nursing staffs work as a cohesive unit utilizing a multi-disciplinary approach toward patient care and clinical research. The residents and fellows take night and weekend call in the general operating room to keep all of their anesthesia skills current. Linda S. Aglio, MD Director of Neuroanesthesia