DrNB Cardiac Anesthesia: Admissions, Medical Colleges, fees, eligibility criteria details
DrNB Cardiac Anaesthesia or Doctorate of National Board in Cardiac Anaesthesia also known as DrNB in Cardiac Anaesthesia is a super specialty level course for doctors in India that they do after completion of their postgraduate medical degree course. The duration of this super specialty course is 3 years, and it deals with preoperative, intraoperative, and postoperative care of adult and pediatric patients undergoing cardiothoracic surgery and related invasive procedures.
The course is a full-time course pursued at various accredited institutes/hospitals across the country. Some of the top accredited institutes/hospitals offering this course include Sir Gangaram Hospital, New Delhi, National Heart Institute, New Delhi and more.
Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counseling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.
SYLLABUS:
1. General
i. History of Anaesthesia for cardiothoracic & vascular surgery
ii. Natural History of Cardiac & Pulmonary diseases
iii. Demography Diagnosis, Pre-Op. evaluation & Preparation for surgery
2. Basic Curriculum
i. Basic sciences include applied Anatomy, Physiology, Pharmacology, Physics, Biochemistry, Microbiology, and Coagulation studies.
ii. Monitoring
iii. Cardio Vascular diagnostic and therapeutic techniques
iv. Special consideration — Cardiopulmonary bypass
v. Drugs related to anaesthesia of CPB, Pharmacokinetics during CPB Pulmonary Life-Support — Advanced cardiac life support
vi. Infection Control
vii. Teamwork, Communication skills, Ethics, Medico-legal Aspects of Cardio
viii. Thoracic and Vascular Anaesthesia and Documentation.
3. Operative Observations
i. Operative DIRECT CARE (Conduct of anaesthesia)
ii. Post-operative care and pain relief
iii. Research Projects/Exchange Programme with other Centers
iv. Examinations — Basic Sciences
v. (Theory and Practical) Clinical Practice of Anaesthesia, Allied Sciences & Recent advances Detailed Syllabus: Basic Sciences
1. Anatomy: Heart: Embryology, development of heart, pulmonary and vascular anatomy, coronary artery anatomy
2. Physiology:
i. Cardiac: Cellular Physiology, Haemodynamics, Role of Autonomic nervous system on Cardiovascular Function, Cardiac functions, Action Potential
ii. Cardiac rhythm
iii. Blood Physiology, Coagulation
iv. Acid Base and Electrolyte Balance
v. Pulmonary, Open & Closed chest ventilation. Ventilation / perfusion mismatch.
vi. Pulmonary airway mechanics, one-lung ventilation.
vii. Thoracotomy and pulmonary physiology.
viii. Renal, Hepatic, CNS, Endocrine System, etc.
ix. Metabolic effects of surgery
x. Endocrine response to anaesthesia and surgery
xi. CBF, ICP, autoregulation
xii. PFT and Interpretation
3. Pathophysiology:
i. Shock, Heart & Hemodynamic failure, Congenital defects, COPD, Cardiopulmonary reserves, acquired cardiac & pulmonary diseases.
ii. Vascular pathology
iii. Immunological and metabolic response during CPB.
iv. Total Circulatory Arrest.
v. Altered Lung function, infection prevention, diagnosis and management.
4. Pharmacology:
i. Total circulatory arrest, Pharmacokinetics & Pharmacodynamics of Anaesthetic and Vasoactive drugs.
ii. Biochemical reactions and applied concepts.
iii. Drugs related to anaesthesia practice,
iv. Cardiovascular drugs.
v. Antibiotics for ICU use Bronchodilator.
vi. Antiarrhythmic drugs, nitric oxide.
5. Physics:
i. Basic principles, analyzing, measuring & monitoring devices and their role in the interpretation of the results.
ii. Electronics, computing of patients' data.
iii. Laser in cardiac surgery,
iv. robotic technique.
v. Equipment: Computer application, maintenance, Monitoring,
vi. use of Electronics in Documentation & analysis of data,
vii. Equipment in OT, Equipment for transport of patients,
viii. ICU equipment
ix. Physics for ECHO
6. Clinical Sciences
i. Anaesthesia for Cardio-thoracic & Vascular Surgery
ii. Anaesthesia for diagnostic procedures in adults & Paediatric age groups
iii. Anaesthesia for - Cardiac Surgery: For closed & Open heart surgery.
iv. Anaesthesia Vascular Surgery: Aortic surgery, carotid artery surgery.
v. Anaesthesia for Thoracic procedures.
7. Paediatric: Basic haemodynamics, palliative procedures, Pre-op. preparations & special care in monitoring, Fluid balance & airway management
i. Anaesthesia for neonatal simple & complex cardiac surgery
ii. Anaesthesia management for re-surgery
iii. Paediatric diagnostic procedures in Cath Lab & echocardiography
iv. Invasive therapeutic techniques like ASD devices, a stent in major vessels, and coil embolization.
v. Paediatric lung surgery.
8. Adult: Anaesthesia for ischemic heart disease, valvular heart disease, vascular disease, adult congenital heart surgery
i. Electrophysiological & Arrhythmia surgery. Heart transplant, heart-lung transplant, ventricular assist devices
ii. Anaesthetic techniques for pulmonary surgery: Diagnostic & elective. Emergency procedures for lung surgery. One - Lung anaesthesia and Ventilation, Physiology (gas exchange & airway dynamics).
iii. Anaesthesia during emergency surgery and cases directly emerging from Cath Lab after Cath Lab complications.
iv. Anaesthesia in patients for diagnostic & palliative procedures in Cardiology, Radiology, and Cath Lab (outside operative rooms). Invasive cardiology procedure.
v. Anaesthesia management of re-surgery.
vi. Management for Post Op. ventilation care, prolonged ventilation, weaning, Control of Pain - its techniques & agents. Postoperative pain management during ventilation care.
vii. PAC, Intra op. monitoring, Cardiac output and coagulation monitoring.
viii. Preoperative risk scores
ix. Heart & lung transplant
x. Acid-base management (ph stat, alpha stat)
9. Cardiopulmonary Bypass:
i. Perfusion technology (principles, equipment, oxygenators, haemofiltration)
ii. Hypothermia, techniques & protocols
iii. Myocardial Protection
iv. Haemodilution
v. Anticoagulation, Pharmacology, Monitoring methods
vi. Side-effects, complications & management of CPB.
vii. Vital organ system care -cerebral, cerebral protection, cerebral monitoring, renal, and hepatic protection.
viii. Total circulatory arrest, left heart bypass Anaesthesia management during CPB Pharmacokinetics & pharmacodynamics of drugs during CPB.
10. Intensive Care Management:
i. Protocols for sub-system care, cerebral, Renal, Hepatic & others.
ii. Ventilatory Care, weaning of Ventilatory support. Parenteral Nutrition, control of infection.
iii. Renal failure, bedside dialysis techniques
iv. Postoperative management of single ventricular repair
v. Hepatic failure
vi. ICU monitoring technique in postoperative pain management
vii. ICU Management, especially after neonatal surgery ventilatory support in neonates, ECMO programme for neonates and children
viii. Intensive coronary care
ix. Cerebral monitoring
x. NIV Nutrition
xi. Sepsis, ARDS, antibiotics, antifungals, poisoning with cardiothoracic drugs
11. Allied Sciences:
i. Relevant to the practice of safe quality Cardiac Anaesthesia
ii. Cardiac Surgery: Surgical technique, curative surgery, Palliative procedures risk evaluation, Prognosis, Robotic surgery.
iii. Cardiology: Pre-op. evaluation, pathophysiology, Electrophysiology, Diagnostic Radiology Procedures-ECG, x-ray Angiography, Cardiac Cath. Echocardiography, Nuclear studies, their interpretations & management Special procedures: Pacing, Cardioversion, PTCA, etc. Automated cardioverters, invasive procedures for arrhythmia i.e. ablation of the abnormal pathway.
iv. Biotechnology: Various mechanical & electronic equipment. Animal experiments, materials used for CPB techniques, VAD. IABP, Laser for TMR, ECMO
v. Statistics: Bio-Statistics
vi. Research Methodology
vii. Hospital Administration: Sterilization/Gas supply, equipment maintenance, ambient air control and infection control techniques in OT
viii. Microbiology-Infection control, prevention, diagnosis and management.
12. Monitoring in Anaesthesia: Invasive & Non-Invasive monitoring techniques for Peri -operative period
i. Understanding of basic concepts of monitoring
ii. Indications, cost-effectiveness, complications
iii. Equipment usage & knowledge of accessories and their management Knowledge of the following monitoring:
iv. Cardiac functions: ECG, ABP, Ventricular Pressures, Calculation of cardiac output, Vascular resistance, Flow, Echo, Dopplers& (CAT, PET, NMR)
v. Pulmonary functions: PFT includes Blood gases, Acid-base and Pulmonary Airway mechanics. Coagulation Profile, Temperature, renal, B. Sugar and other biochemical monitoring
vi. Neuromuscular blockade: Recent advances in monitoring. BIS cerebral oximetry, Evoked potential monitoring, and CNS monitoring during CPB.
vii. NIRS- Near Infrared Spectroscopy for monitoring in Anesthesia
13. Recent Advances: Knowledge of recent developments in the field of Cardiothoracic & Vascular surgery
i. Cardiology- PTCA, Balloon embolectomy etc.
ii. Heart-lung transplant - physiology, pharmacology (Anaesthetic consideration) - Donor - recipient Selection, Immunosuppression etc.
iii. Cardiac assist devices
iv. Artificial heart, IABP, LHAD
v. Advances Pulm. support - ECMO, High-frequency Ventilation
vi. Blood substitutes
vii. Current advances and concepts in drugs, equipment, and monitoring methods
viii. Recent advances in Radiology, Cardio-Thoracic Surgery, Cardiology, Cardio Pulmonary Bypass about Perioperative care of the patient in Cardio Thoracic and Vascular Anaesthesia.
ix. Foetal cardiac surgery
14. Miscellaneous:
i. Cardiac Risk and Cardiovascular Testing.
ii. Cardiovascular Imaging.
iii. The Adult Cardiac Catheterization Laboratory: Diagnostic & Therapeutic Procedures.
iv. Cardiac Electrophysiology: Diagnosis & Treatment.
v. Cardiac Physiology
vi. Coronary Physiology and Atherosclerosis.
vii. Molecular and Genetic Cardiovascular Medicine.
viii. Systemic Inflammation.
ix. Pharmacology of Anesthetic Drugs.
x. Cardiovascular Pharmacology Section III MONITORING.
xi. Evolution of Echocardiography.
xii. Intraoperative Echocardiology.
xiii. Decision-Making and Perioperative Transesophageal Echocardiography.
xiv. Monitoring of the Heart and Vascular System.
xv. Electrocardiographic Monitoring.
xvi. Central Nervous System Monitoring.
xvii. Coagulation Monitoring.
xviii. Myocardial Revascularization.
xix. Valvular Heart Disease: Replacement and Repair.
xx. . Congenital Heart Disease in Adults.
xxi. Thoracic Aortic Surgery.
xxii. Uncommon Cardiac Diseases.
xxiii. Anesthesia for Heart and Lung Transplantation.
xxiv. Pulmonary Thromboendarterectomy.
xxv. Cardiac Pacing and Electroversion.
xxvi. Procedures in The Hybrid Operating Room.
xxvii. New Approaches to the Surgical Treatment of End-Stage Heart Failure.
xxviii. Management of Cardiopulmonary Bypass and Organ Protection.
xxix. Update on Extracorporeal Devices & Related Technologies.
xxx. Fluid & Blood Management During Cardiac Surgery.
xxxi. Coagulation Disorders and Cardiac Surgery.
xxxii. Discontinuing Cardiopulmonary Bypass.
xxxiii. Postoperative Cardiac Recovery and Outcomes.
xxxiv. Postoperative Cardiovascular Management.
xxxv. Postoperative Respiratory Care.
xxxvi. Central Nervous System Dysfunction.
xxxvii. Long-term Complications and Management.
xxxviii. Pain Management for the Postoperative Cardiac Patient
xxxix. Basic Life Support.
xl. Advanced Cardiac Life Support
xli. End of life care
xlii. Declaration of brain death
xliii. Management of organ donation
xliv. Regional anaesthesia for cardiothoracic and vascular procedures
xlv. Cardiac and thoracic trauma
xlvi. Bronchoscopy
xlvii. History- Cardiac Anaesthesia, cardiac surgery, ECMO, cardiology
15. Postings:
i. The posting is so designed that the trainee gets posted in various areas of the department, including operation theatre, postoperative ICU, Intensive coronary care unit, and Cath. Lab, echo room, and cardiothoracic surgery department.
ii. The purpose of rotation in Cardiac Surgery is to understand overall patient management and develop and improve perspective on Cardiac Anaesthesia Services. He or she will be learning invasive cardiovascular diagnostic and therapeutic procedures done in the Cath Lab and emergency services from viewpoint of Cardiac Anaesthesia.
iii. The Trainee will participate in regular Joint Preoperative Meetings and discussions with Cardiac Surgeons, Cardiologists, Pediatricians, Physiotherapists, Nurses and Physicians for better patient management.
iv. Besides this a programme for invasive monitoring demonstrations, seminars, workshops, and journal club will also be organized. In addition, soft skills: working in a team, communication skills, leadership skills, ethics, techniques of documentation and knowledge of medico legal aspects will also be required to develop.
Period of Posting in Various Units The trainee will be posted in different specialities and during this posting will be as follows:
Cardiac anaesthesia: 2 years
CTVS : 3 months
Cath Lab: 2 months
Echo lab: 1 month
ICCU: 1 month
Paediatric ICU: 1 month
Research experience: 1 month (optional)
Perfusion:15 days
Post-op cardiac surgical ICU: 2 months
Elective posting 3 months to learn recent techniques (to go to other centres, national or international) Intensive Coronary Care Unit During their posting in CCU for one month, the candidate is required to attend the CCU rounds and to learn for himself the coronary intensive care in addition to the ventilatory care.
Topics to be included in all subjects:
Biostatistics, Research Methodology and Clinical Epidemiology Ethics Medico-legal aspects relevant to the discipline Health Policy issues as may apply to the discipline
Career Options
After completing a DrNB in Cardiac Anaesthesia, candidates will get employment opportunities in Government as well as in the Private sector.
In the Government sector, candidates have various options to choose from Registrar, Senior Resident, Demonstrator, Tutor, etc.
While in the Private sector, the options include Resident Doctor, Consultant (Cardiac Anesthesia), Visiting Consultant (Cardiac Anesthesia), Junior Consultant (Cardiac Anesthesia), Senior Consultant (Cardiac Anaesthesia), Cardiac Anaesthesia Specialist, etc.
Courses After DrNB in Cardiac Anaesthesia Course
DrNB in Cardiac Anaesthesia is a specialization course that can be pursued after finishing a Postgraduate medical course. After pursuing a specialization in DrNB in Cardiac Anaesthesia, a candidate could also pursue certificate courses and Fellowship programs recognized by NMC and NBE, where DrNB in Cardiac Anaesthesia is a feeder qualification.
Frequently Asked Questions (FAQs) – DrNB in Cardiac Anaesthesia Course
- Question: What is the full form of DrNB?
Answer: The full form of DrNB is a Doctorate of National Board.
- Question: What is a DrNB in Cardiac Anaesthesia?
Answer: DrNB Cardiac Anaesthesia or Doctorate of National Board in Cardiac Anaesthesia also known as DNB in Cardiac Anaesthesia is a super specialty level course for doctors in India that they do after completion of their postgraduate medical degree course.
- Question: What is the duration of a DrNB in Cardiac Anaesthesia?
Answer: DrNB in Cardiac Anaesthesia is a super speciality program of three years.
- Question: What is the eligibility of a DrNB in Cardiac Anaesthesia?
Answer: The Candidates must have a postgraduate medical Degree in MD/DNB (Anaesthesia) obtained from any college/university recognized by the MCI (Now NMC)/NBE, this feeder qualification mentioned here is as of 2022. For any further changes to the prerequisite requirement please refer to the NBE website.
- Question: What is the scope of a DrNB in Cardiac Anaesthesia?
Answer: DrNB in Cardiac Anaesthesia offers candidates various employment opportunities and career prospects.
- Question: What is the average salary for a DrNB in Cardiac Anaesthesia candidate?
Answer: The DrNB in Cardiac Anaesthesia candidate's average salary is between Rs.18 lakhs to Rs. 25 lakhs per annum depending on the experience.
- Question: Can you teach after completing DrNB Course?
Answer: Yes, the candidate can teach in a medical college/hospital after completing the DrNB course.
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