Anaesthesia for Medical Students

Overview Textbooks and References Ten-year series, OSCEs, Tests
  • Introduction
  • Syllabus
  • Timetable
  • Examination
  • Textbooks
  • Booklist
  • No Senior's Notes
  • Amazon search for "Anesthesia"
    Online references
  • GASNet - Yale
    Links and Directories
  • NUS Anaesthesia Department
  • Past Year Questions
  • End of posting test
    Online Quizes

    Anaesthesia Anatomy Biochemistry COFM Dermatology ENT Emergency Medicine Eye Geriatrics Medicine Microbiology
    Obstetrics & Gynae Orthopaedics Paediatrics Pathology Pharmacology Physiology Psycho Med Radiology Surgery
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    Category of subject: Clinical - short posting
    Duration of posting: 3 weeks in 3rd/4th year
    Final examination: None
      Anaesthesia (or Anesthesia) is "a three week full day course in the third or fourth year consisting of lectures in the basics of anaesthesia, surgical intensive care and resuscitation, demonstrations, hands-on clinical experience and tutorials" according to the NUS website. It's actually a fairly relaxed short posting with the likes of ENT and eye. The course is divided amongst the hospitals, with each hospital taking charge of the lectures, tutorials, and hands-on for one subspeciality (outlined below). There is also a section on intubation and resuscitation, even involving a realistic patient simulator in NUH.
      At the end of the posting, there is a short clinical test (sample below), which accounts for a miniscule portion of the final surgical mark. If you fail however, you may be required to repeat the posting during your holiday!!. There is no final exam; however, there will be a few questions on it in the surgical MCQs of the final MBBS.
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    Official syllabus available?: No
    Unofficial syllabus:
  • Introduction
  • Pre-op evaluation
  • Anaesthetic drugs
  • Principles and types of anesthesia
  • Patient monitoring
  • Post-op complications
  • Obstetric anaethesia
  • Paediatric anaethesia
  • Neurosurgical anaethesia
  • Fluids and electrolytes
  • Airway management
  • Resuscitation
  • Pain control
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    Schedule: 2 CGs do each anaethesia posting together. The first week is spent in NUH, followed by rotations through the other hospitals - approximately 1-2 days each. The resuscitation course is held at NUH and involves a human simulator. There are no compulsory calls or ward rounds.
    Teaching methods:
    Usually didatic lectures and tutorials in the morning, followed by an OT posting in the late morning or afternoon. There will be 2-3 of you in each theatre, and if you're lucky, you'll get to intubate a patient or two. Other than that, there's nothing much to look at other than the drugs and monitors (which will get boring very fast). Familiarize yourself with the equipment and procedures as these will come out for the test.
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    Breakdown of marks
    - Unknown.
    - Probably < 1% of the overall MBBS Surgical paper.
    Final exam
    - Nil, except as a few MCQs and maybe 1 OSCE in the surgical paper.
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    Primary textbook (choose 1)
    Lecture notes usually sufficient.
    If you're really keen however, try:
    (1)Anaesthesia - a practical handbook by Hwang Nian Chih from SGH. Recommended mainly for its local authors and overview of all the relevant subtopics. About $30 from the Co-op, pub 1998, but it's not in the official booklist.
    (2)Oxford Handbook of Anaesthesia by Keith G. Allman, most recent edition Apr 2002. I haven't read it myself, but is probably more organized and comprehensive.
    Reference text
    (1) Basics of Anesthesia by Robert K. Stoelting. Don't be fooled by the name, this 500 page, $100+ book has enough "basics" to see you from medical student days all the way through your anesthesia traineeship.
    Other must-have stuff
    Nice-to-have stuff
    Revision guides & MCQs
    Book review sites
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    Past year questions

    Anaesthesia End-Of-Posting SAMPLE Questions

      The end of posting test in 1999 was held in the anesthesia department of NUS. It consisted of an OSCE style exam with 6 stations, with candidates moving from station to station at the sound of the buzzer. Each station has questions either on theory, an actual instrument, or involving an examiner and practical procedures.

    Q1:56 year old man admitted for Below Knee Amputation, random blood sugar = 26 mmol/L
    a)How would you treat his diabetes?
    b)What investigations would you order?
    c)What is his ASA status?
    d)What anaesthetic technique would you use?
    e)How would you assess the suitability of this technique?

    Q2:Given:Epidural catheter
    a)What is device used for?
    b)Name this device.
    c)Name 2 complications arising from its use.
    d)Name 4 structures this passes through.
    e)What is the purpose of a test dose?

    a)Action is terminated by liver metabolism (T/F)
    b)Is used in the treatment of cerebral oedema (T/F)
    c)?Decreases the cardiac contractility dose-dependently (T/F)
    d)? (T/F)
    e)? (T/F)
    a)Onset is within 15-20 seconds (T/F)
    b)Duration between 6-20 mins (T/F)
    c)? (T/F)
    d)Name 2 cardiovascular effects of propofol.

    Q4:20+ year old man in road traffic accident, upon assessment is non-responsive to commands and pain, has suffered head injury and chest injuries.
    a)What is his Glasgow Coma Scale?
    b)What would you do in the immediate management of this patient?
    c)What investigations would you order immediately?
    d)The patient goes hypotensive during transport, name 2 likely reasons.

    Q5:Given:CVP line
    a)What is this device?
    b)Name 3 uses of this device
    c)Name 2 complications of inserting this device
    d)What level does this device lie at?
    e)This can be inserted at the following: (T/F)
    i)Internal jugular v. ii)Basilic vein iii)Subclavian v. iv)Saphenous v.

    Q6:Examiner with dummy - patient has collapsed in ward
    a)What would you do on arrival?
    b)Given airway clear, but not breathing... (question depends)
    c)What do you need for intubation?
    d)Check the ETT
    e)(Intubate patient - describe as doing)
    f)How do you know how far to insert the ETT?
    g)How much do you inflate the EGG?
    h)How do you know the ETT is in the right place?

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