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Guest TimmyMax

Anaesthesia!

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Guest Jag

So when can you be called a doctor? After your last rotation, or after you pass you licensing exam? When do those exam results come back?

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Guest kosmo14

You can be called a Dr. when you convocate from your respective University. The title Dr. comes from your degree rather than the results of the exam. If you fail the LMCC you will still be a Dr. but may have to have orders co-signed until you pass it. You can rewrite in the fall. Results usually out end of June.

 

Good luck Timmy, I write tomorrow.

 

I do get a kick out of the fact that you start residency orientation on the 28 of June. We actually get to wait until July 4.

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Guest kosmo14

Another thing to add, will I feel like a Dr.? After studying for this exam, not a chance. I feel dumber with each chapter of TO notes I read.

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Guest TimmyMax

Hey,

 

Yeah, like kosmo said, we don't officially get the title of 'doctor' until the end of our convocation ceremonies. At the end of the UWO ceremony, when the time comes, near the end of the ceremony, whoever is presiding will say something to the effect of "Doctors, please rise!" or something along those lines and that will be the first time that we are "officially" addressed with the term "doctor" and can "officially" respond. After that, the rest is gravy.

Other than that, best of luck with your little quizzie, as they like to call it in these parts, kosmo! It's good to know that I'm not the only one who feels more and more inept in their medical knowledge with each page-turn of the Toronto Notes! I just read a big pile of paediatric genetic conditions that I'm never going to remember for a week from tomorrow! Let us know how it goes, specifically what all the questions were and what you put for them! ;)

 

Best of luck!

Timmy

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Guest lilninjastardoc

Should we let nurses deliver anesthetics?

They do in the U.S. and other nations

Allowing it here could cut wait time

May 6, 2006. 01:00 AM

PETER KRIVEL

STAFF REPORTER

 

 

Shai Goel is studying at the University of Pittsburgh to be a nurse anesthetist and would love to return to Toronto to practise.

 

But he knows that isn't likely.

 

"I'm not expecting nursing anesthesia to come to Canada tomorrow," says Goel, who graduated from the University of Toronto and practised nursing at Toronto Western and General hospitals.

 

Nurse anesthetists — nurses with master's degrees who administer 66 per cent of anesthetics given to patients each year in the United States — are one of the profession's most desired specialties, with a starting salary in 2003 of $120,000 (U.S.), according to the American Association for Nurse Anesthetists.

 

Nurse anesthetists practise in 30 countries other than the U.S., but not in Canada, even though they could play a major role in cutting down wait times for surgeries here, critics say.

 

Nurse anesthetists are the sole anesthesia providers in two-thirds of all rural hospitals in the U.S. But only doctors are allowed to administer anesthetics in Canada.

 

"From the moment the wait time strategy was initiated a year and a half ago, lack of anesthesia services was signalled as a major issue and it remains so today," says Dr. Alan Hudson, the chair of Ontario's Wait Times Strategy, a group working to reduce wait times in the province.

 

The closest Canada comes to nurse anesthetists are anesthesia assistants, who train in programs at Thompson Rivers University in Kamloops, B.C. and the Michener Institute in Toronto. But graduates are not allowed to dispense anesthetics.

 

Ontario's health minister, George Smitherman, "promised me that there will be nurse anesthetists," says Doris Grinspun, executive director of the Registered Nurses Association of Ontario.

 

"They initiated the role of anesthesia assistant. That is very different and we're not in support of it. It's a role that will need to be totally supervised. It doesn't have the in-depth education of nurse anesthetist. It's a Band-Aid solution."

 

 

--------------------------------------------------------------------------------

`In the U.S., you will see one doctor to three or four nurses; here, we have a large group of physicians and one nurse'

 

Doris Grinspun, executive director, Registered Nurses Association of Ontario

 

--------------------------------------------------------------------------------

 

 

Health ministry spokesperson John Letherby says, "the ministry recognizes the shortage of anesthetists and the need to ensure access to needed surgery. We remain open to exploring a range of options for health human resources to address these issues, now and in the future."

 

The Ontario Medical Association has erected a lot of the barriers against nurse anesthetists, Grinspun says.

 

"We need to decide: are we going to serve one profession or the other? Or are we going to serve the public together?

 

"If it's to serve the public, then we need to move to the role of nurse anesthetists."

 

Dr. Stephen Brown, chair of the section of anesthesiology for the Ontario Medical Association, says the OMA's believes nurses have a vital role to play in the delivery of anesthesia care.

 

"We have developed a model with the Ministry of Health and Long-Term Care that will help to improve wait times. This model has nurses working as anesthesia assistants under the direct supervision of an anesthesiologist. We believe these types of care teams are an innovative approach to address the shortage of anesthesiologists. This position is consistent with that of the Canadian Anesthesiologists' Society, The College of Physicians and Surgeons of Ontario, and the Ontario Medical Association."

 

As to whether the Ontario Medical Association sees nurse anesthetists as moving into their territory, Brown responds:

 

"All doctors, including anesthesiologists, support working with other health care professionals to bring the best possible care to patients in Ontario.

 

"We support attempts to bring innovative solutions that improve patient care and maintain patient safety."

 

Grinspun sees other expanded roles for nurses, which might involve endoscopies, cataract clinics for post surgery, incontinence treatment, pressure ulcers and education for the management of asthma.

 

"In the U.S., there are nurses who run clinics for primary health care," she says. "You will see one doctor to three or four nurses. The access is huge. Here we have a large group of physicians with one nurse.">:

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Guest pappy mckeys

What's with the red angry face at the end of your post? Maybe you could elaborate?....

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Guest lilninjastardoc

www.thestar.com/NASApp/cs...5373949365

 

oh..what I meant is that there's this whole nurse/MD turf thing...which I thought was limited to Family docs and nurse practitioners....and now it seems like nurses what to do some anesthesia, and some docs dont wanna give it up - see the comment made my OMA - he's just skirting the issue tactfully...

 

my take on is - why can't we all get a long! :P

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Guest TimmyMax

Hey,

 

I finally got part of my rotation schedule, almost the instant after I had last posted, whining that I hadn't heard anything so far- I guess the squeaky wheel does get the grease! Argh, sad, but so true! (Just for the record, I didn't email the central scheduling committee or anything whining about not hearing anything thus far- I waited things out, the old-fashioned way!)

So yeah, at UWO, we do 3 months of anaesthesia in PGY-1, and I found out that I have been scheduled to do my anaesthesia time next summer (April-June), which is just fine with me, because it will be a natural lead-in to PGY-2, where we do mostly anaesthesia anyway, so it's all good in the 'hood! It was kind of cool, the email that they sent out to us- it was actually a very-complicated-looking MS Excel spreadsheet with about 60 names on it- all the anaesthesia residents at UWO, plus every other resident who was doing a rotation in anaesthesia- this includes the ER residents, some fellows, some surgeons- fun stuff! You could look people up and see when they were passing through- since UWO matched both of their ER spots to UWO students, I was able to look up my two classmates to see when they would be passing through the department. Of course, there were complete rotation schedules for the anaesthesia PGY-2s and above, but for everyone else, including us poor, lowly PGY-1s, there was just the timing of our anaesthesia rotations and nothing else, so that kind of sucked.

Anyway, London does all of their PGY-1 rotation scheduling en masse, so I won't find out until mid-June, according to the rumours. At this point, I'd be happy to start with anything except for ICU. Why? Because in your first month of residency, you won't know anything anyway, and thus your first rotation will be a bit of a free-fall as you struggle to figure out what it is exactly you are supposed to be doing on whatever service you're assigned to. Since ICU is something that I could very well end up doing, I don't want to be useless for that month and basically have it pass me by. I'd much rather start with something easy, like Gen Surg or OB/GYN, but that's just my preference. Unfortunately, if that were the case, I'd likely be starting the year down in Windsor, which would mean a snap move at the beginning of July, three days after I get back from New Zealand, but anh, I guess those are the breaks.

I was informed that since they don't have a Paeds ER rotation down in Windsor, I'll only be down there for two months next year, which is just as well, since they actually have a Paeds ER in London, whereas they don't in Windsor, and I'd much rather do Paeds ER in London anyway. The only reason I asked for a Paeds rotation in Windsor is because I thought that we had to do 4 weeks of Paeds ward in PGY-1. I guess that we don't, so that's out of the question, which kind of bites, because the Paeds team in Windsor is top-notch- as good if not better than the team here in London. I did my Paeds clerkship down in Windsor and it was nothing short of awesome! That's why I threw in originally to return there for Paeds, but I guess it's not meant to be. Oh well, there's always electives, I guess!

Anyway, I finally sent in my CPSO and CMPA forms. Another financial kick in the crotch, but to be honest, there's not much you can do about it. The further you get along, the more you realize that a lot of things are just shameless cash-grabs. Like the $680 sitting fee for LMCC Part I. Or the $1400 sitting fee for LMCC Part II, which becomes $2100 if you miss the registration deadline! I'm dreading how much my Royal College exams are going to set me back!

Anyway, that's pretty much all that's new in my world. I wrote the LMCC Part I this past Friday. It had its incredibly difficult moments, its easier moments and all ranges in between. Here's hoping that I passed, because I would hate to have to write that thing again in October! Boo!

I'll post again when something else happens, but between now and July 1st, I've got medicine convocation on Friday (woo!) and a flight to Auckland, New Zealand on the 27th! If you don't hear from me after the 27th, you'll know where to find me (sort of)!

 

Best of luck!

Timmy

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Guest TimmyMax

Hey,

 

Since the CaRMS stats have recently been released for 2006, I just thought that I'd give a little anaesthesia post-mortem for those that are interested...all numbers refer to Canadian medical graduates and 1st iteration unless stated otherwise...

(All numbers and stats can be found here:

www.carms.ca/jsp/main.jsp?path=../content/statistics/report/re_2006)

 

Applicants to anaesthesia as only discipline choice: 41

Total applicants to anaesthesia: 170

Applicants listing anaesthesia as their 1st choice discipline: 113

 

Total anaesthesia residency spots available: 100

Total anaesthesia residency spots unfilled after 1st iteration: 2 (both at MUN)

 

Total matched to anaesthesia in 1st round: 98

Total matched to anaesthesia in 1st round listing anaesthesia as 1st choice discipline: 94

Total matched to anaesthesia in 1st round listing anaesthesia as 2nd choice discipline: 2

Total matched to anaesthesia in 1st round listing anaesthesia as 3rd choice discipline: 2

Total matching to other disciplines listing anaesthesia as 1st choice discipline: 12

Total unmatched listing anaesthesia as 1st choice discipline: 7

 

Total IMG applicants to anaesthesia: 12

IMG applicants listing anaesthesia as their 1st choice discipline: 5

IMGs matched to anaesthesia listing anaesthesia as 1st choice discipline: 1

IMGs matched to other discipline listing anaesthesia as 1st choice discipline: 1

IMGs unmatched listing anaesthesia as 1st choice discipline: 3

 

An interesting caveat to keep in mind is that of the 100 spots available in anaesthesia, 22 of them belong to the 3 francophone schools (Montreal, Laval and Sherbroooke), leaving 78 spots for us poor saps who aren't bilingual, such as myself.

The remaining residency spot was matched in the 2nd round to a CMG who had gone umatched the year before (2005) and unmatched in the 1st round of 2006.

Hope these figures help!

 

Best of luck!

Timmy

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Guest TimmyMax

Hey,

 

Sorry about the late post- I've been in New Zealand for all of June as my graduation present to myself- awesome trip, btw, I was totally sad to have to come back- defecting there and getting a job did cross my mind, but I wasn't sure about their IMG policy so I elected against it. Better to stick with the sure thing (medical employment in Canada) I figured, but I'll definitely be looking into exchange or fellowship opportunities down there. If only the country wasn't located literally half a world away...

So I showed up for hospital orientation at LHSC on the 30th of June and surprisingly enough, my name was actually on all of the administrators' lists and they even had a new resident package with my name on it, confirming that the past few months hadn't been a dream after all. Along with the 150 or so other new residents, I found myself in a familiar place (Aud C at UH) listening to some hospital-affiliated person drone on about something or other and trying not to doze off. Not the greatest start to my residency career, but administrative @#%$, like MTV, makes me want to hurl. I was looking forward to the breaks when I could mingle with my classmates and meet some of the new faces that had made their way into our midst, in effect replacing my dearly (or not-so-dearly) departed colleagues. What can I say? Change is good.

After a ton of administrative special guest speakers, the content of which I don't care enough to get into, the morning session mercifully ended and I found myself waiting in line after line for pretty much every little administrative detail imaginable. Granted, UWO did get a lot of the stuff mailed out and taken care of ahead of time, but still, you had to line up to meet with someone to confirm all of the information you had submitted from a health perspective and get yet another Mantoux test (which, as an official M.D., you could read your own test after the required 48 hours- suh-weet!), which was followed by the inevitable N95 mask fit-testing in case SARS or LARS or Mad Cow or the plague or whatever breaks out again. There was a 'systems training' session held where one could learn about Powerchart and the other supposedly state-of-the-art hospital software, which sucks at best anyway as I remembered from personal experience, so I didn't bother going, opting to get lunch instead.

In the afternoon, there was a special session for the six new anaesthesia residents which matched through CaRMS and the others that were new in the program who had gotten in through other means, which consisted of two family docs doing a third year and two IMGs for a total of ten PGY-1s in the program. We were each issued a gigantic binder with the residency program information in it, the 5th edition Barash's 'Clinical Anaesthesia', a giant volume which is basically the biggest medical textbook I've ever seen! It'll be pretty daunting to eventually crack that puppy, no doubt!

Anyway, the long and the short of it is that I got my 'official' rotation schedule, which consists of the following:

 

July- Internal Medicine (aka: 'team')

August- Emergency Medicine

September- General Surgery (Windor)

October- OB/GYN (Windor- suh-weet!)

November- Ambulatory Medicine (Windor)

December- Paediatric Emergency (aka: screaming kids 101)

January- Respirology (aka: doling out puffers 101)

February- Intensive Care

March- Cardiology (aka: quoting random $hit from studies 101- barf!)

April-June- Anaesthesia (hooray!)

 

I start with Internal, which I wasn't too happy about initially, but then again, I guess you have to do team sooner or later, so it's probably best to get it out of the way, even though I would have preferred to start with something easier like General Surgery. I guess you can't have everything your way!

The one thing that I am happy about is that my ICU rotation is in the new year. I definitely didn't want to start with ICU, because as a new resident, I wouldn't know anything to begin with and therefore not get nearly as much out of it as I would if I had done it later in the year, so that worked out pretty well for me, I must say. Other than that, I can't say that I have many qualms with my schedule- there are three months to run the show in Windor on various services. I was kind of sad to learn that we don't get to do a month of ward paediatrics like I had originally thought. Oh well, maybe something to sign up for as an elective in later years if I want an easier rotation, I guess.

Anyway, that's the highlights from my first day of residency that I just wanted to post and share. I'll post some more stuff during the year as the need arises.

 

Best of luck!

Timmy

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Guest satsumargirl

Hey TimmyMax,

 

Thanks for keeping us posted :)

 

Quick question...I have managed to get a short elective in anesthesiology this fall. (just a 2nd year, so min 10 hrs).

 

Wondering if you have any advice on how to make the most of this elective?

 

I got "essential anesthesiology" from the library to skim over so I have some idea of what anesthesiology involves.

 

Other than that...any good things to know or ask or pay attention to when I am there?

 

Thanks :)

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Guest TimmyMax

Hey Sats,

 

Nice work! I think, however, that trying to bull your way through "Essential Anaesthesiology" might leave you missing the big picture. I'd recommend "Anaesthesia for Medical Students, a gray, spiral-bound book written by Pat Sullivan- it should be in your library as well. If not, ask your local anesthesiology department to borrow it. It's a much easier (and quicker) read and doesn't get too caught up in the technical aspects of things.

On your elective, you should really pay attention to how the anaesthesiologist does things and ask lots of questions. Read a bit about the drugs used and try to learn a bit about how they work- the Sullivan book is pretty good for that! Bone up a bit on your resp and cardiac physiology so that you can look like a star during the case, and be sure to introduce yourself to the patient and the OR nurses before each case. If the anaesthesiologist sees that you are pretty keen and eager to learn, they'll be more likely to let you do something, perhaps start an IV or attempt to intubate. Just don't forget your stethoscope and all will be good!

Above all, remember to have fun! Anaesthesia is a very light-hearted field and lot of fun, I find (when all goes well, of course)!

 

Best of luck!

Timmy

 

P.S.: When in doubt, the answer is almost invariably hypotension!

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Guest noncestvrai

My advice, even though I only did a week of anesthesia, is open your eyes, look at stuff, monitors, and ask questions. I read important parts of that small grey book, I was fine for the pimpimg sessions. The most you do the better, don't be shy, they'll help you out before you chip a few teeth. Look at the chest when you bag, auscultate the chest and so forth...

 

LOOK at what your teacher does when putting IVs, remember the bigger the number the smaller the needle, and you don't have to cut the arterial circulation when you put a tourniquet...

 

For me it was the best week of my all first 2 years of med, they even let me put some propofol in the line!

 

Good luck and enjoy!

 

noncestvrai

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Guest satsumargirl

Thank you both for your advice...I will try and find that book, it doesn`t look like our library has it.

 

I am looking forward to this elective. Both times I was in the OR I was kind of wishing I could see more what the anaesthesiologist was doing.l :D

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I am hoping to specialize in anaesthesia. Really appreciated the insights posted by TimmyMax and Kosmo. Just hoping somebody is able to advise me re: planning electives. Feel ill-equipped to do so at this point and don't have too many contacts. For our school, we are mandated to do electives in at least 3 specialities and I'm wondering which 3 might be most useful. Also wondering how long at an anaesthesia elective is sufficient to get a good grasp of the program at a particular location and get a good reference. Is it frowned upon to do all/most electives in one location (home or close to it) as I have family commitments that limit my ability to travel for any length of time (ie new baby)? Thanks for any advice anybody can offer.

lcc

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Hey,

 

Perhaps I can help. Areas that are complementary to anaesthesia include internal medicine (especially Resp and Cardio) and critical care. One could also make a case for surgery, Ob/Gyn, ER and paediatrics, since those areas encompass the remainder of your patient population and procedures.

As for a seeming lack of contacts, I wouldn't sweat it too much. What I would advise is going on the CaRMS website and getting the email addresses of the program directors and secretaries of the schools you are interested in applying to and sending them an email asking for an elective. Email both at the same time- the PD will invariably refer you to the program secretary, but this way you kill two birds with one stone- your elective request is submitted and you make your interest known to the PD at the same time.

As for where you do your electives, if I was reviewing an application and saw that a given applicant had done 8 anaesthesia electives, all at UBC, I would be very reluctant to offer that person an interview, since it would appear that that person wants very much to stay at UBC for residency. I did two away electives, and went on the idea that away electives demonstrate a willingness to go elsewhere, which is what they represent. Ideally, you should do electives at every school before deciding, but the reality is that you only have so much elective time, and the various programs know this. In addition, away electives cost a lot of money, which doesn't help. Nonetheless, I tried to make my choice of away elective locations as broad as possible, although I was limited by the financial side of things. That's the main idea, anyway.

Above all else, make sure that you do an elective at the schools you ultimately want to match to! Some programs will ask you why you didn't do an elective at their school, especially if you say in the interview that their school is your number one choice. If you don't have a good answer for that question, then that's pretty bad form if you ask me.

Anyway, that's all I've got for now. It is possible to get a strong reference letter after only a 2-week elective, but it can be tough, especially if you are away. That's why I'd recommend doing 2-week anaesthesia electives at your home school (since you know the environment and hopefully some of the routine there) and 3-week anaesthesia electives everywhere else (one week to get oriented and learn the routine, a second week to hone your skills and a third week to impress). That's just the way that I would do things if I had to go through CaRMS again (thankfully I don't!).

Hope this helps and good luck with your (awesome) choice of career! :)

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Hey,

 

Anesthesia at UBC was great. I am not considering it as a future career but I got to do a lot as a 3rd year medical student. Most of the docs let us do spinals, epidurals, IVs, LMAs, and intubate. Teh hardest thing was getting the nurses to let us do IVs as they often didn't know us, and accordingly, didn't trust us.

 

At UBC, you can choose to be placed with one preceptor or have a different one everyday.

 

Cheers,

Physio

 

It's great to be back after a 5 month hiatus!

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Hey everyone,

 

Just thought that I'd post a little something about my first PGY-1 year in anaesthesia, I mean, my rotating internship. Here are my rotations for the year:

 

July - CTU aka team medicine (Barrrrf! Glad that one's over! I'll never have to do team again- hooray!!!)

August - Adult ER (Glad that one's over as well- ER is cool at times, but definitely not for me. I did get to tube somebody, so that's decent)

September - Gen Surg (Did this one in Windor and had a blast! Hooked up with my old supervisor from my medical student days and all was good. Great month!)

October - OB/GYN (Again in Windor- top-notch group of OB/GYNs down there! By the end of the month I was doing the anaesthetic for all of the GYN procedures. Avoided GYN clinics like the plague. Caught some babies while I was at it, too)

November - Ambulatory Gen IM (Windor again. Thought I'd hate this one as well, but it was really educational and enjoyable! Great group of general internists down in Windor and one of my fave rotations thus far)

December - Paeds ER (Back in London. Jury's still out on this one- lots of family medicine-type problems without much educational value but so far so good)

January - Respirology (Definitely one of my least favorite two weeks as a medical student, but I looked at the roster and my team is pretty cool)

February - ICU (Daunting but exciting- definitely looking forward to this one)

March - Cardiology (More Eternal Medicine...sigh)

April-June - Anaesthesia!!! (Yesss! The light at the end of the tunnel!)

 

So there you have it. Halfway through the year and that's what a typical anaesthesia PGY-1 year at UWO looks like. Sometime soon, I'll be meeting with my Program Director to discuss and plan the next four years of my life, during which I'll have to complete 6 months of Critical Care, 6 months of Internal Medicine and 24 months of Anaesthesia. Pretty sweet, eh? Yeah, I thought so!

 

Timmy

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Thanks for keeping us posted on your experience Timmy. Anaesthesia is (to my surprise) on my radar. My main concern is ability to maintain a good family life with this career path. Please keep the tidbits coming.

 

Cheers,

UBCmed09

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Hey,

 

Personally, I haven't heard too much on the subject here in Canada and I really can't see it happening any time in the near future. For starters, the idea of having one anaesthesiologist supervising multiple nurse anesthetists or anesthesia assistants while they give an anaesthetist goes against the CAS guidelines of one anaesthesiologist to one patient, a rule that is cardinal and must be respected and adhered to at all times, which is why you rarely see an anaesthesiologist in charge of more than one resident at any one time (and should not). While things may be different in the U.S. and nurse anaesthetists may give 67% or however many percentage of the anaesthetics in the U.S., you have to remember that this is Canada and the U.S. does a lot of things differently than we do in the field of medicine.

Personally, I don't like the idea of training someone to give what is essentially "cookbook" anaesthesia who is not trained to deal with all of the complications that can potentially arise while someone is under, which is why the program takes five years and not two (or one) to complete. It creates a potentially dangerous situation where an anaesthestists would have to be multiple places at once, dealing with multiple crises at once and that's bad medicine in my books. Therefore, I cannot support such an idea at this time and I do not feel that it is the future of this field.

Maybe kosmo can chime in with his opinion, but that's how I feel on the issue. I'll definitely become more informed on the issue in terms of goings-ons once my rotating internship finishes and I actually get to do some anaesthesia, but until then, I don't believe that this is the future of the field.

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I think that the model of current anesthetic practice will certainly change. This is likely due to the pressure of governments to provide healthcare reform. The problem is many decisions are made by those who have little to no relevant medical knowledge. The CAS president is a practicing anesthesiologist at our school and member of our faculty. I have had the opportunity to be in his room numerous times, and we discussed this in quite a bit of detail. I certainly think we will see some form of assistant attending to the easier low risk cases in the future, while the anesthesiologist will be responsible for supervising these assistants and dealing with the more complex high risk cases. I think if this is to happen the must be some sort of accredited schooling for these assistants, and the public is willing to accept the risk. There is no question that anesthesia is safe today, but it is likely that safety is due to the vigilance and training of anesthesiologists. Will the safety profile drop with assistants running the rooms? I don't know. What I do know is that I have been is rooms where we have a ASA class I patient having minor surgury and for whatever reason s**t hit the fan, and if it weren't for the ability of the anesthesiologist to quickley assess the problem come up with a quick resolution things wouldn't have gone so well for the patient. That is where having 5 years+ of postgrad training plus a medical degree is of significant value to the patient. If it were my father undergoing a routine surgery I would like him to wait an extra 6 months for the surgery in order to have a anesthesiologist administer his anesthetic rather than an assistant under the supervision of the anesthesiologist.

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Hey,

 

Personally, I haven't heard too much on the subject here in Canada and I really can't see it happening any time in the near future. For starters, the idea of having one anaesthesiologist supervising multiple nurse anesthetists or anesthesia assistants while they give an anaesthetist goes against the CAS guidelines of one anaesthesiologist to one patient, a rule that is cardinal and must be respected and adhered to at all times, which is why you rarely see an anaesthesiologist in charge of more than one resident at any one time (and should not). While things may be different in the U.S. and nurse anaesthetists may give 67% or however many percentage of the anaesthetics in the U.S., you have to remember that this is Canada and the U.S. does a lot of things differently than we do in the field of medicine.

Personally, I don't like the idea of training someone to give what is essentially "cookbook" anaesthesia who is not trained to deal with all of the complications that can potentially arise while someone is under, which is why the program takes five years and not two (or one) to complete. It creates a potentially dangerous situation where an anaesthestists would have to be multiple places at once, dealing with multiple crises at once and that's bad medicine in my books. Therefore, I cannot support such an idea at this time and I do not feel that it is the future of this field.

Maybe kosmo can chime in with his opinion, but that's how I feel on the issue. I'll definitely become more informed on the issue in terms of goings-ons once my rotating internship finishes and I actually get to do some anaesthesia, but until then, I don't believe that this is the future of the field.

 

The only reason I was asking is because I got that OMA email about how they are fighting a proposal by nurses to add some nurse specialist roles, one of which is nurse-practitioner. That and the current state of affairs in the states, with their Anaesthesia society fighting a failing multi year and million dollar legal battle.

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Hi Timmy,

 

Can you suggest some anesthesiologists at UWO who's good to shadow? FYI, the UWO anesthesia website has been down for quite some time...it would be good to have it up so students can look up faculty members!

 

thanks,

ally

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