Transition to Discipline Bootcamp - W Anesthesia- W Anesthesia - B Internal Medicine - B General Surgery - B Adult ER - B Pediatrics - B Pediatric ER - W Obstetrics - B Duration (months) 1 1 2 2 1 1 1 1 1 EPAs D1, D2, D3 D1, D2, D3 F1, F2, F3, F4, F6, F7, F8, F11, F12, F13 F9, F10 F8, F9, F10 F7, F9, F10, C18 F10, F15, F16 F9, F16 F11 PGY 1 PGY 2 PGY 2 Anesthesia - B PGY 2 Anesthesia - W Peds Anesthesia - B/W ICU - B Obs Anesthesia - W Cardiology - B CCU - W Respirology - B Duration (months) 2 to 3 3 to 4 2 weeks 1 or 2 1 1 1 1 or 2 EPAs F1, F2, F3, F4, F5, F6, F7, F8, F9, F11, F12, F13 F1, F2, F3, F4, F5, F6, F7, F8, F9, F12, F13 F14, F15 F3, F4, F7, F9, F10 F1, F2, F3, F4, F5 F8, F9, F10 F3, F4, F7, F9, F10 F8, F9, F10 F6, F11, F12, F13 Peds Anesthesia - W PICU - W Adult Anesthesia ICU - W Neuro - W Anesthesia - B Pain - W Duration (months) 2 1 2 to 3 1 1 1 1 to 3 EPAs C17, C19, C24, C25 C3, C4, C5, C6, C7 C1, C2, C3, C8, C9, C10, C11-C18, 19, C20-24 C3, C4, C5, C6, C7 C33, C34 C1-2, C3, C8-18 C15, C19, C29, C30 C26, C27, C28 C14, C16, C33, C37, C41 C29, C30, C32, C33, C34, C35, C36 C14, C16, C33, C37 C1-4, C16, C19 C19, C29 C38, C39, C42, P9 C8, C9, C10 C42, C44, P12 C37, C41, C42, C44 C41, C42, C44 C34, C41, C42 Pain - W Cardiac - W Elective Scholarly*** Transfusion / PAC* ICU - W Thoracics* - W Peds - W Duration (months) 1 to 3 2 2 6 1 1 or 2 1 1 EPAs C15, C19, C29, C30 C16, C31, C32 C1, C2, C3, C8, C9, C10 C40, C42, C43, P10, P11 C1-3, C43 C3, C4, C5, C6, C7 C18, C19, C35, C36 C17, C19, C24, C25 C38, C39, C42, P9 C42 C7 - Palliative elective C1, C2, C3, C8, C9, C10, C11-19, C20-24 F7, C42 C14, C33, C37, C41 C42 C26, C27, C28 P9 C1-4, C8, C19 C11-19, C29, C30, C32-37 C29, C30, C32, C33, C34, C35, C36 P1, P2 C42, C44, P12 C1-3, C8, C9, C10, C16 C29, C37, C42 C41, C42 C37, C41, C42, C44, P10, P11 C1-3, C8, C9, C10 C44 - Echo / Regional P5, P7 PGY 5 Transition to Practice Peds - W ICU - ICCS** - W SSCU - W Obs - W IHA / PAC - W Adult Anesthesia Duration (months) 1 1 1 1 1 5 to 6 EPAs C17, C19, C24, C25 C3, C4, C5, C6, C7 C1-C3, C4, C6, C7, C11, C15 C20, C21, C22 P1, P2-P6 P1-P6, P8-P12 C26, C27, C28 C14, C16, C31, C32, C37 C19, C41, C42, P12 C23, C24, P6 P8 C29, C37, C42, P5, P7 C41, C42, C44, P12 C44 C1-3, C8, C9 C1-3, C8, C9, C10 Certification, Continuing professional development (maintenance of competence and advanced expertise) Legend D = Transition to Discipline EPA, F = EPA, C = EPA, P = Transition to Practice EPAs, Suggested path to EPA completion Total EPAs per stage / Total Overall: TTP = 4, = 27, = 44, Transition to Practice = 12 / Total = 87 Bolded EPAs are the priority EPAs specific to that rotation For each academic year there are 12 Clinical rotations per year, and 1 block of vacation = 1 month. Note vacation weeks not included above Brandon Residency Program is a Satelite program of the University of Manitoba Department of Anesthesia. s in Brandon = B, s in Winnipeg = W *Recent introduction of new rotations: a.) Thoracics - Can be done in late PGY3 or PGY4 in first 6 months of academic year, b.) Transfusion / PAC - Cannot be done in PGY5 **6 Months Total of ICU, ICCS recommended. Must do: MICU, MSICU, PICU, SICU ***Scholarly activity is currently alloted 6 months. Allocation of this time is on a case-by-case basis and subject to approval by the PD. Call requirements and clinical duties apply Obstetric Anesthesia rotation at BRHC is a longitudinal experience that takes the place of the PGY1 Obstetric Anesthesia rotation A portion of F12 and F13 must be assessed during the Winnipeg PGY2 Obstetric Anesthesia rotation Elective rotations subject to approval by PD, could include: Out-of-province elective, Palliative, Echo, Sleep medicine, Mercy Ship / International, other Out-of-phase EPA, or Optional for phase. Noted in these locations due to greater opportunity for assessment or rare nature of EPA PGY 3 PGY 4
C18: Multiphase EPA. Partial credit available during Gold in C19: This EPA may be observed in MRI (Conventional MRI and IMRIS Suite), interventional cardiology (adult and pediatric), interventional radiology, brachytherapy, EBUS, high-dose radiation, ECT, invasive pediatric procedures (intrathecal chemo or bone marrow aspiration) C19: Off sites while on Acute Pain (APS) at discretion of Section Head for Pain Medicine and Attending, strongly encouraged F12, F13, C20-24 may be assessed if on adult anesthesia rotations (on-call) at SBGH Transition To Discipline D1: Performing preoperative assessments for healthy adult patients who will be undergoing a non-complex scheduled surgical procedure D2: Monitoring adult patients undergoing non-complex surgical procedures, under general or regional anesthesia D3: Performing the postoperative transfer of care of healthy adult patients following a non-complex surgical procedures, including postoperative orders F1: Using the anesthetic assessment to generate the anesthetic considerations and the management plan, including postoperative disposition and obtaining informed consent, for non-complex patients and non-complex surgery. F2: Providing perioperative anesthetic management for non-complex cases in adult patients F3: Performing the non-airway basic procedures of Anesthesiology F4: Identifying patients presenting with an anticipated difficult airway and preparing for management options F5: Managing and coordinating patient positioning during anesthesia care and preventing and recognizing related complications F6: Anticipating, preventing and managing common or expected intraoperative events and physiologic changes during non-complex cases F7: Assessing the indications for and management of side effects and complications related to the transfusion of blood products F8: Diagnosing and managing common issues in the post-anesthesia care unit (PACU), or the surgical ward F9: Initiating resuscitation and diagnosis of life-threatening conditions in a time-appropriate manner F10: Assessing, diagnosing and managing patients in acute care settings with common medical or surgical presentations, and advancing their care plans. F11: Assessing and providing initial medical management for pregnant patients with common problems of pregnancy or acute medical, surgical or obstetric conditions F12: Assessing and providing labour analgesia for healthy parturients with an uncomplicated pregnancy, including the management of common complications of labour analgesia F13: Providing anesthesia for patients undergoing non-complex cesarean section F14: Providing perioperative anesthetic management for non complex cases in pediatric patients F15: Managing pediatric patients with common postoperative complications in the post anesthesia care unit or ward F16: Assessing and managing pediatric patients with common medical conditions C1: Assessing, investigating, optimizing, and formulating anesthetic management plans for patients with complex medical issues C2: Managing postoperative patients in collaboration with the surgical team with the goal of improving patient outcomes (elective) C3: Assessing, diagnosing and managing acute or potentially life-threatening conditions outside of the perioperative period C4: Providing comprehensive assessment and ongoing management of complex critically ill patients in an intensive care setting C5: Managing the care of multiple patients with remote consultant support during afterhours coverage in intensive care unit C6: Performing as an integral member of the patient care team on daily ICU rounds by recommending management decisions consistent with best practice standards and guidelines (elective) C7: Providing care for patients whose goals of care are palliative, including comprehensive pain and perioperative management, and demonstration of appropriate communication skills (elective) C8: Managing patients presenting with an anticipated difficult airway, including appropriate extubation plans C9: Managing patients presenting with unanticipated difficult airway, including cannot intubate, cannot oxygenate situation C10: Providing perioperative management for patients requiring airway diagnostic and therapeutic procedures C11: Providing perioperative anesthetic management for adult patients with complex medical issues undergoing scheduled or emergent surgical procedures C12: Providing perioperative anesthetic management for geriatric patients undergoing scheduled or emergent surgical procedures C13: Providing perioperative anesthetic management for patients with critical illness C14: Managing serious and life-threatening perioperative complications in a time-appropriate manner C15: Managing patients with perioperative anesthesia complications, including disclosure (elective) C16: Managing patients with perioperative anesthesia complications, including disclosure (elective) C17: Providing resuscitation and comprehensive management, including crisis resource management, for patients presenting with a life-threatening emergency, across the spectrum of age C18: Providing perioperative management for patients with major polytraumatic injury C19: Providing anesthetic management for patients undergoing procedures outside the usual environment of the operating room C20: Providing labour analgesia and peripartum anesthetic management for high-risk parturients having a non-surgical delivery C21: Providing perioperative anesthetic management for parturients (low and high risk), with or without significant comorbidities, for scheduled, urgent or emergent cesarean section C22: Providing peripartum anesthetic management and resuscitation of parturients (including intra-uterine resuscitation) presenting with serious and life-threatening obstetrical complications C23: Providing perioperative anesthetic management for pregnant patients undergoing non-obstetric surgery C24: Performing neonatal resuscitation C25: Assessing, investigating, optimizing and formulating anesthetic management plans for pediatric ASA 1-3 patients (above the age of one year) with coexisting conditions C26: Providing perioperative anesthetic management of pediatric ASA 1-3 patients (above the age of one year) undergoing scheduled or urgent/emergent procedures of low to moderate complexity C27: Providing resuscitation and comprehensive management for the pediatric patient (over the age of one year) presenting with a serious or life-threatening emergency(elective) C28: Establishing and managing difficult intravenous access and invasive monitoring for pediatric patients (above the age of one year) C29: Managing patients with common, serious or life-threatening complications of regional anesthesia (elective) C30: Providing perioperative anesthetic management for adults with a peripheral nerve block regional anesthesia technique appropriate for the planned surgical procedure C31: Participating in the provision of perioperative anesthetic management for patients with significant cardiac disease who are undergoing scheduled, common cardiac surgery C32: Providing perioperative anesthetic management for patients undergoing scheduled, urgent/emergent major aortic surgery, carotid surgery, or peripheral vascular surgery C33: Providing perioperative anesthetic management for patients with or without increased intracranial pressure undergoing scheduled, urgent or emergent intracranial procedures C34: Providing perioperative anesthetic management for patients undergoing scheduled or emergent spinal procedures C35: Providing perioperative anesthetic management for patients undergoing thoracic surgery via thoracotomy or thoracoscopy, including pulmonary resection surgery C36: Providing perioperative anesthetic management for patients undergoing mediastinal and esophageal surgery, including management of mediastinal masses C37: Providing perioperative anesthetic management for organ retrieval surgery including perioperative anesthetic management of the donor, and determination of neurologic death C38: Providing comprehensive multi-modal management of acute and acute on chronic pain conditions C39: Assessing, diagnosing and managing patients with common chronic pain disorders, including both medical and basic interventional treatments, using a collaborative, multidisciplinary approach C40: Executing scholarly projects C41: Recognizing and managing ethical dilemmas that arise in the course of patient care C42: Formal teaching, and teaching junior learners in the clinical setting (elective) C43: Developing a personal learning plan for the transition to practice stage C44: Using ultrasound to assist in diagnosis and management of hemodynamically unstable or critically ill patients Transition To Practice P1: Managing all aspects of care for patients presenting to a preoperative clinic, including organizational aspects of the daily workload in terms of time management, advocacy and allocation of resources P2: Managing all aspects of care for admitted patients referred for consultation to the Anesthesiology service
P3: Managing all aspects of patient care for a scheduled day list, including the organizational aspects related to the management of the operating room case load P4: Managing all aspects of patient care for an afterhours list (overnight, weekend), including postanesthesia care unit management and the organizational aspects related to the management of the operating room case load P5: Managing all aspects of anesthetic patient care for procedures outside the operating suite, including the organizational aspects related to the provision of anesthesia and patient safety issues P6: Managing all aspects of anesthetic patient care for obstetrical patients, including the organizational aspects related to the management of the obstetric ward P7: Managing all aspects of care for a scheduled routine pediatric list, including the organizational aspects related to the management of the operating room case load P8: Managing and coordinating the workday delivery of anesthesia services at a hospital level, i.e. fulfilling the role of operating room manager (elective) P9: Providing and coordinating the care of patients with simple and complex acute pain conditions referred to and managed by the pain service P10: Developing an ongoing personal career and learning plan P11: Leading initiatives to enhance the system of patient care P12: Leading a post crisis debriefing and feedback session (elective)