Paediatric Anaesthesia
Introduction:
Paediatric anaesthesia is a subspeciality focused on the perioperative care of children undergoing surgery and invasive procedures. The Department of Anaesthesiology at Aga Khan University Hospital, a 700+ bed academic teaching hospital, provides anaesthetic services for all surgical specialities. The Paediatric Anaesthesia section has eight full-time trained consultants and offers a twelve-month fellowship covering paediatric anaesthesia and pain management. Fellows receive clinical and didactic training in the care of neonates, infants, children, and adolescents in operating rooms and remote locations. The programme provides exposure to a wide range of paediatric cases, including cardiothoracic, ENT, neurosurgical, and orthopaedic procedures. It aims to develop skilled and competent paediatric consultant anaesthetists capable of managing routine, complex, and rare paediatric anaesthesia cases.
Goals & Objectives:
• The Paediatric Anaesthesia Fellowship aims to develop competent paediatric anaesthetists who can provide safe perioperative care to neonates, infants, children, and adolescents undergoing surgical, diagnostic, and therapeutic procedures.
• The programme focuses on building strong clinical experience in paediatric anaesthesia, including paediatric airway management, invasive monitoring, preoperative assessment, anaesthetic planning, intraoperative care, and postoperative management.
• Fellows are expected to understand age-related anatomical, physiological, pharmacological, developmental, and psychological differences in paediatric patients and apply this knowledge to clinical practice.
• The fellowship provides structured training through rotations in general paediatric anaesthesia, non-operating room anaesthesia, paediatric cardiovascular anaesthesia, PICU, NICU, and paediatric pain management.
• Key objectives include developing competence in neonatal and critical care, paediatric cardiac anaesthesia, regional anaesthesia, multimodal pain management, and management of routine, complex, and emergency paediatric cases.
• The programme also emphasizes family counselling, informed consent, effective documentation, multidisciplinary teamwork, patient safety, quality improvement, ethical practice, professionalism, and continuous learning.
Scope after Graduation from the Programme:
• After successful completion of the Paediatric Anaesthesia Fellowship, the graduate will be able to work as a competent paediatric anaesthetist capable of providing safe perioperative care to neonates, infants, children, and adolescents undergoing surgical, diagnostic, and therapeutic procedures.
• The graduate will be prepared to manage routine, complex, and emergency paediatric anaesthesia cases in operating rooms and non-operating room locations, including MRI, CT, radiology, and other procedural areas. They will have skills in paediatric airway management, vascular access, invasive monitoring, regional anaesthesia, pain management, postoperative care, and crisis management.
• Graduates will also be able to provide anaesthesia care for specialised paediatric surgical services, including general surgery, ENT, neurosurgery, orthopaedics, urology, neonatal surgery, and paediatric cardiovascular cases. Their exposure to PICU and NICU will enable them to contribute to the perioperative care of critically ill children and neonates, including ventilation, haemodynamic management, neonatal resuscitation, and safe transport.
• The programme will also prepare graduates for academic and leadership roles through training in teaching, research, audits, quality improvement, multidisciplinary teamwork, ethical practice, and patient safety. Graduates may serve as paediatric anaesthesia consultants, contribute to resident and trainee education, participate in institutional protocols, and support the development of paediatric anaesthesia services in tertiary care hospitals.
Administrative Set-up:
Programme Director:
Dr Khalid Siddiqui
Department Chair:
Dr Asad Latif
Programme Officer:
Ms. Zarnab Imtiaz Ali
Duration and Outline of Training:
The training period is one year.
Outline of Training:
• The Paediatric Anaesthesia Fellowship is a twelve-month structured clinical and academic programme focused on perioperative care of neonates, infants, children, and adolescents.
• Training includes rotations in general paediatric anaesthesia, NORA, paediatric cardiovascular anaesthesia, NICU, PICU, paediatric pain management, and elective placement.
• Fellows gain supervised experience in preoperative assessment, anaesthetic planning, airway management, invasive monitoring, regional anaesthesia, intraoperative care, postoperative recovery, and pain management.
• The programme provides exposure to routine, complex, and emergency paediatric cases, including neonatal, ENT, neurosurgical, orthopaedic, urological, plastic, and cardiothoracic procedures.
• Learning is supported through OR supervision, bedside teaching, tutorials, case-based discussions, simulation, journal clubs, academic sessions, research, quality improvement, and continuous assessment.
On-call Duties and Reporting Time:
• The fellow is expected to report to the operating room at 7:45 AM for scheduled paediatric procedures.
• The fellow should review preoperative assessment forms, follow up on pending laboratory investigations, and discuss the planned cases with the covering faculty.
• The weekly duty schedule includes one on-call session per week, currently assigned on Friday.
The weekly schedule is:
• Monday: Non-clinical sessions; no on-call duty.
• Tuesday: Clinical morning, afternoon, and evening sessions; no on-call duty.
• Wednesday: Clinical morning and afternoon sessions; no on-call duty.
• Thursday: Clinical morning and afternoon sessions; no on-call duty.
• Friday: Clinical morning, afternoon, evening, and on-call session.
• Saturday: Post-call day; off.
• Sunday: Off.
Work-hour standards include a maximum of 80 hours per week, one call per week.
Evaluation and Assessment Process:
• Continuous workplace-based assessment:
Fellows are assessed regularly during clinical work for patient care, clinical judgment, procedural skills, communication, teamwork, and professionalism.
• End-of-rotation viva:
A 15–20-minute oral viva is conducted within one week after each rotation to assess knowledge, clinical reasoning, and problem-solving skills.
• Written assessment:
MCQs and short-answer/essay questions are used to assess theoretical knowledge, with written tests conducted periodically.
• Quarterly evaluation:
Fellows are evaluated every three months for attitude, knowledge, manual skills, patient management, decision-making, and overall progress.
• Logbook review:
Fellows maintain a logbook to document cases, procedures, skills, and clinical experience, which is reviewed as part of assessment.
• Academic assessment:
Journal clubs, presentations, research, audits, and scholarly activities are included in the evaluation process.
• Consultant and rotation feedback:
Faculty members provide feedback on the fellow’s clinical performance, professionalism, and progress during each rotation.
• Progress review:
The Fellowship Director meets with fellows to discuss performance, strengths, deficiencies, and areas for improvement.
• Graduation requirement:
Successful completion requires satisfactory clinical performance, completed assessments, logbook documentation, academic participation, and research or audit work.
Research:
• Fellows are expected to participate in an anaesthesia-related research project, audit, or other scholarly activity during the fellowship.
• The programme aims to develop interest and basic skills in formulating research questions, designing achievable studies, understanding basic statistics, interpreting results, and preparing manuscripts.
• Fellows are encouraged to present their work at national or international meetings and actively participate in ongoing audits, research activities, journal clubs, and academic teaching sessions.
Eligibility:
• The applicant must have an MBBS or equivalent degree recognized by the Pakistan Medical and Dental Council / Pakistan Medical Commission.
• The applicant should have completed a one-year house job or internship.
• The applicant must have completed residency training in Anaesthesiology.
• FCPS Part I is mandatory.
The selection process is based purely on merit.
Positions Available:
Position is available for 2027 Induction cycle.
