Anesthesia, Pain Management and Perioperative Medicine

Location:	QEII - Health Sciences Centre 10 West Victoria 1276 South Park Street P.O. Box 15000 Halifax, NS B3H 2Y9
Telephone:	(902) 473-2331

The Department of Anesthesia, Pain Management and Perioperative Medicine provides general, regional and local anesthesia for all types of general surgery, neurosurgery, cardiovascular surgery, urology, gynecology, plastic and orthopedic surgery, and obstetric and pediatric anesthesia in the operating and case rooms of the hospitals affiliated with Dalhousie University. It has intensive care responsibilities and consultative services in most hospitals. The department at the Queen Elizabeth II Health Sciences Centre is jointly responsible with the Departments of Surgery and Medicine for intensive care activities. The Department at the IWK Health Centre is responsible for ICU activities at the Children’s site. Additionally, the department operates pain clinics at the QEII Health Sciences Centre, IWK Health Centre, Hants Community Hospital and the Saint John Regional Hospital.

Its faculty is well equipped to teach all aspects of medicine related to anesthesia and acute care medicine and illustrate the application of the basic sciences of physiology, pharmacology and anatomy to anesthesia. The department is actively involved in the undergraduate medical education program through the Case Based Learning (CBL) tutorials, electives, lectures and clerkship.

Electives

First and second year

One half day per week may be taken as an elective in anesthesia acquiring specific skills or investigating a particular topic, furthering their knowledge of perioperative medicine and gaining skills in airway management, ventilation and I.V. access.

Third year

Students may choose to complete a combined ICU/Anesthesia selective rotation within the Internal Medicine block. Students who choose this four-week rotation will complete one week of anesthesia, which will allow them the opportunity to gain or further their knowledge in anesthesia techniques.

Fourth year

Students may chose two to three weeks anesthesia as an elective to further practice the basic skills associated with airway control and ventilation. These rotations can be completed in various areas of anesthesia, including Pediatric Anesthesia, Pain Management, and Obstetrical Anesthesia. Various elective options are available at our teaching sites throughout the Maritimes.

Residency Training

The anesthesia residency program a competency based program designed for five years in duration, meeting the program requirements of the Royal College of Physicians and Surgeons of Canada. Participating hospitals are QEII HSC, IWK Health Centre and the Saint John Regional. The program in anesthesia contains four levels of training. 

1. Transition to Discipline - 2 blocks of Orientation in non-subspecialty anesthesia
2. Foundations - 23 blocks of fundamental anesthesia, medicine, surgery, pediatrics, obstetrics, critical care, pain/regional, and elective/remediation
3. Core - 27 blocks of subspecialty anesthesia, medicine, critical care, and elective/remediation
4. Transition to Practice - 13 blocks allocated but may be completed in a minimum of 5 blocks; includes complex anesthesia, obstetric anesthesia, pediatric anesthesia, critical care, teaching, and elective

Transition to Discipline

This 8 week stage emphasizes the orientation and assessment of new trainees arriving from different medical schools and programs (including outside Canada). It includes orientation to academic, administrative and clinical components required to succeed early in the Dalhousie Anesthesia Program. New residents are matched with 3 clinical mentors who they will work with over the 8 weeks, one of whom will become the resident's academic advisor for their residency program. The clinical orientation also includes basic teaching sessions and an intensive simulation curriculum on management of common intraoperative problems.

Foundations

This 23 block (1 block = 4 weeks) stage covers broad-based competencies that every trainee must acquire before moving on to more advanced, discipline-specific competencies.  The stage is comprised of 9 modules including:  Airway and ENT, Perioperative Medicine, Surgery, Obstetrics, Pediatrics, Cardiovascular, Pain and Regional, Emergency and Critical Care and Other.  Each module helps the resident to focus on basic assessment and knowledge of anatomy, physiology, and pharmacology combined with their application to anesthesia.  For example, the ENT and Airway module includes one block on ENT surgery and 2 blocks of Airway anesthesia.  The Obstetrics module includes one block of actual obstetrics and one block of obstetrical anesthesia.  The rotation designated as "Other" can be used for research, elective or remediation and allows for flexibility within the Program.

Core

This stage includes all the major subspecialty areas that make up the discipline. Residents rotate though twelve modules over 47 blocks.  Modules include Pediatrics, Neuro, Obstetrics, Cardiovascular, Thoracic, Complex Surgery, Community and Remote anesthesia as well as Perioperative Medicine, Pain and Regional, Emergency and Critical Care Medicine and Other.  The Community rotations in both Core and Transition to Practice take place in New Brunswick (Moncton or Saint John) and are an integral part of the program.  

Transition To Practice

This stage of residency is designed to promote independent practice.  Residents will complete a minimum of 5 blocks including Pediatrics, Obstetrics, Complex Surgery, and Community anesthesia as well as Critical Care.  The other 8 blocks can be used for electives or research.  Most residents will require the full 13 blocks however it may be possible to finish early if the resident is able to defend their portfolio to show that they have met all the required competencies and training elements. 

Research 

There is a formal course on research methodology and critical appraisal. There is an active journal and research club. Completion of a scholarly project during training is mandatory. Major areas of research activity in the department include pediatric and adult pain, airway management, obstetrics, cardiovascular and ambulatory anesthesia.

Academic Curriculum

Residents are released from clinical duties on Wednesday afternoons to attend the academic program.  A completely renewed curriculum was rolled out for the 2013 academic year. 

Residents at the Foundations stage, participate in the Foundations Program which concentrates on basic principles of anesthesia including preoperative assessment, pharmacology and physiology, anesthesia equipment and anesthesia practice.  Teaching is mostly case based, simulation, and small group learning. 

Core residents attend the Core Program which runs over 2 years and covers all subspecialties. Again, teaching is mostly case based and simulation.   The Transition to Practice year will concentrate on exam preparation and independent practice.

Continuing Professional Development

The Department of Anesthesia, Pain Management and Perioperative Medicine’s Continuing Professional Development program is designed to provide education opportunities for members of the department, our community partners and the broader anesthesia community. Opportunities provided through the Office of Education are of the highest quality, are timely in their development and are available to all members of the department and its community at large. Regular activities within the department include grand rounds, subspecialty and critical appraisal journal clubs, workshops and seminars. As well, physicians and allied health professionals from other departments partake in many of our continuing professional development activities.

Fellowships

The department offers fellowship programs in six specialized anesthesia areas including women's and obstetrics anesthesia, airway, cardiac anesthesia, regional anesthesia and acute pain, chronic pain and global health. These programs ensure optimal patient care while offering plentiful opportunities for the fellows to develop skills in clinical care and judgment, teaching and research.