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Training Anesthesiologists to be Perioperative Physicians

Training Anesthesiologists to be Perioperative Physicians. Colin J.L. McCartney MBChB PhD FCARCSI FRCA FRCPC Professor and Chair of Anesthesiology and Pain Medicine University of Ottawa Head of Anesthesiology and Pain Medicine The Ottawa Hospital Scientist,

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Training Anesthesiologists to be Perioperative Physicians

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  1. Training Anesthesiologists to be Perioperative Physicians Colin J.L. McCartney MBChB PhD FCARCSI FRCA FRCPC Professor and Chair of Anesthesiology and Pain Medicine University of Ottawa Head of Anesthesiology and Pain Medicine The Ottawa Hospital Scientist, Ottawa Hospital Research Institute

  2. Faculty Disclosure Off-Label Product Use

  3. Overview • Why anesthesiologists? • SWOT analysis • Current training systems • Future requirements

  4. Grocott 2012 • Unmet needs in perioperative care? • The anaesthetist as perioperative physician • Organization of perioperative care

  5. SWOT analysis • Strengths: Much experience in current programs • Weaknesses: Lack of academic basis • Opportunities: Huge opportunity to retake perioperative medciine • Threats: Shortening of training programs. Lack of academic basis

  6. My training • 6 years anaesthesia training in UK • 2 years ICU during 6 years • Emphasis was always on pre, intra and postoperative care of the perioperative patient • The role of the “anaesthetist” always included perioperative medicine • Salaried position

  7. Why Anesthesiology? • Essential for care of our patients • Essential for involvement in creation of future systems at hospital, health-care system levels • Essential to be leading research agenda • Policy development: leaders in field asked to address research gaps

  8. Current Training Systems • Canada: 4-5 years. ICU training. Rotations in other medical specialties. • UK/Ireland: 6 yrs + training. Significant commitment to care before and after surgery. Significant critical care experience. • United States: 6/52 ICU training in 3 year residency.

  9. What we need to change? • Attitude: get out of the OR and do the work needed despite the payment model • Training programs: ensure significant component committed to pre- and post-operative care including ICU • Fellowship programs • Research: own the specialty

  10. Perioperative Research • Part of every training program • Importance of funding research • “If you’re not at the table….” • National organizations need to make funding a priority • We need to make changes ourselves because funding agencies will be happy for others to do this

  11. Future Path for Training • Get out of the OR and: • Fund and deliver the research mission (resources=time+money) • Deliver immediate pre- and postoperative care • Develop innovative training programs at residency and fellowship level (pre-operative assessment, POCUS, involvement and leadership in HDU and ICU care) • Change focus from “what we are paid to do” to “what we should do”

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