ROTATION INFORMATION
DEPARTMENT OF ANESTHESIA
RESIDENCY TRAINING PROGRAM
UNIVERSITY OF MANITOBA
RESPIROLOGY
INTRODUCTION
The University of Manitoba Training Program for Residents in Anesthesia has been
developed in accordance with the guidelines of the Royal College of Physicians and
Surgeons of Canada. Along with the BCT year and other Internal Medicine and
Subspecialty rotations, this Respirology rotation is designed to allow the resident to:
a)
b)
c)
d)
Develop primary skills (patient assessment, use of laboratory tests, and special
investigations) across a broad range of medical practice
Develop a mature and effective physician-patient relationship
participate in the team management of patients and, when appropriate, supervise
more junior members of the team (the opportunities for these are more limited
in anesthesia rotations)
Acquire both general medical knowledge, and specialty specific knowledge
necessary to function as a competent consultant in anesthesia.
GOALS AND OBJECTIVES
The following Rotation Specific Goals and Objectives for Respirology, provide specialty
specific emphasis to particular components of the general Program Goals and Objectives.
Please refer also to the National Curriculum for Canadian Anesthesia Residency for more
information on expected knowledge and skills.
All appropriate Program Goals and Objectives also apply to this rotation.
1. Medical Expert/Clinical Decision Maker
By the end of this rotation, the resident will be able to perform the following:
A. Explain the pathophysiology, diagnosis and treatment of common respiratory
problems that occur in adult patients, including:
i. Reactive Airway Disease
ii. Asthma and status asthmaticus
iii. COPD
iv. Restrictive lung disease
v. Pulmonary malignancy
vi. Pulmonary infections
a. Bacterial and viral pneumonia
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B.
C.
D.
E.
F.
G.
H.
b. Tuberculosis
c. Fungal infections
vii. Occupational lung disease
viii. Adult Respiratory Distress Syndrome
ix. Pulmonary hypertension and Cor Pulmonale
Apply an organized method of assessment of patients with respiratory disease
and communicate a succinct evaluation and management plan to Attending
Staff.
Appropriately order and interpret CXR, CT, MRI, angiographic, PFT’s and
Flow-Volume Loops, and nuclear data.
Explain the indications for, and demonstrate interpretation of, the common
diagnostic tests (CXR, CT, MRI, angiographic, PFT’s and Flow-Volume
Loops, ABG, and nuclear data)
Perform fiber-optic bronchoscopy for diagnosis and treatment
i. Perform topical anesthesia of the airway
Discuss the assessment, management, and optimization of patients presenting
with respiratory disease for thoracic and non-thoracic surgery.
Discuss the pharmacology and indications for use of commonly used drugs
(e.g. antibiotics, bronchodilators, inhaled and systemic steroids etc.)
Formulate and implement an appropriate plan for patient management based
on understanding of the respiratory problem, coexisting problems, and patient
factors such as anxiety, discomfort, culture, language, ethnicity, age, and
gender
2. Communicator
By the end of this rotation, the resident will be able to perform the following:
A. Establish a therapeutic relationship with respiratory patients emphasizing
understanding, trust, empathy, and confidentiality
B. Elicit and synthesize relevant information from the patient and/or family, and
be able to assess and take into account, the impact of a patient's age, gender,
ethnocultural background, social supports, and emotional influences on
cardiac illness
C. Discuss appropriate information with the patient, his/her family, and other
healthcare providers (respirologists, surgeons, other physicians requesting
consultation, nursing staff, and other health professionals) to facilitate the
optimal management plan for the care of the patient
3. Collaborator
By the end of this rotation, the resident will be able to perform the following:
A. Communicate a succinct assessment and management plan to Attending Staff
and to other physicians requesting consultation.
A. Effectively consult with other physicians and health care professionals and
demonstrate appropriate judgment regarding the assessment of respiratory
disease
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B. Coordinate the care of respiratory patients with other members of the care
team, especially respirologists, surgeons, or other consultation requesting
physicians, and nurses, as well as staff in the intensive care unit, and wards
C. Demonstrate skill in managing urgent and crisis situations such as hypoxia or
airway obstruction, as a team member or leader
4. Manager
By the end of this rotation, the resident will be able to perform the following:
A. Manage time and assign priorities for :
i. Efficient use of time for patient assessment
ii. Changes in response to emergencies
B. Make treatment plans that take into account the cost-effective use of medical
resources such as drug or other therapeutic choices
5. Health Advocate
By the end of this rotation, the resident will be able to perform the following:
A. Demonstrate knowledge and recognition of broad health and societal issues
with impact on the care of the patient with respiratory disease including:
i. Risk factors and demographics which contribute to the development
of respiratory disease
ii. Lifestyle changes and programs which aid in the prevention of
respiratory disease
iii. Factors that identify high-risk patients
iv. Short-term and long-term programs for postoperative health
maintenance
B. Intervene on behalf of patients regarding their care and safety
6. Scholar
By the end of this rotation, the resident will be able to perform the following:
A. Develop, implement, and monitor a personal continuing education strategy
B. Search and critically appraise current respirology literature, and apply new
knowledge based on appropriate evidence
C. Demonstrate effective oral presentation of case reports, journal club, or rounds
with sound synthesis of pertinent information
D. Formulate questions for ongoing appraisal
E. Facilitate learning of patients, housestaff, students and other professionals
7. Professional
Throughout this rotation, the resident shall:
A.
B.
C.
D.
Deliver highest quality care with integrity, honesty, and compassion
Demonstrate appropriate interpersonal and professional behavior
Practice medicine ethically consistent with the obligations of a physician
Be aware of the ethical and legal aspects of patient care
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E. Show recognition of personal limits through appropriate consultation (with
staff supervisors, other physicians, and other health professionals) and show
appropriate respect for those consulted
F. Demonstrate including the patient in discussions of care management
G. Recognize potential conflict in patient care situations, professional
relationships, and value systems, and demonstrate the ability to discuss and
resolve differences of opinion. Additionally, be able to accept constructive
feedback and criticism and implement appropriate advice
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