Journal of the Portuguese Society of Anesthesiology

Residency in Anaesthesiology and Reanimatology in Latvia

Olga Zemļanuhina — 2024-07-15

No presente artigo descreve-se p programa de formação especializada em Anestesiologia e Reanimação da Latvia

Anaesthesia, Pain, and Intensive Care Medicine Training in Malta

Petramay Attard Cortis — 2024-07-15

A description on the organization of the Anaesthesia, Pain, and Intensive Care Medicine Training in Malta is provided.

Between Mountains and Modern Medicine: Adaptability in Anesthesia Training in Switzerland

Joana Berger Estilita — 2024-07-15

Switzerland's healthcare system is globally recognised for its access to care, supported by a robust network of hospitals and private healthcare providers. The Swiss anaesthesia workforce consists of approximately 2700 physicians, including specialists and trainees, with a notable presence of international medical graduates, predominantly from Germany. The country also relies heavily on nurse anaesthetists, who undergo extensive training to support anaesthesia procedures under physician supervision.

Becoming an anaesthesia trainee in Switzerland requires a medical degree compliant with EU or EFTA standards and proficiency in one of the three official languages (German, French, or Italian). The residency program is regionally divided, with different structures in the German-speaking and French-Italian regions. The Swiss anaesthesia residency spans five years and emphasises a competency-based curriculum that includes mandatory anesthesiology and intensive care rotations.

Training facilities are categorised into four levels (A1, A2, B, C) based on their training quality and scope. Residents undergo rigorous assessment through continuous evaluations, practical and written exams, and contributions to medical literature. The Swiss Institute for Post-Graduate and Continuous Medical Education (SIWF/FMH) oversees the certification process.

Challenges in the training system include managing workload and stress, with ongoing campaigns to reduce clinical hours from 50 to 42 per week and ensure teaching time. Long waiting times for rotations in A Level clinics and the need to match the growing elderly population with sufficient trained anesthesiologists also present significant challenges.

Addressing these issues through curriculum development, workload management, and increased training opportunities is crucial for maintaining the high standards of anesthesiology in Switzerland and meeting future healthcare demands.

Anaesthesiology specialty in Spain: state of the art

Maria Aliano — 2024-07-15

New perspectives of anaesthesiology education in Lithuania

Vilma Traskaite – Juskeviciene — 2024-07-15

The article explores the evolution and current state of anaesthesiology education in Lithuania, emphasizing the integration of European standards and the adoption of Entrustable Professional Activities (EPAs). It traces the historical development of the specialty from its inception in 1847 to its recognition as an independent field in 1952. The Lithuanian postgraduate medical education strategy has evolved to include EPAs, a framework that enhances competency-based education by focusing on practical skills and real-world clinical capabilities.

Six core EPAs have been implemented in the Lithuanian University of Health Sciences' anesthesiology residency program, each designed to ensure that trainees acquire and demonstrate essential competencies. These EPAs cover pre-anesthetic consultation, airway management, general and regional anesthesia, postanesthesia care and acute pain management, and chronic pain management.

Furthermore, integration of simulation-based training provides a safe environment for residents to practice and refine their skills is of highest value both for trainees and their tutors. Despite the advancements, the field faces challenges such as increasing demands from residents for more flexible training programs, a declining interest in anesthesiology among medical graduates, and higher expectations from regulatory authorities and society.

In conclusion, anaesthesiology education related challenges require innovative educational strategies and a collaborative effort from medical educators, professional bodies, and policymakers. By maintaining a dynamic and resilient educational framework, Lithuania can continue to produce skilled and competent anesthesiologists ready to meet the demands of modern medical practice.

Anesthesia training in Croatia from the young physician’s perspective: Generation gap and transition from learning by doing to modern techniques.

Ivana Bureš Valentić — 2024-07-15

eescreve-se no presente artigo o progrmaa de formação em anestesiologia na Croácia, focando as diferenças entre gerações e a transição para técnicas mais modernas de aprendizagem.

Postgraduate specialist medical training in Anaesthesiology & intensive care in Estonia

Rein Kruusat — 2024-07-15

No presente artigo descreve-se p programa de formação especializada em Anestesiologia e Reanimação da Estónia

Israeli residency program In Anesthesia - a narrative review

Nadav Sheffy — 2024-07-15

Anaesthesia Training programme in Israel

Anesthesia Education in Belgium: Pathways, Processes, and Perspectives

Quinten Tavernier — 2024-07-15

Anaesthesia education in Belgium is a well-structured and evolving system that emphasizes practical training and patient safety. Medical training begins with a three-year Bachelor of Medicine program, followed by a three-year Master of Medicine program. After obtaining a Master of Medicine, graduates can pursue further postgraduate training to achieve specialisation in specific fields. To become an anaesthesiologist, one must obtain an advanced Master of Medicine in Specialist Medicine - Anaesthesia and Resuscitation while simultaneously completing five years of residency training.

This article provides an in-depth overview of the anaesthesia education pathway in Belgium, highlighting the unique features of the system and its effectiveness in preparing practitioners for the field. The selection procedure and training process are detailed, emphasizing elements that are integral to the Belgian system. The article also discusses the challenges faced by the system, including the rapid advancement of medical knowledge and technology and the shift towards competency-based medical education and simulation training.

Anaesthesia Training and Continuous Education in Greece: Current Situation and Future Perspectives

Georgios Stefanakis — 2024-07-15

In Greece, the updated 2019 program for the training in anaesthesia follows the guidelines of the European Board of Anaesthesiology, encompassing all theoretical and practical learning objectives. The training is time- and count-based, lasts for 5 years and can take place in 4 types of training centres. At the end of the residency, the trainee must provide proof of activities in the relevant logbook and is subject to formal assessment. As there is no recertification or revalidation program for specialists, in order for them to demonstrate their knowledge and engagement in lifelong learning, they are motivated to earn CME/CPD activities credits. Compared to the past decades, training in anaesthesia has improved, placing more emphasis on professionalism, but there is still a long way to go and many challenges, mainly regarding resources (human and infrastructure), still exist.

Anaesthesia Training in Serbia: How Far from European Training Requirements?

Vojislava Neskovic — 2024-07-15

The European Training Requirement in Anesthesiology Update (ETR), from the standing committee on Education and Professional Development (EPD) of the Section and Board of Anesthesiology of the European Union of Medical Specialties (UEMS) defines the standards and a basic structure of the training program for the specialization of anaesthesiology, pain therapy, and intensive care, which can be adapted in different countries according to their educational systems. Recommendations are based on modern pedagogical concepts of outcome or competency-based education. In Serbia, based on the Law on Health Care, The Ministry of Health establishes a lawful requirements and documents of rules on specialties and subspecialties for health workers and health associates, including the training program in anaesthesiology, resuscitation, and intensive care. Here we present the program of specialist training in Anaesthesia, Resuscitation, and Intensive Care in Serbia, comparing to ETR and pointing out the main strengths and places for improvement, to achieve a transparent, fair, reliable, and recognizable educational standard.

Why do we need to learn to Teach?

Lesley Bromley — 2024-07-15

No presente artigo são referidos alguns dos argumentos relativos à importância de ensinar os Anestesiologistas a ensinar.

Training process in Anaesthesiology and Intensive Care in Slovakia

Peter Firment — 2024-07-15

Descreve-se no presente artigo o programa de formação em Anestesiologia e Medicina Intensiva na Eslováquia

Training programs in Anaesthesiology.

Manuel Vico — 2024-07-15

Thoracic segmental spinal anesthesia for cesarean section in a parturient with atrial septal defect - a case report.

Prajnananda Haloi — 2024-07-15

Background

Atrial septal defect (ASD) is a common congenital disease of the heart, and most women with ASD without coexisting PAH experience uneventful pregnancies. Anesthetic management of pregnant ASD patients presenting for lower segment cesarean section (LSCS) is challenging due to potential complications.

Case

A 30-years-old pregnant women with ASD presented for LSCS. She had a 24 mm ostium secundum ASD with left to right shunt, and mild pulmonary arterial hypertension (PAH). Thoracic segmental spinal anesthesia (TSSA) was administered at the T9-T10 intervertebral space. The surgery was uneventful and postoperative pain was managed with bilateral transversus abdominis plane (TAP) block administration and NSAIDS. Her hospital stay was uneventful and was discharged on the 4^th post-operative day.

Conclusion

In conclusion, TSSA for LSCS with ASD can be a safe and effective anesthetic option, but further studies are needed to establish its clinical utility in this specific context.

The Structure of the Anaesthesia specialty training in the U.K.

Lucia Misquita — 2024-07-15

The document provides an overview of the structure and process of anaesthesia specialty training in the UK. Anaesthesia is a highly subscribed training with competitive entry into the program. The Royal College of Anaesthetists (RCoA) is the professional body responsible for setting standards for anaesthetists and anaesthetists in training in the UK. The anaesthesia training curriculum is set by RCoA.

Anaesthesia training is outcome based rather than time based in the UK. The indicative length of training is seven years and is divided into three stages. Trainees must complete the Primary and Final Fellowship examinations of the RCoA. There is also an option for out of programme training or experience within the programme architecture.

Doctors undertaking dual training in Anaesthetics and Intensive Care Medicine have a programme that allows attainment of capabilities in both curricula. Trainees may also choose less than full time training flexible options at any point in their training.

Navigating through the Restructured Anaesthesia Specialist Training in Bavaria, Germany

Thomas Schachtner — 2024-07-15

Anaesthesia training in Germany, particularly in Bavaria, is meticulously structured to equip medical professionals with the expertise needed to excel in this critical field of modern healthcare. This article provides a detailed examination of the anaesthesia specialist training process in Bavaria following the reorganisation of specialist training by the German Medical Association in 2018. The focus of this article is on the implementation of the new specialist training regulations (WBO 2021) by the Federal Association of Medical Doctors in Bavaria (BLAEK) since August 2022. The training duration, organization, assessment methods, regulatory bodies, recertification programs, and both strengths and future challenges are explored. Key elements include an individualised acceptance process, structured training duration of five to six years, competency-based learning with an electronic logbook, mandatory courses in specialized anaesthesia techniques, and periodic recertification through continuing medical education activities (CME). Strengths of the training curriculum encompass structured education, comprehensive clinical exposure, and interdisciplinary collaboration. However, future challenges include workforce shortages, technological advancements, and evolving healthcare landscapes, necessitating ongoing adaptation and innovation to ensure the delivery of high-quality anaesthesia care in Bavaria, Germany.

Perspetivas e Desafios na Formação Específica em Anestesiologia

Henrique Gouveia — 2024-07-15