Residents in this program will have a number of opportunities unique to Northern Ontario. While the majority of the training takes place in Sudbury, the opportunity to have clinical experiences in various centers across the North, from small rural hospitals to other major centers such as Thunder Bay, provides a unique chance to understand how anesthesia is provided outside of the major teaching center, and exposure to potential career opportunities.
Core academic learning experiences take place at hospital sites throughout Northern Ontario. In addition to the communities listed below, NOSM has affiliations with 22 hospitals where additional experiences may be sought, including, but not limited to Dryden District Health Centre, Lake of the Woods District Hospital in Kenora, Meno-Ya-Win Health Centre in Sioux Lookout, Muskoka Algonquin Healthcare, Riverside Healthcare Facilities Inc. in Fort Frances, St. Joseph’s Care Group, Temiskaming Hospital, Timmins and District Hospital, and Notre Dame Hospital in Hearst, which allows for a wide variety of unique learning opportunities.
Health Sciences North (HSN)
North Bay Regional Health Centre (NBRHC)
Sault Ste. Marie
Sault Area Hospital (SAH)
The Departments of Anesthesiology offer a number of services throughout their respective hospitals. The Anesthesiologists are constantly challenged to update their practices and offer different services which align with the changes in the nature of medicine and overall healthcare.
Health Sciences North site has provided Royal College training in anesthesia for approximately 10 years. It is well known to be an outstanding clinical rotation. The service to education ratio is strongly in favour of education and the clinical faculties routinely receive outstanding evaluations.
SAH has been a home base for FPA residents for 4 years. We offer a balance of royal college trained anesthesiologists and family practice anesthesiologist with a low learner to staff ratio. This affords learners with a tremendous opportunity to enhance their education.
Preoperative Assessment Clinics
In addition to the Pre-Anesthesia clinic rotation, the residents will be regularly scheduled in the clinic as they progress through the residency. There are a number of urgent inpatient consults which are handled on call and the residents will be the first to assess these patients.
HSN and Sault Area Hosptial have active obstetrical service. Residents often are called upon to place labor epidurals during the day and while on call. There is a staff person assigned to cover obstetrics 24 hours a day with an OB person during the daytime and the first call anesthesiologist after hours. We are involved in operative deliveries, planning of high risk deliveries and emergencies.
Acute Pain Service (APS)
At HSN, the pre-admission clinic physician covers APS. During your formal rotation and scheduled day in pre-admit clinic, you will participate in morning and afternoon acute pain service rounds. Currently, our service follows up on patients having received intrathecal narcotics, single shot nerve blocks and manages patients with an epidural and patient control analgesia pumps. With the advent of a formal regional block room in the future, we hope to incorporate the management of continuous peripheral nerve catheters.
At SAH residents will be given the opportunity to follow their own patients who receive blocks, PCA or epi-dural through their post operative course.
Currently at HSN and SAH, regional anesthesia is conducted in the operating room with the evolution of a formal block room/space in the horizon. Common procedures in which single shot peripheral nerve blocks are performed are orthopedic (i.e. Shoulder, knee, ankle) and vascular (i.e. av fistula) cases.
Chronic Pain Program
We are pursuing an additional chronic pain specialist and negotiating with the hospital in developing a formal chronic pain clinic. This is part of the 5 year vision of the HSN department.
Arrest and Trauma Service
The main affiliated hospitals of NOSM have highly active anesthesia departments and busy emergency practices. HSN is a major trauma referral centre. Residents will do regular call shifts and also will be actively sought during any emergencies during daytime hours to involve them as much as possible.
When on call for anesthesia, the residents are currently part of the Trauma Team. This experience is currently new but is providing the residents with an enhanced trauma experience. Over the next 2 years this collaboration will continue to mature and is expected to be an integral part of the anesthesia call experience outside of the operating room.
HSN is a level 2 Trauma Centre with 217 major trauma presentations in 2014-2015 fiscal year.
At SAH the anesthesia resident is encouraged to attend all traumas and code blue situations whenever they aoccur and are felt to be the most rewarding education experience available at the time so long as it doesn’t compromise the care of any patient the resident is currently managing.
Intensive Care Unit (ICU)
Both HSN and TBRHSC have tertiary ICUs with longstanding clinical rotations. The HSN rotation is with an ICU group in a closed 29 bed Cardiac/Medical/Surgical ICU. There are a low number of learners to faculty (usually 1-2 learners at a time) that facilitates close supervision and individualized teaching.
Echocardiography is becoming an increasingly important part of anesthesia practice. Already essential in Cardiac anesthesia, it is becoming more readily available in other parts of anesthesia practice. Our residents all receive some basic training in transesophageal echocardiography during their cardiac rotations. In addition, we will also likely be able to provide a focused transthoracic echocardiography course. Residents are encouraged to incorporate these skills into their practice on a regular basis.