SURGERY - COURSES

WEST AFRICAN COLLEGE OF SURGEONS DIPLOMA IN ANAESTHESIA (DA) SYLLABUS

PHILOSOPHY AND OBJECTIVE
To generate interest in the anaesthesia training programme amongst Consultant and potential trainees outside teaching hospitals by making it possible for such centres if accredited, to send candidates for the Diploma in Anaesthesia examinations.
This will provide the much-needed manpower in the Region and attract more physicians who do not necessarily want to go to fellowship level into the specialty. It will also improve anesthetic services for the other training programmes in the college and enhance the practice of all aspects of surgery.

• ENTRY REQUIREMENTS
  1. Candidates must be medically qualified, with a qualification registrable by the Medical and Dental Council of country of origin.
  2. Candidates must have completed a one-year rotational housemanship including internal Medicine and Surgery.
  
  DURATION:
  A minimum of one year in an accredited centre is required to qualify to sit for the examination.
  SYLLABUS:
  1. Medicine for Anaesthetists
  2. Drugs in Anaesthetic Practice
  3. Techniques of Anaesthesia
  MEDICINE FOR ANAESTHETISTS
  Basic and applied Medical Sciences Related to Anaesthesia – Pharmacology, Physiology, Anatomy, Pathology and Biochemistry.
  
  1. Cardiovascular system
  2. Respiratory system
  3. Central nervous system
  4. Autonomic nervous system
  5. Gastrointestinal system
  6. Urogenital system
  7. Endocrine including diabetes, obesity
  8. Peripheral nervous system including neuromuscular transmission.
  9. Body fluids, electrolytes, acid-base
  10. Blood including haemoglobinopathies
  11. 1. Routine assessment of patients for surgery
      2. Assessment and preparation of patient with coincidental medical diseases and problems.
      3. Psychological preparation
      4. Medical conditions requiring intensive care: · Cardiovascular including cardiac arrest
         · Respiratory failure
         · Tetanus
         · Burns
         · Shock / Septicaemia / Electrolyte imbalance
         · Multiple injuries
         
  1. DRUGS IN ANAESTHETIC PRACTICE
     Specific anaesthesia drugs, their use, theories of anaesthesia, uptake and distribution, potency, metabolism, elimination and toxicity. Development and assessment of new drugs.
     1. Volatile agents: ethers, halogenated anesthetics, anaesthetic gases.
     2. Intravenous anaesthetic agents. Barbiturates, steroids, benzodiazepines, neuroleptanalgesia, Ketamine, imidazole etc.
     3. Opiates and their antagonists
     4. Local anaesthetic agents
     5. Muscle relaxants
     6. Anticholinesterases
     7. Sympathomimetic agents and sympathetic blockers
     8. Anticholinergic drugs
     9. Antihypertensive drugs
     10. CNS stimulants
     11. Antiemetics
     12. Diuretics
     13. New drugs
  2. TECHNIQUES OF ANAESTHESIA
     
     1. Physical principles involved in the design of anaesthetic machines and their accessories, their maintenance, care and sterilisation.
     2. Gas Laws: Flow of liquids and gases, flowmeters, vaporization and vaporisers, reducing and expiratory valves, breathing systems and monitoring equipment, ventilators, oxygen therapy equipment.
        Electrical and explosion hazards, theatre pollution, anaesthetic accidents.
        Physiological measurements of temperature, humidity, respiratory, cardiac, neuromuscular, hepatic, and renal functions.
     3. Principles and practice of anaesthesia in general or for specific disease states, age groups and surgical procedures:
        - Neurosurgery
        - Pulmonary/cardiac
        - Endocrine disorders
        - Ophthalmic
        - Dental and Maxillofacial
        - Gynaecology/obstetric
        - Otorhinolaryngology
        - Haematological disorders
        - Paediatric & neonatal resuscitation
        - Outpatient/Day care
        - Orthopaedic
        - Urology
        - Emergency surgery
        - Anaesthesia in unfavourable situations
        Regional/local anaesthetic techniques
        Special anaesthetic techniques
        - Hypothermia
        - controlled hypotension
        Blood loss assessment
        management and methods of resuscitation
        Intravenous infusion and blood transfusion
        Patient monitoring, records and medicolegal problems
        Pain assessment and relief
        Recovery and post-operative complications
        Intubation, tracheotomy
        Intermittent positive pressure ventilation
        Oxygen therapy.
        
     4. Clinical Anaesthesia
        Candidates will undertake elective and emergency theatre sessions, and rotate round the major specialties of anaesthesia and undertake pre- and post-operative ward rounds.
        General Surgery/Urology - 560 hours
        Gynaecology - 560 hours
        Obstetrics & Emergency Surgery - 1,840 hours
        Ophthalmology - 160 hours
        ENT/Dental - 160 hours
        Paediatric Surgery - 360 hours
        Skills to be demonstrated at the end of the training - Ability to manage a patient pre-, intra- and post-operatively using conventional techniques.
        - Ability to use regional anaesthesia and intravenous anaesthesia confidently.
        - Ability to start a new unit and maintain standards.
        - Ability to judge limitations so as not to take unnecessary risks.
        - Ability to take up other medical responsibilities apart from anaesthesia if necessary.
        - A logbook of at least 400 cases managed in the areas designated above must be submitted together with application for examination.
        Assessment
        After satisfactorily completing one year training in an accredited centre, the candidate will sit for the Diploma in Anaesthesia Examinations, which consist of:
        1. Written paper in Basic Sciences and Principles and Practice of Anaesthesia (MCQ and Essay).
        2. Orals.
        
        A successful candidate must pass overall and also in the Principles and Practice as well as the Orals.
        Award to successful candidate – Diploma in Anaesthesia (DA WACS).
        Training Institutions
        1. Those already running the Fellowship Programme
        2. Accredited Specialist Hospitals with Fellows and Consultants holding a Diploma in Anaesthesia award
        
        There should be a 12-month training. Candidates should have qualified to sit the examination at the time of the closing date for applications for examination.
        Examinations will be held in April (Lagos) and October (Accra).
        An unsuccessful candidate may present himself to resit the examinations twice, after which he has to undergo a further 6 months training in an accredited institution before presenting himself again.
        FORMAT
        LOG BOOK FOR DIPLOMA IN ANAESTHESIA (sample page)
        Date No. Name of Patient Age in years Sex Diagnosis Pre-operative Assessment(ASA) Emergency Elective Surgical Procedure. Anaesthetic Complications (if any) Comments or Remarks Super-visor
        ANALYSIS
        All cases recorded should be analysed at the end of the book i.e. Total No. of cases (General Surgery, Obstetrics, Gynecology, Orthopaedics, etc).
        (Copies may be purchased at the College Secretariat) .