ROTATION INFORMATION
DEPARTMENT OF ANESTHESIA
RESIDENCY TRAINING PROGRAM
UNIVERSITY OF MANITOBA
INFECTIOUS DISEASES
INTRODUCTION
The competent anesthesiologist is a perioperative physician. The provision of complete
perioperative care includes the management of infectious disease in the entire
perioperative period. Whether investigating and optimizing pre-existing disease or
managing perioperative complications, a current and thorough understanding of common
infectious problems is required.
Along with the BCT year and other Internal Medicine and Subspecialty rotations, this
rotation is designed to allow the residents to:
a)
Develop primary skills (patient assessment, use of laboratory tests, and special
investigations) across a broad range of medical practice.
b)
Develop a mature and effective physician-patient relationship
c)
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)
d)
Acquire both general medical knowledge, and specialty specific knowledge
necessary to function as a competent perioperative physician.
GOALS AND OBJECTIVES
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.
The following Rotation Specific Goal and Objectives for Endocrinology, provide
specialty specific emphasis to particular components of the general Program Goals and
Objectives. These Goals and Objectives are written in the CanMEDS format. The
resident is expected to achieve the following goals and objectives in an appropriately
incremental manner, with increasing experience.
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.
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1. Medical Expert/Clinical Decision Maker
By the end of this rotation, the resident will be able to perform the following:
A. Diagnose and treat the following infectious problems and provide rationale
based on a thorough understanding the microbiology and pathophysiology :
i. Pneumonia
a. Postoperative
b. hospital acquired
c. Ventilator-associated
ii. Wound infections
iii. Endocarditis
iv. UTI
v. Generalized sepsis and septic shock
B. Identify and explain the perioperative implications of preoperative infectious
diseases, including hepatitis, HIV, TB, and colonization with drug-resistant
organisms
C. Formulate and implement an appropriate plan for patient management based
on understanding of the physiology, microbiology and antimicrobial
sensitivities of the infectious problem, coexisting problems, and patient
factors such as anxiety, discomfort, culture, language, ethnicity, age, and
gender
D. Apply an organized method of physical and laboratory assessment of patients
with infectious disease and communicate a succinct evaluation and
management plan to Attending Staff.
E. Discuss the selection, indications, management principles, and complications
of antimicrobial therapy.
F. Identify risk factors for perioperative infections
G. Select appropriate prophylactic antimicrobial therapy, and provide a rationale
that takes into account the risks and benefits of prophylaxis
2. Communicator
By the end of this rotation, the resident will be able to perform the following:
A. Establish a therapeutic relationship with endocrinology 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
infectious illness.
C. Discuss appropriate information with the patient, his/her family, and other
healthcare providers (endocrinologists, other physician requesting
consultation, nursing staff, and other health professionals) to facilitate the
optimal management plan for the care of the patient
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3. Collaborator
By the end of this rotation, the resident will be able to perform the following:
A. Effectively consult with other physicians and health care professionals and
demonstrate appropriate judgment regarding the assessment of infectious
disease
B. Coordinate the care of endocrinology patients with other members of the care
team, especially endocrinologists, 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 severe
hypotension, severe hypertension, hypoglycemia, and diabetic keto-acidosis as
a team member or leader
D. Communicate a succinct assessment and management plan to Attending Staff
and to other physicians requesting consultation.
4. Manager
By the end of this rotation, the resident will be able to perform the following:
A. Manage time and assign priorities to result in:
i. Efficient use of time for patient assessment
ii. Changes in response to emergencies
B. Demonstrate the ability to make judgments regarding the cost-effective use of
medical resources such as drugs, or other therapeutic choices
5. Health Advocate
By the end of this rotation, the resident will be able to perform the following:
A. Recognize and explain the importance of broad health and societal issues with
impact on the care of the patient with infectious disease including:
i. Risk factors and demographics which contribute to the development
of infectious disease
ii. Factors that identify high-risk patients
B. Demonstrate the ability to 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. Formulate questions for ingoing appraisal
C. Search and critically appraise current infectious diseases literature, and apply
new knowledge based on appropriate evidence
D. Demonstrate effective oral presentation of case reports, journal club, or rounds
with sound synthesis of pertinent information
E. Facilitate learning of patients, housestaff, students and other professionals
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7. Professional
Throughout this rotation, the resident shall:
A. Deliver highest quality care with integrity, honesty, and compassion
B. Demonstrate appropriate interpersonal and professional behavior
C. Practice medicine ethically consistent with the obligations of a physician
D. Be aware of the ethical and legal aspects of patient care
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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