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PubMed · 3829285

Anaesthesia training in Nepal.

J R Maltby·N B Rana·R Amatya·B M Shrestha
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Abstract

The background, organization, problems, and successful implementation of an anaesthesia training program in Nepal are described. Nepali physicians had previously taken their postgraduate anaesthesia training in western countries, especially in Britain. The low pay of anaesthetists, poor maintenance of equipment, and irregular supplies of anaesthetic drugs in their own country has led many of them to stay abroad. In 1985 there were only seven Nepali anaesthetists in Nepal for a population of 16 million. An alternative approach to training is presented in which a series of Canadian anaesthetists, over a three-year period, are supporting the establishment of a one-year Diploma in Anaesthesiology program in Nepal. They are working with Nepali anaesthetists and the Institute of Medicine in Kathmandu, Nepal. The local anaesthetists supervise most of the clinical training while the Canadians give academic leadership and guidance.

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AnesthesiologyAnestheticsCanadaEducation, Medical, GraduateInternational CooperationNepalWorkforceJournal ArticleResearch Support, Non-U.S. Gov't

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BibTeXRIS

J R Maltby, N B Rana, R Amatya, B M Shrestha. 1987. Anaesthesia training in Nepal.. https://doi.org/10.1007/bf03007682

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PubMed2007

Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees.

BACKGROUND AND OBJECTIVE: We surveyed delegates at the Group of Anaesthetists in Training (UK) meeting to investigate evidence of a training-gap (number of fibreoptic intubations believed to bestow competence vs. number actually performed). METHODS: Questionnaires were distributed to and collected from delegates in person. Questions covered six areas, including experience of fibreoptic intubation and cricothyrotomy, fibreoptic intubation as a specialist skill and ethical issues. RESULTS: We received 221 replies (76%). All trainees believed competence to be achievable with 10 intubations (interquartile range (IQR) 10-20); the median number performed was 2 (IQR 0-4). This was statistically significant for the groups' senior house officers, 1st and 2nd year registrars and 3rd and 4th year registrars; P < 0.0001. Many final year trainees (12/20, 60%) also failed to achieve their competency target. Few trainees had seen or performed any cricothyrotomies (medians 0, IQRs 0-1 and 0-0). Most (195/208, 94%) believed that fibreoptic intubation was a core skill and 199/212 (94%) believed that all should be competent by completion of training. Ten percent (n = 208) felt it unethical to perform an awake training intubation with full consent and 10% believed it acceptable without explanation. Most (82.7%) would fibreoptically intubate an asleep patient (requiring intubation) without consent. CONCLUSION: Trainees reported a gap between their perception of competence and achievement in awake fibreoptic intubation. Simple and complex simulations and structured training programmes may help. Anaesthetists must address the ethics of clinical training in advanced airway management.

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