Revised: April 1/07
UNIVERSITY OF MANITOBA
DEPT OF ANESTHESIA
ROTATION INFORMATION
for
Oral Surgery Resident
Elective Rotations
INTRODUCTION
The department of Anesthesia at the university of Manitoba offers elective rotations to
residents in the Oral Surgery Program. These elective rotations are designed to fulfill the
requirements of training of the Canadian Society of Oral and Maxillofacial Surgeons.
The goals and objectives are described using the CanMeds Framework, as utilized by the
Royal College of Physicians and Surgeons of Canada. It is recognized that the
fundamental purpose of the elective is the provision of the knowledge and skills within
medical expert role. The provision of training in the other roles is primarily the
responsibility of the parent program, but reasonable expectations for these other roles are
included in these goals and objectives for the purposes of effective formative and
summative feedback about function in these areas.
MEDICAL EXPERT
General Goals and Objectives
By the end of the elective experience the resident shall be able to:
 Perform and explain the principles of conscious sedation
 Maintain and protect an airway in an unconscious patient
 Be able to manage life-threatening emergencies in surgical practice
 Perform an appropriate preoperative assessment
 Safely use local anesthetics
Enabling Goals and Objectives
In order to achieve the general goals and objectives, the resident must be able to:
 Perform and explain the principles of conscious sedation
o Describe the physiology relevant to sedation
o Describe the risks, indications and limitations of conscious sedation
o Select appropriate agents and have appropriate alternatives
o Have a rationale for the selection and be able to explain the relative
advantages and disadvantages
o Establish venous access
 Maintain and protect an airway in an unconscious patient
o Perform safe and effective orotracheal intubation
o Describe the appropriate approach to a difficult or failed intubation
o List the indications and relative contraindications to intubation
o Identify the factors that place the airway at risk
 Be able to manage life-threatening emergencies in surgical practice
o Identify, treat, and anticipate sequelae of
 Anaphylaxis, airway obstruction, seizures
 Cardiovascular effects of local anesthetic toxicity
Revised: April 1/07


Perform an appropriate preoperative assessment
o Obtain a complete history and physical examination
o Identify and explain factors relevant to anesthetic planning
o Select and explain appropriate investigations
Safely use local anesthetics
o Explain the physiology of local anesthetic action and toxicity
o Select appropriate doses and agents, and provide a rationale
o Undertake appropriate resuscitative measures in the event of toxicity
COMMUNICATOR
General and enabling goals and objectives
By the end of the elective experience the resident shall be able to:
 Establish an effective therapeutic relationship with patients and families
o Establish a comfortable rapport
o Obtain all information necessary for anesthetic planning
o Provide the patient with a clear understanding of the options and risks
 Establish an effective working relationship with staff
o Establish a comfortable rapport
o Recognize and respond to feedback from team members
o Clearly communicate priorities and needs to the team
COLLABORATOR
General and Enabling Goals and Objectives
By the end of the elective experience the resident shall be able to:
 Coordinate a multidisciplinary team
o Recognize the roles and contributions of team members
o Utilize the skills of team members effectively
o Establish and facilitate goals for individuals and the team as a whole
MANAGER
General and Enabling Goals and Objectives
By the end of the elective experience the resident shall be able to:
 Demonstrate effective time and resource management
o Demonstrate an awareness of personal and environmental factors affecting
efficiency
o Take appropriate measures to control these factors
o Be aware of costs of equipment, drugs, and make cost-effective choices
HEALTH ADVOCATE
General and enabling Goals and Objectives
By the end of the elective experience the resident shall be able to:
 Take appropriate measures to protect and in improve the health of patients
o Identify individual and systemic risks to patients
o Suggest appropriate measures to mitigate these risks
Revised: April 1/07
SCHOLAR
General and Enabling Goals and Objectives
By the end of the elective experience the resident shall be able to:
 Maintain an effective personal life-long learning strategy
 Maintain and improve his/her practice using evidence-based principles
o Formulate appropriate questions
o Find relevant information
o Appraise the quality of information
o Apply that information to practice
 Provide effective teaching for trainees in undergraduate, postgraduate and allied
health areas
PROFESSIONAL
General and Enabling Goals and Objectives
By the end of the elective experience the resident shall:
 Conduct him/herself with integrity and honesty
 Recognize his/her limitations and access help appropriately
 Identify and meet all responsibilities
 Be able to discuss principles of bioethical decision making and act accordingly
CLINICAL RESPONSIBILITIES
It is recognized that oral surgery residents begin the elective period with very little prior
experience in anesthesia. The following expectations are intended to be met, but it is
expected that the resident will require a significant amount of guidance initially and then
will be able to gradually assume more autonomy in the attendance to these
responsibilities.
1) Daily
a) Preoperative assessment: The resident will assess each patient on his/her slate
preoperatively at the earliest reasonable opportunity. Inpatients scheduled the
night beforehand or earlier must be assessed by the resident the night beforehand
at the latest. To that end, the resident will review the slating for the next day at
the end of each OR day, to determine his/her responsibilities with respect to
preoperative assessment and communication with staff.
b) Anesthetic planning: For each case, the resident will identify the main anesthetic
implications in the case, and will participate in the formulation of an appropriate
anesthetic plan.
c) Communication with Attending staff: It is the responsibility of the resident to
ensure that this plan is discussed with and approved by the attending
anesthesiologist before proceeding. It is also the responsibility of the resident to
contact the attending anesthesiologist on the day prior to the slate. That contact
will be used at the mutual discretion of the staff and resident to prepare a teaching
plan, review the anesthetic plans, and make any applicable special plans for the
conduct of the slate as a whole.
d) Preparation:
i) The resident shall arrive in the hospital with sufficient time to complete the
following and start the first case at the slated time
Revised: April 1/07
(1) check and prepare all necessary equipment for the first case
(2) make any arrangements that will be required for the efficient conduct of
the slate
(3) assess the first patient and review the assessment and plan with attending
anesthesiologist
ii) The resident will prepare for each subsequent case with sufficient alacrity to
ensure the efficient conduct of the slate.
e) Administration of Anesthesia: The resident will implement the anesthetic plan,
including modification in response to evolving conditions, from preoperative
assessment and optimization through to postoperative disposition, under the
guidance of the attending anesthesiologist.
f) Postoperative Followup The resident will follow up on any complications and
communicate the results of that followup to the attending anesthesiologist. The
resident will direct the postoperative management of such complications in
concert with the attending anesthesiologist to point of their resolution or
delegation to an appropriate health care provider.
2) Call
a) The resident shall take call as indicated on the call schedule for the clinical site in
which s/he is rotating. This call shall conform to the relevant policies on call
found in the Residency Program Policy Manual. While on call, the resident is
expected to perform all of the same functions as outlined above for an elective
slate, within the context of emergency care.
OTHER RESPONSIBILITIES
1) Talk Rounds and Grand rounds
Resident will attend all talk rounds and Grand rounds that occur at their site during
their rotation with the following exceptions
i) While on holidays
ii) Wednesday morning talk rounds when on call Wednesday evening
iii) Illness
2) Evaluations
As per the policy in the Residency Program Policy Manual, residents must hand in
one daily evaluation form for each elective day. The resident must make reasonable
attempt to obtain this evaluation from the staff. If that does not occur, a blank form
must be submitted indicating the reason for non-completion.
LEARNING RESOURCES
During this rotation, the following resources will be available to residents in addition to
those available at all times through the University Department:
1) Clinical teaching- The most important learning resource during clinical rotations is
the direct teaching that occurs during discussion with staff of the management of
actual cases, and topics of interest. The quality of this discussion is enhanced by
communication in advance to generate a teaching plan.
2) Site Library- each tertiary site has a collection of current textbooks relevant to the
pattern of practice of the site
Revised: April 1/07
3) Computer access- each tertiary site has computer access within the OR for resident
use in accessing literature