4 years programme                July

The DM Anaesthesia and Intensive Care programme is a four year graduate course which aims to provide the graduate with the knowledge and clinical competency to function as a specialist anaesthetist and intensivist, equipped for independent practice in hospital-based and stand-alone facilities. 

The programme will be a minimum of four years except under special circumstances (see Exemptions) from the date of entry. At least three years of the programme must be spent in the Commonwealth Caribbean. Throughout the programme, candidates must hold recognized posts in accredited hospitals or be on an 'elective’ approved by the Board for Graduate Studies and Research through the Specialty Board in Anaesthesia and Intensive Care. A list of accredited hospitals may be obtained from the Office of Graduate Studies and Research. Some hospitals are accredited only for the Part I of the course; others are accredited to provide training during the Part II of the course for a specified time. A minimum of three (3) months in the first two (2) and three (6) months in the last two (2) years MUST be spent at the University-affiliated hospital of the campus territories. During the first year, in those accredited hospitals where only adults are treated, students must spend no less than three months in an accredited paediatric hospital. Conversely, for students working in a hospital where only paediatric patients are treated, no less than six months must be spent in an accredited adult multi-disciplinary hospital. There must also be a minimum of three months exposure to obstetric anaesthesia and exposure to intensive care.

On acceptance into the programme there will be a six month probation period during which the student’s clinical and academic performance, and professional attributes, will be assessed. A candidate who fails this assessment will be requested to withdraw from the programme. 

DM Part I

• The Part I is of two (2) year's duration. It aims to ground the postgraduate student in the essentials and basic sciences that underpin the practice of anaesthesia and intensive care. It includes extensive basic and applied physiology and pharmacology, physics and relevant anatomy. Also there is an introduction to research methodology that informs the student of evidence-based medicine and its application to everyday clinical practice.
• The subject areas will be taught in modules. There will be in-course assessments at the end of each module. Students who fail an assessment will be counseled and allowed to proceed to the next module. However they will have to repeat the assessment of the failed module before the next modular assessment becomes due. A second failure will require that the student NOT advance but have to repeat the entire module when this is next offered. This may be 6-12 months later. A third failure will result in the candidate being required to withdraw from the programme.
• A cross-campus Internal Examination will be undertaken at the end of the first year (DM Part I, Year 1 examination). A satisfactory performance in this assessment is required before the student can advance to the second year of the programme. If a candidate fails this Internal Examination, depending on the degree of failure, he or she may be required to:

a) undergo remedial study and repeat the examination in 6 months

b) repeat the entire first year and then re-sit the examination

• In either scenario, if the candidate is unsuccessful for the second time, he or she is required to withdraw from the course.
• Provided that clinical competency, professionalism and in-course assessments are satisfactory, the DM Part I examination is taken at the end of the second year.

DM Part II

• Admission to the second part of the programme depends on a Pass performance in DM Part I Examination and satisfactory assessments of clinical competency and professionalism. The DM Part II is of two years duration. It may include a period not exceeding one year, in the penultimate year, spent as an elective. Approval must be obtained from the Board for Graduate Studies and Research, through the Specialty Board and the Faculty Committee for Graduate Studies, at least six months prior to the commencement of the elective period. The elective year may be spent in a hospital, which can provide the candidate with experience not readily available in the hospital to which he/she is employed. To gain credit for such an elective the candidate must submit a satisfactory assessment report from their named supervisor at the elective hospital.
• A maximum of three (3) months may be spent in a course of study in an affiliated area e.g. research methodology, epidemiology, teaching methods or medical administration.
• During the Part II, rotations through all anaesthesia subspecialties, Intensive Care and Acute and Chronic pain services must be undertaken. The anaesthesia subspecialties will include cardiothoracic, paediatric, obstetric, otorhinolarngology/faciomaxillary and neuroanaesthesia. Training in teaching methods and research methodology are integral components of the programme. Emphasis will also be placed on the responsibilities of professional practice, medical ethics and the law, health care management, information technology and independent practice.
• A steady progression of specialty skills, judgment, professional and ethical responsibility and clinical independence is expected over the four years of training. Students are required to keep a record (log book) of all anaesthesia and procedures performed. In addition they are required to satisfactorily complete a list of minimal competency in cognitive and procedural skills felt to be fundamental to the training of specialists in anaesthesia and intensive care. Students will be expected to develop and maintain a system of continuous learning in order to keep abreast of major clinical and research developments.
• All students should appreciate the need for on-going research in the field of Anaesthesia and Intensive Care and are required to complete an original Clinical Research Project to be submitted in partial fulfillment of the requirements for the Degree of Doctorate in Anaesthesia and Intensive Care of the University of the West Indies. Students will also be encouraged to become involved with research efforts of department/section members. 
• Satisfactory in-course assessments as per Part I must be achieved during the Part II for continued progress in the programme.

Clinical Research Project

• Students are advised to discuss the preparation of Clinical Research Project with their Supervisor(s) while the book is in preparation and should not wait until it is completed. Every student will be required to pose relevant research question(s), formulate hypothesis (es), design an achievable Clinical Research Project, understand the statistical evaluation to be used and know how to draw valid conclusions. The project offers the students the opportunity to study in detail, an area of interest of their own choice and to express views based on personal investigation and on review of the literature which could be later developed for publication. From the project, the examiners will assess the critical faculties, powers of observation and the level of evaluation in the area of anaesthesia &/or intensive care chosen by the student.
• Case log and minimal competencies
• Students are required to keep a record of all anaesthesia procedures performed. In addition they are required to complete a predetermined list of minimal competency in cognitive and procedural skills felt to be fundamental to the training of specialists in anaesthesia and intensive care
• The following three (3) requirements MUST be completed before the student will be allowed to sit the DM Part II examination:

a) A satisfactory standard of clinical competency, professionalism and in-course assessments

b) Case log & minimal competencies

c) Clinical Research Project

Examinations

• Students are normally expected to present themselves for the first examination being held for which they are eligible. In exceptional circumstances (such as ill health), a student may request permission from the Campus Committee for Graduate Studies through the Specialty Board and the Faculty Committee for Graduate Studies and Research to defer the date of the first sitting.
• Candidates must register for the examination at the appropriate time.
• Should any candidate fail the examination of any Part at the first attempt, completion of that part must be within one calendar year of the first attempt.
• No student will be allowed more than two attempts at any one examination. Failure after the second attempt necessitates withdrawal from the programme. Re-admission of candidates will be in accordance with the University regulations for Graduate Diplomas and Degrees.
• Candidates must comply with the University Regulations regarding Examinations for Higher Degrees.
• A detailed syllabus for the course is available from the Faculty Office or the Director of the programme.
• Before admission to any examination, candidates must be certified by their supervisors as having completed the relevant parts of the programme.
• Examinations are in two parts, Part I and Part II (DM Anaesthesia & Intensive Care). They are normally held twice per year in May/June and November/December and rotate amongst the three university campuses.

Part I Examination

The Part I examination is held at the end of the Year 2 and comprises of a written paper and a multiple choice question paper and an oral examination. Candidates will be invited to an oral examination depending on their performance on the multiple choice questions papers. Candidates receiving less than 48% on the multiple choice question papers will not be invited for the orals as this represents an irretrievable situation. On successful completion of Part I, continuation in the training programme will be dependent on the recommendation of the Specialty Board based on its continuous assessment and the results of the Part I examination.

Part II Examination

Part II examination must be attempted for the first time within one year of acceptance of the Clinical Research Project. The Part II examination comprises of two written papers, a clinical examination and an oral examination. Candidates MUST pass ALL papers/components of the examination to be deemed an overall pass, regardless of the cumulative score. However a score 47.5% or more but less than 50% in one component (except in the clinical) is redeemable provided the performance in the other 2 components is above average. 

Completion of the Programme

• Students will be considered as having successfully completed the programme when the following FOUR requirements have been met:

a) Satisfactory performance of all rotations.

b) Acceptance of their certified case log/minimal competencies.

c) Acceptance of the Clinical Research Project and submission of completed book

d) Satisfactory performance in the Part I and II examinations

• Failure to complete the programme in the prescribed times will require withdrawal from the programme.
• Appeals by students against decisions taken by the Specialty Board in Anaesthesia and Intensive Care may be made as per general regulations – Doctor of Medicine.