Fellowship Cardiothoracic Anaesthesiology
 


​​Cardiothoracic Anaesthesiology 

 
Cardiothoracic Anaesthesia is the subspecialty of anaesthesiology devoted to the preoperative, intraoperative, and postoperative care of patients undergoing cardiothoracic surgery both adult and paediatric patients and related invasive procedures.

Clinical Educational Objectives

Fellowship goals include maximizing proficiency in​

  • ​​assessing cardiovascular and respiratory diseases; from patient history and physical examination to interpretation of invasive and noninvasive diagnostic studies
  • evaluating anaesthetic risk and necessary interventions to minimize risk 
  • anaesthetic plan selection (including postoperative analgesic and recovery strategies) suitable for cardiac and thoracic surgical patients, based on:
    • determination of cardiovascular and pulmonary monitoring requirements and expertise in invasive monitoring and echocardiography techniques
    • design and administration of anesthetic medications and regional  anaesthetic procedures tailored to optimize surgical conditions, with consideration of patient disease processes
    • understanding of the principles of extracorporeal circulation
    • understanding of myocardial preservation 
    • Recommendations and consultation in postoperative intensive care and pain management problems

Academic Educational Objectives

Involvement in an anaesthesia research project assures skill development in:

  • The ability to formulate clinically relevant hypotheses in cardiac and thoracic anaesthesiology
  • Project design skills, to create achievable studies able to answer questions according to execution of research project (one dissertation topic during fellowship and one publication in a Pakistan Medical and Dental Council recognized journal)
  • Introduction to statistical analysis techniques
  • Interpretation of results and preparation of a manuscript
  • Presentation of research at national/international meetings
  • Ability to critically evaluate the research of other investigators
  • Fellowship teaching opportunities include experience in resident education and participation in didactic sessions and other clinical teaching
  • Fellow will actively participate in different audits and ongoing research activities 
Programme Design

As primary anaesthesiologists of adult/ paediatrics cardiac and thoracic surgical patients, Cardiothoracic Fellow’s initial responsibility and experience is in preoperative assessment, intraoperative and postoperative management. Direct faculty supervision is provided. During this period, Fellows follow a curriculum that meets the Department and College of Physicians and Surgeons Pakistan (CPSP) Fellowship criteria designed to have them:
  • become familiar with the cardiothoracic surgical and intensive care teams, and the operating room and intensive care facilities
  • attain proficiency in preoperative patient assessment, invasive monitoring and TEE techniques , and intraoperative/ postoperative patient management
  • experience elective and emergency adult/paediatric cardiac and thoracic procedure
  • fulfill designated reading assignments in selected cardiac and thoracic anaesthesia textbooks and journal articles develop objectives for the remainder of the programme with the guidance of the cardiothoracic anaesthesia and critical care faculty under the direct guidance of a mentor, design and initiate a research project (ideally planned between acceptance and starting the Fellowship). The protocol may entail clinical database and/or laboratory research in original or ongoing projects. Clinical schedules are flexible to commitments for proposed research projects. Research is supervised by a faculty member with experience in the area of investigation

Other features of the clinical experience include

Four days per week clinical involvement (one day per week is protected for non-clinical activities), and participation in combined cardiothoracic night call schedule to provide experience in the management of emergency cardiothoracic surgeries.

Training in  echocardiography

2 weeks in cardiology echo lab involving a significant practical experience in transthoracic echocardiography and TEE.

TEE use in all adult/ paediatric cardiac surgical cases
​Duration of training - Two years 

Eligibility

MBBS or equivalent degree recognized by PM&DC 
  • One year house job or internship 
  • FCPS Part II is preferred or at least should have completed the FCPS II training from a reputable institution (Four years structured training in anaesthesia and should be eligible for the fellowship exam) 
  • VIVA/ Written test will be taken for entrance into fellowship programme 

Skills​

Fellow should be able to perform, manage and interpret following procedures with minimal assistance from consultants: arterial catheterization, central venous catheterization, pulmonary artery catheterization, double lumen placement/other lung isolation techniques, thoracic epidural insertion, fiberoptic bronchoscopy, TEE for myocardial ischemia and contractility and valvular lesion. 

Evaluation

Continuous assessment will be done by all faculty members and a form will be filled out every three month along with viva evaluation by two consultants. There will be a MCQ test every six month. Feedback (verbal and written) will be discussed by one of the faculty members every three month. 
Six monthly written and oral assessment and feedback (verbal and written) will be given by Programme Director. 

Goals

At the completion of the Fellowship, successful fellows will have achieved the following goals:
  • Safe and skillful management of complicated cardiothoracic surgical patients, including proficiency in intraoperative transesophageal echocardiography techniques
  • knowledge through organized learning opportunities in a process that is aligned with and complementary to all other aspects of the Fellowship requirements
  • Knowledge beyond the level expected of a graduating resident in the general areas of CT anaesthesia
  • Understand the tasks, challenges, and decisions required of professional colleagues in the areas of Cardiothoracic Medicine (e.g., CT surgeons, cardiologists, pulmonologists, perfusion technologists, etc.)
  • completion of a research project and presentation of results at a national meeting
  • understand aspects of CT anaesthesia research
  • a comprehensive understanding of the aspects of perioperative transesophageal echocardiography
  • understand areas of general importance to physicians (e.g., being an effective educator, making good slides, ethics and medicine, patient safety, quality assurance programmes, etc.)
  • successful participation in residency education, including conducting didactic lectures and participation in specialty conferences​
Administrative set-up ​

​The Cardiothoracic Anaesthesiology group includes eight full-time and one part-time consultant. A fellowship committee comprising five members including fellow(s) who will look after the affairs related to fellowship programme.
 

Faculty Members

Programme Director 
Dr Khalid Samad
Associate Professor
MBBS Karachi; MCPS Pakistan; FCPS Pakistan

Full-time Faculty 


Professor
Dr Fazal H. Khan 
MBBS Karachi; FCPS Pakistan; European Diploma in Intensive Care 
Dr Rehana S. Kamal 
MBBS Punjab; FRCA UK; FFARCS Ireland; FCPS Pakistan 

Associate Professors 

Dr Hamid Iqil Naqvi
MBBS Karachi; FCPS Pakistan
Dr Hameedullah Saleemullah 
MBBS Karachi; FCPS Pakistan

Dr Mohammad Hamid
MBBS Karachi; Diplomate American Board of Anaesthesia 
Assistant Professors 

Dr Fauzia Minai 
MBBS Karachi; FCPS Pakistan 
Dr Khalid Siddiqui 
MBBS Karachi; FCPS Pakistan 

Dr Irfan Akhter
MBBS Karachi, FCPS Pakistan
Fellowship Cardiothoracic Anaesthesia, AKU, Karachi, Pakistan

Senior Instructor

Dr Khalid Ahsan
MBBS Karachi, FCPS Pakistan
Fellowship Cardiothoracic Anaesthesia, AKU, Karachi, Pakistan ​

Related Links

How to Apply