Anaesthesiology and Intensive Care Residency Programme

The specialty of anaesthesia deals with the peri-operative management of surgical patients requiring anaesthesia. Anaesthesiologists are responsible for provision of anaesthesia to facilitate all kinds of surgical procedures including cardiopulmonary bypass and highly specialised neurosurgical and paediatric procedures. With the recognition and development of anaesthesia as a medical specialty, it is now no longer limited to the operating room. Outside operating room the anaesthesiologists are considered active members of basic and advance life support and trauma teams and are responsible for management of critically ill patients in ICU. They also provide anaesthesia care to advance radiological and gastro-endoscopy procedures. They also provide anaesthesia to the obstetric patient and provide epidural services to the laboring patient.Their role as a pain physician has also been recognised to deal with variety of acute and chronic painful disorders.

The Department of Anaesthesia at AKUH, Karachi started in 1985 with three faculty members. Our Department pioneered a structured training programme in the specialty within the country. The residency training programme started in 1986 with induction of three residents. In the last 20 years, the department has grown considerably with 29 full-time, 5 part-time faculty and 30 residency positions. The programme is recognised by the College of Physicians and Surgeons Pakistan (CPSP). To date, 60 residents have qualified from the programme.

The programme was initially design ed as a four-year structured training. From November 1, 2003 an additional fifth year has been incorporated to fulfill the CPSP requirement. The programme is intended to provide education and clinical experience in the science and practice of medicine related to anaesthesiology. Our highly qualified teaching faculty members are responsible to ensure the stepwise graded training of residents. In our residency programme, extensive clinical training is provided with well design ed academic curriculum. The clinical rotation and academic meeting schedule assures balance anaesthesia training for each resident. Five years of residency training comprises one year of basic clinical training, and four years specialised training include training in services not well established anywhere in Pakistan e.g. obstetric epidural and pain management services.

Rapid extension of anaesthesia services inside and outside operating room put great demands on the consultant anaesthesiologists and the trainee's time and attention. Our programme is constructed in such a way that the training aspects are given equal attention through the provision of protected time for research and scholarly activities. Our teaching faculty serves as mentors and provide learning environment that contribute towards effective education. Department also supports residents to attend workshops organised by CPSP, PGME and Community Health Sciences. The residents are encouraged to participate actively in local, national and international conference of anaesthesia, intensive care and pain management.

There is a tremendous development of anaesthesia as medical specialty. The role of anaesthesiologist has expanded enormously; as a result, the need for trained professional anaesthesiologists is rising in the world. Currently our graduates are working as consultant anaesthesiologists not only in Pakistan , but also in Middle East , UK , Ireland and Canada . Considering the shortage of consultant anaesthesiologists particularly in Pakistan 's our graduates will have a wonderful opportunity to lead the departments of anaesthesia in various academic institutions.

Objectives

The general objectives of the anaesthesiology residency programme are to produce anaesthesiologists who should be:

• Well informed, independent and clinically competent consultant physicians, capable of functioning in a variety of clinical inpatient, outpatient, and surgical intensive care settings in both urban and rural population of Pakistan .
• Able to understand the basic principles of research and medical ethics and conduct themselves with personal and professional integrity.
• Able to provide a proper structured training in other institutions of Pakistan .

Duration of training

The programme comprises five years of training.

Eligibility

• MBBS or equivalent degree approved by the PM&DC
• One-year internship with six months in Medicine or allied disciplines and six months in Surgery or allied disciplines
• FCPS-I is preferred but not mandatory.

Scope and content

Clinical training schedule

The resident will be rotating in the following according to level of training:

Resident I

Resident II

Resident III

Resident IV

Resident V

Didactic content

Weekly tutorials are held on Clinical Anaesthesia. Residents are given problem based scenarios, which they have to present and are evaluated by the faculty coordinating the session. In addition, monthly morbidity and mortality meetings, journal club sessions, seminars, clinical case discussions, audit meetings and guest lectures, problem-based learning and evidence-based anaesthesia problems are held regularly in morning departmental meetings.

Evaluation 

Continuous evaluation and immediate feedback takes place between residents and consultants during the clinical training. Evaluation takes place after each rotation. In addition, formal in-training exam is carried out twice a year and is based on an ongoing assessment and formal tests with multiple choice questions (MCQs), essays, Toacs, and rotation vivas. Regular feedback is given to the residents on ways to improve their skills and knowledge.

On-call duties

The residents work in a rota of 1 in 3 or 1 in 4. The first year resident is mainly responsible for the pre-operative rounds. The second year/third year resident provides cover for Intensive Care Unit and cardiac arrests in the Hospital. The third year resident also has the main responsibility in the operating room and the fourth or final year resident acts as a team leader, and is responsible for his junior colleagues and liaison with the consultant on call.

Positions available

There are a total of thirty positions in the programme. Every year new residents are inducted depending upon the position available which it self is dependent upon how many residents graduate each year.

Administrative set-up

The programme is Directed by Dr. Samina Ismail, and Coordinated by Dr Aliya ahmed. Following is the list of faculty in the department:

Full-time Faculty

Professors

Dr Fauzia A. Khan
MBBS Punjab; LRCP, MRCS London ; FRCA UK ; FCPS ( Pakistan )

Dr Fazal H. Khan
MBBS Karachi; FCPS Pakistan ;European Diploma in Intensive Care

Dr M. Qamarul Hoda
MBBS Karachi ; MCPS Pakistan ;FFARCS Ireland

Associate Professors

Dr Gauhar Afshan
MBBS Karachi ; FCPS Pakistan

Dr Hameedullah Saleemullah
MBBS Karachi ; FCPS Pakistan

Dr Mueenullah Khan
MBBS Punjab; FCPS Pakistan

Dr Samina Ismail,
MBBS, Karachi ; FCPS Pakistan

Programme Director

Dr Aliya Ahmed
MBBS Karachi ; DA UK ; FFARCS Ireland
Programme coordinator

Dr Mohammad Hamid
MBBS Karachi
Diplomate American Board of Anaesthesiology

Assistant Professors

Dr Abdul Monem
MBBS Sindh; FCPS Pakistan

Dr Aziza M Hussain
MBBS Karachi ; FCPS Pakistan

Dr Fauzia Nasim Minai
MBBS Karachi; FCPS Pakistan

Dr Khalid Samad
MBBS Karachi ; FCPS Pakistan

Dr Mansoor A. Khan
MBBS Karachi; FCPS Pakistan

Dr Robyna Irshad
MBBS Punjab; FCPS Pakistan ; MHSc (Bioethics) Canada

Dr Saeed-uz-Zafar Qureshi
MBBS Karachi ; FCPS Pakistan

Dr Mohammad Ali
MBBS Lahore ; FCPS Pakistan

Dr Khalid Siddiqui
MBBS Karachi ; FCPS Pakistan

Dr Tauseef Ahmed
MBBS Karachi ; FCPS Pakistan

Dr Mohammad Irfan Akhter
MBBS Karachi ; FCPS Pakistan  

Senior Instructors

Dr Mohammad Imran
MBBS Karachi ; FCPS Pakistan

Dr Faisal Khan
MBBS Pakistan ; FCPS Pakistan

Dr Faisal Shamim
MBBS Karachi ; FCPS Pakistan  

Instructors

Dr Saad Ahmed Naved
MBBS Hyderabad

Dr Rehan Qureshi
MBBS Pakistan

Dr Nazeer
MBBS Pakistan

Dr Syeda Fauzia
MBBS Pakistan

Dr Anwarul Huda
MBBS Pakistan

Dr Riaz Solangi
MBBS Pakistan

Part-time Faculty

Professors

Dr Rehana S. Kamal
MBBS Punjab; FRCA UK ; FFARCS Ireland ; FCPS Pakistan

Dr Ursula Chohan
MBBS Karachi ; DRCOG, DA, FFARCS UK

Assistant Professors

Dr Shahla Siddiqui
MBBS Karachi
Diplomate American Board of Anaesthesiology

Dr Shemila Abbasi
MBBS Karachi ; FCPS Pakistan  

Lecturers  

Dr Iffat A.R. Siddiqui
MBBS Peshawar , DARCS RCP London

Dr Zafar Ali Mirza
MBBS Karachi ; DA UK