cardiothoracic anaesthesia

53 Pages·2006·0.19 MB·English

SPECIALISED PROCEDURES FOR CREDENTIALING

1. ANESTHESIA
- Cardiothoracic Anesthesia
- Paediatrics Anaesthesia
- Intensive Care
- Pain Medicine

2. MEDICAL
- Endocrine
- Respiratory Medicine
- Advance Internal Medicine
- Cardiology
- Dermatology
- Nephrology
- Neurology

3. O&G
- Gynae – Oncology
- Maternal Fetal Medicine
- Reproductive Medicine

4. PAEDIATRICS
- Neonatology
- Paediatrics Cardiology
- Hepathology / Gastroenterology
- Nephrology
- Neurology
- Haematology Onclogy
- Respiratory Medicine
- Paediatrics Anesthesia

5. ENT
- Otology / Neuro Otology
- Rhinology
- Head & Neck
- Peadfiatrics ENT

6. PATHOLOGY
- Chemical Pathology
- Medical Microbiology
- Tranfusion Medicine
- Cytopathology/Cytogenetic
- Metabolic & Endocrine

7. PLASTIC SURGERY

8. FORENSIC MEDICINE

9. ORAL & MAXILLOFACIAL SURGERY
SPECIALIZE PROCEDURES - ANAESTHESIA

1. CARDIOTHORACIC ANAESTHESIA

2. PEADIATRIC ANAESTHESIA

3. INTENSIVE CARE MEDICINE

4. PAIN MEDICINE
CARDIOTHORACIC ANAESTHESIA

No Procedures Minimal Training necessary Maintenance of
for competence competence
1 Anaesthesia for cardiac 6 month experience in cardiac Active practice in
surgery anaesthesia cardiac
anesthesia
2 Conduct of - attended short course Active practice in
cardiopulmonary bypass - 6 months experience in cardiac
running the heart-lung machine anesthesia
3 Insertion and managem -attend short course Active practice in
ent of an Intra- Aortic -performed 10 procedures under cardiac
Ballon Pump. supervision anesthesia
4 Trans-oesophageal -attend short course I. Active practice
Echocardium(TEE) in the -assisted in 10 procedures in cardiac
Operation theatre -performed 20 procedures under anesthesia
And ICU supervision ii.Perform at least
30 procedures
per year

PEADIATRIC ANAESTHESIA

No Procedures Minimal Training necessary Maintenance of
for competence competence
1 Anesthesia for neonatal 6 months experience in neonatal Active practice
surgery anaesthesia In paediatric
anaesthesia
2 Thoracic epidural i. 6 months experience Active practice in
Anaesthesia for pediatric in paediatric paediatric in
Patients anesthesia anaesthesia
ii. performed 10
procedures under
supervision
INTENSIVE CARE MEDICINE

No Procedures Minimal Training necessary for Maintenance of
competence competence
1 Percutaneous i. 6 months training in ICU after i. active practice in
Tracheostomy in being credentialed as specialist intensive care
the operation theatre ii. assisted in 10 procedures ii. perform at least
and ICU iii performed 20 procedures 30 procedures
under supervision per year

2 Continuous Renal i. 6 months training in ICU after i. active practice in
Replacement Therapy being credentialed as specialist intensive care
in ICU ii. assisted in 5 procedure ii. perform at least
iii performed 10 procedures under 30 procedures
supervision per year

PAIN MEDICINE

No Procedures Minimal Training necessary Maintenance of
for competence competence
1 Sympathetic blocks i. 3 months training in Pain i. Active practice
-lumbar , coelic plexus Medicine after being in Pain Medicine
and stellate credentialled as specialist ii. Perform at least
ganglion(local ii. assisted in 2 procedures 5 procedures per
anaesthetic blocks) iii.performed 2 procedures year
under supervision
2 Implantable intrathecal i. 6 months training in pain i. Active practice
and epidural catheters medicine after being in Pain Medicine
and pump credentiallled as specialist ii. Perform at least
ii. assisted in 2 procedures 5 procedures per
iii performed 3 procedure under year
supervision
Spinal Cord Stimulation i. 6 months training in pain i. Active practice in
3 And other methods of medicine after being pain medicine
neuromodulation credentialed as specialist ii Perform at least 5
ii. assisted in 5 procedures procedures per
iii performed 10 procedured year
under supervision
4 Sympathetic blocks i. 6 months training in Pain i Active practice in
-lumbar, coelic plexus medicine after being Pain medicine
and stellate credentialed as specialist iiPerform at least
ganglion(neurolytic ii. assisted in 2 procedures 5 procedures per
blocks) iii. performed 3 procedures year
under supervision
SPECIALIZE PROCEDURES - MEDICINE

1. ENDOCRINOLOGY

2. RESPIRATORY MEDICINE

3. ADVANCED INTERNAL MEDICINE

4. NEPHROLOGY

5. RHEUMATOLOGY
1. ENDOCRINOLOGY

No Procedures Minimal Training necessary for competence
1. Insulin Tolerance Test (cid:131) Aware of indications and contraindications
(cid:131) Assisted and interpreted at least 5

2. Water Deprivation Test Perform and interpret under supervision at least 5
3. 72-hour prolonged fast Perform and interpret under supervision at least 5
for diagnosis of
insulinoma

4. Fine needle aspiration Supervised on at least 5 occasions
of thyroid

Recognized Training Centres:

1. Hospital Universiti Malaya
2. Hospital Universiti Kebangsaan Malaysia
3. Hospital Universiti Sains Malaysia
4. Hospital Pulau Pinang
5. Hospital Putrajaya

2. RESPIRATORY MEDICINE

No Procedures Minimal Training necessary for competence
1 Fiberoptic -observe F.O.B-10 cases
bronchoscopy -Perform F.O.B under supervision-25 cases
(F.O.B) -Perform F.O.B competently by own self-50 cases
-Perform F.O.B on ventilated patients-5 cases
-Perform bronchial brushing – 20 cases
-Perform bronchial biopsy-20 cases
-Perform bronchio-alveolar lavage -20 cases
-Perform trans bronchial lung biopsy-5 cases

3 Pleural biopsy -Perform under supervision –5 cases
-Perform competently by own self -10 cases
4 Chest tube -Perform under supervision –5 cases
insertion -Perform competently by own self -10 cases

5 Medical -Perform under supervision –2 cases
pleorudesis -Perform competently by own self -5 cases
6 Spirometry -Perform under supervision –5 cases
-Perform competently and interpreter correctly
-50 cases
7 Full Lung Function -Observe-10 cases
-Interprete correctly -50 cases
8 Radiological -Chest radiograph interpretation under supervision-100 cases
Interpretation -CT Thorax interpretation under supervision
-50 cases
9 Tuberculin skin test -Observe – 5 cases
-Perform competently -20 cases
10 Sleep Study -Set up under supervision-5 cases
-Interprete under supervision-10 cases
11 CPAP for sleep -Observe-5 cases
Apnoea
12 Non invasive -Observe -5 cases
Intermittent Positive
Pressure
Ventilation
(NIPPV)

13 Percutaneous Lung -Observe-5 cases/procedures
Biopsy
ADVANCED INTERNAL MEDICINE

No Procedures Minimal Training Maintenance of competence
necessary for
competence

1 ECG/Holter 50 cases 10 cases
2 Exercise Stress Test 20 cases 100 cases
3 Transthoracic Echo 100 cases 100 cases
4 Temporary Pacing 10 cases 10 cases
5 Percardiocentesis 5 cases 5 cases
6 Bronchoscopy 40 cases 20 cases
7 Diagnostic OGDS 75 cases 50 cases
8 Diagnostic Colonoscopy 50 cases 25 cases
9 TEE 50 cases 25 cases
10 Abdominal Ultrasound 200 cases 50 cases
11 Swan-Gantz Catheterization 5 cases 5 cases
Criteria For Credentialing of Nephrologists.

1. A physician shall be credentialed as a nephrologist if he/she has successfully
completed 3 years training in nephrology in accredited center/s.

2. For a physician who has been practicing before 1980 and who may not fulfill the
above criteria, to be credentialed as a nephrologist:

a. He/She should have a minimum of one year training in nephrology in a
recognized center.

AND

b. Spends a significant proportion of his/her time in clinical practice in
nephrology.
Core Procedural Skills Of Sub Specialists On Completion of Fellowship / Sub Specialty
Training In Nephrology

No. Procedures Minimal Training necessary Maintenance Please Minimum
for competence of indicate ((cid:57)) training
competence the necessary
procedures for a
that a generalist to
generalist perform the
can perform procedure
with the competently
required
minimum
training
1. Percutaneous 1. Minimum training duration – Remains in
renal biopsy 6 months. active
nephrology
2. Minimum successful practice.
procedures – 30

3. Supervised by credentialed
consultant who has maintained
credential status.

2. Interpretation of 1. Minimum training duration – Continued
basic renal 1 year. interest in the
histopathology field
2. Supervised by credentialed
renal histopathologists.

3. Haemodialysis 1. Minimum training duration – Remains in
6 months. active
nephrology
2. Supervised by credentialed practice
nephrologists.

4. Chronic Peritoneal 1. Minimum training duration – Remains in
Dialysis 6 months. active
nephrology
2. Supervised by credentialed practice.
nephrologists.
5. Continuous renal 1. Minimum CRRT procedures Remains in
Replacement – 10. active
Therapy (CRRT) nephrology
2. Supervised by credentialed practice.
nephrologists.

6. Plamapheresis 1. Minimum Plamapheresis Remains in
procedures - 5 active