Anesthesia is a primarily facilitatory discipline. Despite the obvious attractions, few patients present themselves for anesthesia services. Rather, anesthesia serves to make possible the provision of other various medical services, including all varieties if surgery, as well as obstetrical and diagnostic studies of various sorts, especially in the pediatric specialty areas. It has been said that the greatest advance in surgery in the past 50 years has been anesthesia, and certainly morbidity and mortality due to anesthesia have diminished drastically with advances in monitoring, pharmacology, and training.
Recent highlights for the McMaster Department of Anesthesia include significant faculty recruitment; a significant increase in contributions to education, research, and administration at the local, national, and international levels; and the use of simulation technologies to teach clinical skills and to explore their potential use in distance medicine.
The Department of Anesthesia at McMaster University along with other Canadian Academic Anesthesia Departments has the responsibility of providing leadership in the discipline of anesthesia. This is achieved through the conduct of fundamental and applied research. It is also achieved through a commitment to the highest level of teaching of students, colleagues and the public. Integral to these goals is the organization and provision of safe and effective services in anesthesia by competent and caring physicians.
We have established a significant level of participation in undergraduate teaching. The anesthesia clerkship rotation has undergone significant alteration over the past five years, including the use of medium-fidelity clinical simulation, and has received consistently positive evaluations from students and faculty. This has occurred in the face of a dramatically-increasing number of undergraduate students at McMaster. The Department has also recently assumed responsibility for the Critical Care Medicine Residency Training Program, which had previously not been overseen by any departmental administrative structure.
We are proud of our leadership role in simulation. The use of simulation to support our clerkship rotation provided a demonstration platform for other disciplines. We have a long history of a close working relationship with the Centre for Simulation Based Learning (CSBL), and the staff of the CSBL have provided tremendous support to the Department in the delivery of the simulation program.
We have been fortunate to have leadership roles within the Department filled by a series of committed and effective individuals, some of whom have also gone onto other leadership positions. Dr. Rob Whyte is the Assistant Dean of the Undergraduate MD Program. Dr. Daniel Cordovani, recruited to the Department 5 years ago, is the Program Director of the Anesthesia Undergraduate Clerkship Program. Dr. Harsha Shanthanna fills the position of Associate Chair of Research. Dr. Karen Raymer is our current Anesthesia Postgraduate Residency Program Director. Dr. Anne Wong is the Associate Chair of Education in the Department of Anesthesia and the Assistant Dean for the Program for Faculty Development for the Faculty of Health Sciences.
In the international forum, Professor Robert Lee has been invited to act as an "ambassador" for Problem Based Learning (PBL) in medical education to Taiwan and Malaysian universities: both requested assistance in establishing PBL in their medical schools. Dr. Janet Farrell is clinical chief at St. Joseph's Healthcare Hamilton is the deputy chair of the Canadian Anesthesia Society International Education Foundation (CASIEF). For many years, Dr. Dauphin has contributed to anesthesia education in Haiti and more recently in Uganda. The department also supports Dr. Stephen Ttendo as an associate faculty member in our department. He is the chair and chief of anesthesia at Mbarara University, Uganda, and has made a significant impact on his profession in Uganda. Each year, one McMaster anesthesia resident is eligible for an elective in Uganda under his supervision. The Department trains residents from Haiti and Uganda at McMaster University at a minimal cost. Most importantly, the rate of return of these residents to their country of origin is 100%. This type of return is essential if the quality of care in those countries is to be positively affected.
Dr. Lehana Thabane, a methodologist from the Health Research Methods, Evidence and Impact Department (previously known as Clinical Epidemiology & Biostatistics), is an associate member of our department providing advice to our clinical faculty on research study design. We also support 50% of a statistician to assist in design and analysis of research studies. Faculty members are being supported for the pursuit of further education, whether Master's or PhD degrees. We have also supported other development, including training in echocardiography.
We are proud of our faculty who have taken up leadership roles in continuing education at the provincial, national, and international levels. Under the leadership of Dr. Chris Ricci, a small group of McMaster clinical faculty working with the Ontario Medical Association (OMA) executive and other Ontario academic departments, has expanded the annual anesthesia section meeting of the OMA from fewer than 80 registrants at inception to a meeting of nearly 400 resistrants, with a full three-day academic program. This is now the second-largest meeting for anesthesia in Canada.
We sponsor regular city-wide rounds on a monthly basis, through unrestricted educational grants from pharmaceutical and equipment sponsors. Peri-operative medicine rounds, held jointly with the Department of Medicine and the Department of Surgery, have attracted several hundred attendees. Monthly pain rounds occur at the Pain Management Centre attracting an interdisciplinary group and with speakers from Canada and the United States. Regular journal clubs continue to be well attended. The Associate Chair of Research has instituted research evenings three to five times annually at which research protocols are discussed and reviewed prior to submission. An annual "research retreat" updates members regarding activities within the Department.
In addition to anesthesia service, the department continues to have a large number of members providing chronic pain care - the largest university affiliated pain management centre in Canada. This in turn attracts a large number of applicants for fellowship training positions.
The academic department is closely associated with the two clinical departments and their respective hospitals. The department is a member of the Association of Canadian University Departments of Anesthesia (ACUDA). This national organization brings together chairs, postgraduate and undergraduate program directors, research directors, and continuing education directors from every university department in Canada. Many projects have been initiated at this level including a national curriculum in anesthesia and manpower studies informing ministries of health at the national and provincial levels.
Our affiliation is with the anesthesiologists in St. Catharines and Cambridge support the regional medical school activities in St. Catharines and Waterloo respectively, and they have entered actively into the business of teaching students and residents. We are very appreciative of their support and involvement.
Members of the Department are involved at several levels (steering committee, data collection, and review) in the interdisciplinary group under the leadership of Dr. P.J. Devereaux to carry out studies in peri-operative medicine (VISION, POISE-II trials). Through interaction with the University Health Network and a community-based software developer, Adjuvant Informatics, Dr. James Paul is part of a group developing an electronic database/pre-operative screening tool that will provide continuously updated risk assessment based upon best current evidence and revised according to actual outcome data. We collaborate with McMaster's Program for Educational Research and Development, and the School of Nursing, and the School of Rehabilitation Science in the interdisciplinary education and pain-related studies.
A special endowment from benefactor Michael G. DeGroote is in place for a National Centre for Chronic Pain, as a third pillar to the Michael G. DeGroote Institute for Pain Research and Care at McMaster University. This was developed following a suggestion from the College of Physicians and Surgeons of Ontario (CPSO) to provide updating and implementation or "push-out" of pain practice guidelines. Dr. Thabane and Dr. Buckley are working with Lina Santaguida from the Centre for Evidence Based Practice in this pursuit, along with Rhoda Reardon and Dr. Angela Carol from the CPSO.
The major strengths of the department is the people.
The faculty and staff of the department are committed to the training of excellent clinicians. This commitment extends beyond the Faculty of Health Sciences to the University community, our hospital partners in Hamilton and the surrounding region, as well as through international outreach relationships in Haiti, Uganda, and Shanghai.
The phrase "Leaders in Pain" was coined at our faculty retreat (2016). The DeGroote Institute for Pain Research and Care, the DeGroote National Pain Centre, and the Pain Medicine Residency Program are collaborating through research and education to provide tools and resources for the management of chronic pain, with the clinical services provided at both hospital sites, SJH and HHS, and the DeGroote Pain Clinic at HHS.
Our collaborations with HEI, Psychology, Engineering, other clinical departments, and the affiliated teaching hospital departments present excellent academic opportunities. The pre-eminence of the Population Health Research Institute in the field of peri-operative research creates opportunity for our faculty members to participate in and lead trials in this field, a natural home for our members.
"Together, Advancing Health Through Learning and Delivery"
Our goals are to continue to expand our involvement and output in research and education through the implementation of a supportive infrastructure and recruitment of residents with a commitment to these areas.