Perioperative Medicine

Perioperative Medicine

2 Blocks

Leads

Dr. Anna Wyand (Civic) & Dr. Sylvain Gagne (General)

Welcome Message

The perioperative medicine module comprises two rotations over Core I and Core II. The perioperative module members are Drs. Anna Wyand, Claudia Gomez, Gregory Bryson, Ilia Charapov, Sylvain Gagné, Patti Murphy, Pat Sullivan, and Daniel Dubois.

Our goal is to introduce you to the concepts of perioperative assessment and optimization, as well as introduce you to a variety of medical conditions so that you work on completing the milestones that make up the perioperative EPA.

Core I will focus on learning some of the considerations for the prevalent medical comorbidities with which you are gaining experience in the operating room, as well as perioperative testing, interpretation of these test results, and the rationale for performing them.

Core II will focus on your ability to synthesize your knowledge of assessment, testing and be able to independently assess, document and present a management plan for your patients. You will have more clinical experience at this point and be more familiar with the anesthetic options for the procedures.

For both rotations you will be booked in the Perioperative Assessment Unit (PAU) at either the Civic or General Campus. You will participate in the usual on call duties during both the day and night.

EPAs & Milestones

  • Perioperative medical management of the surgical patient
    • Demonstrates understanding of anesthetic considerations for major highly prevalent co existing diseases.
    • Demonstrates understanding appropriate and relevant laboratory tests and investigations for perioperative outcomes.
    • Demonstrates ability to appropriately consult health care professionals for perioperative care.
    • Demonstrates understanding of surgical procedure on patient comorbidities.

Academic Curriculum

Learning Cases

Core 1

  • What are my chances Doc?
  • A heart murmur in the perioperative clinic
  • Perioperative testing
  • Coronary artery disease
  • Atrial fibrillation
  • Preoperative Preparation for Elective Surgery in a Patient who is a Jehovah’s Witness
  • Rheumatoid arthritis (optional)

Core 2

Learning Cases

  • CAD Stent/hypertension
  • Obstructive Sleep apnea
  • Coagulopathy
  • DNR suspension
  • Pacemaker/AICD
  • The patient with Liver disease
  • COPD
  • The opioid tolerant patient (optional)

Assessment Tools

  • Direct Observation via CCAT
  • Completed a minimum of 14 Perioperative Assessment Clinic days (by the end of Core 2)
  • Completed 3 outpatient Perioperative Medicine assessments observed by staff
  • Completed 1 telemedicine assessment
  • Compliant with Resident Logbook (80 Consults by the end of Core 2)
  • Completed 13 Core Perioperative Medicine learning cases (by the end of Core 2)
  • Completed Case Summary (Core 1)
  • Core Module MCQ

Resources

  • National Curriculum for Canadian Anesthesia Residency. First Edition 2010.
  • Miller’s Anesthesia (2015): Chapter 38. Preoperative Evaluation
  • Stoelting’s Anesthesia and Co-Existing Disease (2012) is a good resource for anesthetic considerations for the various comorbidities
  • Egbert LD & and Jackson SH. Therapeutic Benefit of the Anesthesiologist–Patient Relationship. Anesthesiology 2013; 119:1465-8 http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1918062
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