ANESTHESIOLOGY

Department ofAnesthesiology and PerioperativeMedicine

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We provide the highest quality programs to enable our residents to become confident, successful anesthesiologists.

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Overview

In order to achieve this goal, we have developed a comprehensive fiveyear program that is fully accredited by the Royal College of Physiciansand Surgeons of Canada. Given that our focus is to prepare trainees for careers in a variety of settings, we encourage them to be adaptableand practice in a realistic environment. Queen’s University launched a Competence by Design curriculum for our Anesthesia Residencyprogram in July 2017. A competency based medical educational design, determines what are the defining characteristics of a skilledanesthesiologist, and the program is structured around achievement of the competencies required for successful practice. The emphasisshifts to the learner to demonstrate that they can do a task, as thegoals are now knowledge application rather than knowledge acquisition.

The Kingston Health Science Centre composed of Kingston GeneralHospital and Hotel Dieu Hospital provides ample clinicalopportunities for our residency program in all subspecialties includingcardiothoracic, pediatric, neurosurgery, and obstetrics, to acute painmanagement, regional and orthopedics. Residents are continuouslyexposed to all areas of anesthesia and have input into their roomassignments through the Resident Manager. More than 50% of oursurgical cases are ASA 3-5, as one would expect in a tertiary centrewith a large catchment area. Graduating residents feel extremelyconfident in managing the most complex traumas or patients withmultiple medical comorbidities.

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Competency-Based Residency

Our program remains 5 years in length and is divided upinto 4 stages; transition to discipline (2 four-week-blocks),foundation (18 blocks), core (36 blocks) and transition topractice (9 blocks). Each stage is organized around anddefined by measurable Entrustable Professional Activities(EPAs) that must be attained by the end of each stage. AnEPA is an activity or a task that the learner ‘does’. TheseEPAs are uniform and consistent in all programs acrossthe country. Assessment strategies will be linked to eachEPA to facilitate multiple assessments and feedbackopportunities for the learner. Each EPA will be comprisedof many milestones that outline the progression and spanthe seven CanMeds domains.

Time becomes a resource rather than a prerequisite forprogram completion, with the recognition of a necessarytime structure in order to provide health care services.The curriculum is divided into rotations or ‘modules’similar to a traditional residency in order to coveressential services and have an on-call schedule, but wehave the freedom to improve their design in order toachieve the desired end product.

The academic program is delivered during a protected halfday weekly. There are 3 separate programs; an introductoryTransition to Discipline orientation, one Foundations level,which cycles yearly, and a final Core level on a two-yearcycle. The academic program may not necessarily coincidewith the clinical rotation that the resident is doing at thatparticular time, but rather will be done as a group forfeasibility as well as to foster teamwork and collegiality

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On Call Duties

While on call, our residents areavailable for any type ofemergency, a cardiac arrest or as a member of the trauma team, as well as to provideanesthetic services for all surgicalprocedures from obstetrics tocardiac to neonatal surgery. Due to the wide variety ofclinical problems encounteredduring a typical night on call,our residents are paired witha more senior resident for theirfirst four months of call. Thisallows the junior resident toseek advice and assistance atany time. Clinical duties whileon call begin at 1530h until0800h the following morning.The pre-call time is used foracademic requirements, such as research, preparing rounds,independent study, andattending academic events. Theresident call schedule mirrorsthat of our staff.

Electives

Up to six months of elective timecan be used throughout thestages to further explore areas of interest. We encourage allresidents to take advantage ofthis excellent opportunity todevelop their clinical skills andbroaden their experience withindifferent health care centreseither in Canada or abroad, orto focus on potential subspecialtyareas. Many of our residentshave used this time to pursueinternational electives, either incentres of international repute or in a developing nation. If aresident has not completed theirEPAs for their stage, then theelective time is used as anopportunity to complete thesehere in our centre.

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Anesthesia Simulator

Our Anesthesia Simulator Program is one of our highlights.All of our residents attend the simulator lab regularlythrough out the year. There is exposure to a variety ofcritical clinical scenarios in multidisciplinary settings.Hands-on experience and in depth de-briefing afterwardsare cornerstones of the program. The AnesthesiaSimulation Program is a well established and effectiveeducational tool for both formative feedback andsummative assessment. Simulation has become essentialin developing skills in crisis resource management and is most rewarding from the residents’ point of view.

Echocardiography

One of the fastest growing technologies in medicine is diagnostic ultrasound. We offer dedicated training inultrasound guided regional anesthesia and ultrasoundguided vascular access early in the program. In addition,we have developed a comprehensive curriculum oftransthoracic echocardiography training, and were thefirst Anesthesiology training program in Canada to offer training in focused bedside TTE to all our residentsintegrated within a core rotation.

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Scholarship

All of our residents are encouraged to develop a spirit of academicinquiry. Participation in scholarly work is mandatory. Opportunities togain skills in teaching and medical leadership also exist at Queen’s andare supported by the department. Our department supports the residentsto attend conferences and to present their work. Each resident is entitledto conference support of up to $3000 plus additional support forpresentation of individual research. In addition, a book allowance isgiven annually to each resident.

Collaborative Environment

Our program strives to foster independence at an early stage within asafe, comfortable and collegial learning environment. Our staff membersquickly learn your strengths and weaknesses and can focus their attentionand challenges appropriately. Seeing our residents’ progress is our mainfocus. The feeling of belonging extends to the whole of postgraduatemedicine at Queen’s. Residents in anesthesia quickly get to know residentsin other specialties due to their interaction during patient care on adaily basis. This fosters the communication and collaboration that isessential for optimal patient care.

Our residents are part of our team, and we work hard to develop andmaintain a well-functioning, friendly environment. Residents are ourcolleagues and we take pride in watching their knowledge, skills andattitudes evolve. Mentoring our residents as they pass their exams andsecure desirable fellowships or staff positions is one of the main reasonswe work in this centre. Another is that Kingston is a great place to liveand work. We welcome you to join our team.

18-0394Queen’sUniversity M

arketing

DEPARTMENT OF ANESTHESIOLOGY

Victory 2Kingston General HospitalKingston, OntarioCanada k7l 2v7613-548-2482

anesthesiology.queensu.ca