Global Anesthesiology Fellowship Program Objectives
Fellowship Director: Dr. Kelly McQueen
Overview
This fellowship provides training for the provision of clinical care in low-income settings, along with research guidance
to complete successful and meaningful projects on global anesthesia issues.
Many elective opportunities exist within the Global Anesthesia Fellowship and the program is designed to be tailored to
the fellow’s interests. Elective months are available in regional anesthesia, pain management, appropriate and lowtechnology ICU development and research strategies and training.
Opportunities to learn and acclimate to a low-income and limited technology setting are offered through simulation.
Opportunities for research intended to analyze low-come anesthesia practices and outcomes are also in place for the
fellow.
Up to 6 months/year will be spent in a low or middle income country. The international experience is intended to provide
the fellow with austere and low-technology clinical, teaching and research experiences to enhance the preparatory work
expected to be completed by the fellow prior to traveling.
Finally, fellows interested in formal Public Health training are given the opportunity to pursue a Master of Public Health
with a focus in Global Health, during the 2-year fellowship.
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Patient Care: Fellows must be able to provide patient care that is compassionate, appropriate, and effective for the
treatment of health problems and the promotion of health in austere and remote settings. The clinical program serves as
the cornerstone of global anesthesia.
After successful completion of the program the
fellow will be able to:
Objective 1. Conduct a patient assessment in austere
settings; specifically the fellow must
demonstrate basic physical exam skills as well
as the ability to conduct a preoperative
evaluation in a low tech environment
Objective 2. Demonstrate effective use of ketamine
analgesia and anesthesia
Objective 3.
Demonstrate the proper use of a precordial
stethoscope
Objective 4.
Demonstrate the ability to use draw-over
vaporizers when needed
Objective 5.
Demonstrate the ability to safety deliver a
general anesthetic without oxygen
Objective 6.
Demonstrate the ability to assemble,
disassemble and repair basic anesthesia
equipment
Objective 7
Demonstrate the ability to provide appropriate
post-op pain management in remote settings
with few available medications
Objective 8
Demonstrate the ability to prepare for basic
regional techniques in resource poor settings to
include superficial cervical plexus, axillary
brachial plexus block, IV regional anesthesia,
wrist block, digital nerve block, intercostal
nerve block, saphenous nerve block, ankle
block, spinal anesthesia, lumbar epidural,
combined spinal-epidural and mandibular
nerve block
Methods of Evaluating Competency
 Direct observation/Faculty Feedback
 Written test
X Oral presentation/quiz
 Other (list)
X Direct observation
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
 Direct observation/Faculty Feedback
 Written test
X Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
X Oral presentation/quiz
 Other (list)
 Direct observation/Faculty Feedback
 Written test
X Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
 Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
X Other (list) Simulation and
Clinical Rotation
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Medical Knowledge: Fellows must demonstrate knowledge of established and evolving biomedical, clinical,
epidemiological and social-behavioral sciences, as well as the application of this knowledge to the safe practice of
anesthesia in austere and remote settings.
After successful completion of the program
the fellow will be able to:
Objective 1. Describe the global burden of surgical disease
and the global anesthesia crisis
Methods of Evaluating Competency
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
Objective 2.
Understand the specific differences in the
practice of anesthesia in austere and remote
settings without compromising patient safety
Objective 3.
Understand principles of, benefits of, and
options for, regional anesthetic procedures and
how to safely administer them in austere
settings
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
Objective 4.
Understands complications of regional
anesthetic techniques
Objective 5.
Develop familiarity with the growing body of
international literature on global anesthesia and
surgical practices
Objective 6.
Understand the benefits and difficulties of the
administration of ketamine
Objective 7.
Understand the options for acute pain
management in austere and low-income settings
Objective 8
Understand the ethical standard for the
provision of clinical care, donation policies and
expired pharmaceuticals as an expatriate
physician
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
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Practice-based Learning and Improvement: Fellows must demonstrate the ability to investigate and evaluate their care
of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant selfevaluation and life-long learning. Fellows are expected to develop skills and habits to meet the following goals:
After successful completion of the program
the fellow will be able to:
Objective 1. Identify strengths, deficiencies, and limits in
one’s knowledge and expertise
Objective 2.
Set learning and improvement goals
Objective 3.
Identify and perform appropriate learning
activities
Objective 4.
Systematically analyze practice using quality
improvement methods, and implement changes
with the goal of practice improvement
Objective 5.
Incorporate formative evaluation feedback into
daily practice
Objective 6.
Locate, appraise, and assimilate evidence from
scientific studies related to their patients’
health problems
Objective 7.
Use available information technology to
optimize learning
Objective 8.
Participate in the education of patients,
families, students, residents and other health
professionals.
Methods of Evaluating Competency
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
4
Interpersonal and Communication Skills: Fellows must demonstrate interpersonal and communication skills that result
in the effective exchange of information and collaboration with patients, their families, and health professionals. Fellows
are expected to:
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Communicate effectively with patients, families, and the public, as appropriate, across a broad range of
socioeconomic and cultural backgrounds;
Communicate effectively with physicians, other health professionals, and health related agencies;
Work effectively as a member or leader of a health care team or other professional group;
Act in a consultative role to other physicians and health professionals; and,
Maintain comprehensive, timely, and legible medical records, if applicable.
After successful completion of the program
the fellow will be able to:
Objective 1. Communicate clearly in a collegial manner that
facilitates the achievement of care goals
Objective 2.
Present one Grand Rounds lecture on a global
anesthesia topic
Objective 3.
Formulate care plans that utilize the
multidisciplinary team approach, often within
challenging medical and logistic settings.
Objective 4.
Assist other health care team members to
enhance delivering important information
Methods of Evaluating Competency
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
 Direct observation/Faculty Feedback
 Written test
X Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
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Professionalism: Fellows must demonstrate a commitment to carrying out professional responsibilities and an adherence
to ethical principles.
After successful completion of the program
the fellow will be able to:
Objective 1. Demonstrate cross-cultural sensitivity and the
ability to productively interact with
international colleagues and patients
Objective 2.
Demonstrate sensitivity and responsiveness to a
diverse patient population, including but not
limited to diversity in gender, age, culture, race,
religion, disabilities, and sexual orientation
Objective 3.
Demonstrate compassion, integrity, and respect
for others; responsiveness to patient needs that
supersedes self-interest
Objective 4.
Demonstrate respect for patient privacy and
autonomy; accountability to patients, society
and the profession
Methods of Evaluating Competency
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
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Systems-based Practice: Fellows must demonstrate an awareness of and responsiveness to the larger context and system
of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care.
Fellows are expected to:
 Work effectively in various health care delivery settings and systems relevant to their clinical specialty;
 Coordinate patient care within the health care system relevant to their clinical specialty;
 Incorporate considerations of cost awareness and risk-benefit analysis in patient and/or population-based care as
appropriate;
 Advocate for quality patient care and optimal patient care systems;
 Work in multidisciplinary teams to enhance patient safety and improve patient care
 Quality; and
 Participate in identifying system errors and implementing potential systems solutions.
After successful completion of the program
the fellow will be able to:
Objective 1. Demonstrate effective decision making in lowincome setting
Objective 2.
Demonstrate respect for a local standard of care
when it differs from the U.S. standard of care
Objective 3.
Demonstrate patient safety practice in a variety
of clinical settings within the limits imposed by
low-income/low-technology settings
Objective 4.
Articulate ethical limitations for practice in a
country other than the fellow’s home country
Methods of Evaluating Competency
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
X Direct observation/Faculty Feedback
 Written test
 Oral presentation/quiz
 Other (list)
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TEACHING METHODOLOGIES
Fellows in this program will be expected to learn and achieve the learning objectives through the following
methodologies and activities:
X Lecture
 Lab
X Conference
X Seminar
X Simulation (see description below)
X Clinical Experience
X Research
 Small Group
 Independent Study
SIMULATION
Simulation scenarios which illustrate clinical challenges in low-income settings will be utilized in order to acclimate and
prepare fellows. Fellows are expected to create additional scenarios for the education of residents also preparing for
overseas global rotations.
PATIENT ENCOUNTERS/CASE LOGS
Fellows in this program will work up and/or manage a number of patients/cases in various disease states and in a variety
of health care settings, with variable resources while overseas. The fellow with track these patient encounters through a
Redcap database with de-identified case data to include: ASA Status, Age, Gender, +/- Emergency, Diagnosis, Procedure,
Complications/Outcomes.
RESEARCH
A research project pertaining to the global burden of surgical disease and/or the global anesthesia crisis is expected as a
critical element of this fellowship. Based on the project and country of interest, mentorship and research guidance will be
provided by faculty actively involved in related research.
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