DM Cardiac Anaesthesia: Admissions, Medical Colleges, Fees, Eligibility criteria details

DM Cardiac Anaesthesia or Doctorate of Medicine in Cardiac Anaesthesia also known as DM in Cardiac Anaesthesia is a super speciality level course for doctors in India that is done by them after completion of their postgraduate medical degree course. The duration of this super speciality course is 3 years, and it focuses on the study of structural and functional aspects of the heart and the pathophysiology and consequences of extracorporeal circulation.

The course is a full-time course pursued at various recognized medical colleges across the country. Some of the top medical colleges offering this course include Sree Chitra Thirunal Institute for Medical Science and Technology, Thiruvananthapuram, Postgraduate Institute of Medical Education & Research, Chandigarh, All India Institute of Medical Sciences, Rishikesh and more.

Admission to this course is done through the NEET-SS Entrance exam conducted by the National Board of Examinations, followed by counselling based on the scores of the exam that is conducted by DGHS/MCC/State Authorities.

The fee for pursuing DM (Cardiac Anaesthesia) varies from college to college and may range from Rs. 6,000 to Rs. 20,00,000 per year.

After completion of their respective course, doctors can either join the job market or can pursue certificate courses and Fellowship programmes recognised by NMC and NBE. Candidates can take reputed jobs as Senior residents, Consultants etc. with an approximate salary range of Rs.3 lakhs to Rs. 48 lakhs per year depending upon their expertise.

What is DM in Cardiac Anaesthesia?

Doctorate of Medicine in Cardiac Anaesthesia, also known as DM (Cardiac Anaesthesia) or DM in (Cardiac Anaesthesia) is a three-year super speciality programme that candidates can pursue after completing a postgraduate degree.

Cardiac Anaesthesia is the sub-speciality of Radiology which focuses on preoperative, intraoperative, and postoperative care of adult and pediatric patients undergoing cardiothoracic surgery and related invasive procedures.

The postgraduate students must gain ample knowledge and experience in the diagnosis, and treatment of patients with acute, serious, and life-threatening medical and surgical diseases.

PG education intends to create specialists who can contribute to high-quality health care and advances in science through research and training.

The required training done by a postgraduate specialist in the field of Cardiac Anaesthesia would help the specialist to recognize the health needs of the community. The student should be competent to handle medical problems effectively and should be aware of the recent advances in their speciality.

The candidate is also expected to know the principles of research methodology and modes of the consulting library. The candidate should regularly attend conferences, workshops and CMEs to upgrade her/ his knowledge.

Course Highlights

Here are some of the course highlights of DM in Cardiac Anaesthesia

Name of Course	DM in Cardiac Anaesthesia
Level	Doctorate
Duration of Course	Three years
Course Mode	Full Time
Minimum Academic Requirement	Candidates must have a postgraduate medical Degree in MD/DNB (Anaesthesia) obtained from any college/university recognized by the Medical Council of India (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.
Admission Process / Entrance Process / Entrance Modalities	Entrance Exam (NEET-SS) INI CET for various AIIMS, PGIMER Chandigarh, JIPMER Puducherry, NIMHANS Bengaluru Counselling by DGHS/MCC/State Authorities
Course Fees	Rs.6,000 to Rs.20,00,000 per year
Average Salary	Rs.3 lakhs to Rs. 48 lakhs per year

Eligibility Criteria

The eligibility criteria for DM in Cardiac Anaesthesia are defined as the set of rules or minimum prerequisites that aspirants must meet to be eligible for admission, which includes:

Name of DM course	Course Type	Prior Eligibility Requirement
Cardiac Anaesthesia	DM	MD/DNB (Anaesthesia)

Note:

· The feeder qualification for DM in Cardiac Anaesthesia is defined by the NBE and is subject to changes by the NBE.

· The feeder qualification mentioned here is as of 2022.

· For any changes, please refer to the NBE website.

· The candidate must have obtained permanent registration with any State Medical Council to be eligible for admission.

· The medical college's recognition cut-off dates for the Postgraduate Degree courses shall be as prescribed by the Medical Council of India (now NMC).

Admission Process

1. AIIMS, New Delhi and other AIIMS
2. PGIMER, Chandigarh
3. JIPMER, Puducherry
4. NIMHANS, Bengaluru

Fees Structure

The fee structure for DM in Cardiac Anaesthesia varies from college to college. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for DM in Cardiac Anaesthesia is around Rs.6 thousand to Rs. 20 lakhs per year.

Colleges offering DM in Cardiac Anaesthesia

Various medical colleges across India offer courses for pursuing DM in (Cardiac Anaesthesia).

As per National Medical Commission (NMC) website, the following medical colleges are offering DM in (Cardiac Anaesthesia) courses for the academic year 2022-23.

Sl.No.	Course Name	State	Name and Address of Medical College / Medical Institution	Management of College	Annual Intake (Seats)
1	DM - Cardiac-Anaesthesia	Chandigarh	Postgraduate Institute of Medical Education & Research, Chandigarh	Govt.
2	DM - Cardiac-Anaesthesia	Delhi	G.B. Pant Institute of Postgraduate Medical Education and Research, New Delhi	Govt.	1
3	DM - Cardiac-Anaesthesia	Gujarat	B J Medical College, Ahmedabad	Govt.	12
4	DM - Cardiac-Anaesthesia	Karnataka	Sri Jayadeva Institute of Cardiology, Bangalore	Govt.	8
5	DM - Cardiac-Anaesthesia	Karnataka	Jawaharlal Nehru Medical College, Belgaum	Trust	1
6	DM - Cardiac-Anaesthesia	Kerala	Sree Chitra Thirunal Institute for Medical Science and Technology, Thiruvananthapura	Govt.
7	DM - Cardiac-Anaesthesia	Kerala	Amrita School of Medicine, Elamkara, Kochi	Trust	2
8	DM - Cardiac-Anaesthesia	Maharashtra	Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha	Trust	1
9	DM - Cardiac-Anaesthesia	Maharashtra	Seth GS Medical College, and KEM Hospital, Mumbai	Govt.	2
10	DM - Cardiac-Anaesthesia	Pondicherry	Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry	Govt.	1
11	DM - Cardiac-Anaesthesia	Uttarakhand	All India Institute of Medical Sciences, Rishikesh	Govt.	10
12	DM - Cardiac-Anaesthesia	West Bengal	Nilratan Sircar Medical College, Kolkata	Govt.	2
13	DM - Cardiac-Anaesthesia	West Bengal	RG Kar Medical College, Kolkata	Govt.	1
14	DM - Cardiac-Anaesthesia	West Bengal	Institute of Postgraduate Medical Education & Research, Kolkata	Govt.	5

Syllabus

DM in Cardiac Anaesthesia is a three years specialization course that provides training in the stream of Cardiac Anaesthesia.

NMC till date as of (25/02/23) has not defined a Competency-Based Curriculum for DM Cardiac Anaesthesia. The course content of Amrita Vishwa Vidyapeetham below provides a basic outline of what a DM in Cardiac Anaesthesia candidate has to undergo while training:

DETAILED SYLLABUS

BASIC SCIENCES

 ANATOMY: Cardiac embryology, development of heart, pulmonary and vascular anatomy, coronary artery anatomy

 PHYSIOLOGY: Cardiac cellular physiology, hemodynamic, autonomic nervous system, cardiac functions, blood physiology, coagulation cascade and cardiac action potential.

 Cardiac arrhythmias

 Pulmonary: Pulmonary physiology. Pulmonary function tests, blood gas analysis, physiology of ventilation.

Pulmonary airway mechanics, one-lung ventilation. Thoracotomy and pulmonary physiology. Renal, hepatic, CNS, endocrinal system, others, metabolic effects of surgery. Endocrines response to anaesthesia and surgery

 PATHOPHYSIOLOGY: Heart failure, congenital defects, COAD, cardiopulmonary reserves, acquired cardiac & pulmonary diseases. Vascular pathology.

 Immunological response, metabolic response during CPB

 PHARMACOLOGY: Total circulatory arrest. Pharmacokinetics &

Pharmacodynamics of Anaesthetic and vasoactive drugs. Biochemical reactions, applied concepts. Drugs related to anaesthesia practice. Cardiovascular drugs. Bronchodilators

 Current concepts in antibiotic usage. Anti-arrhythmic drugs, nitric oxide

 PHYSICS: Basic concepts. Analyzing, measuring & monitoring devices, electronics, and computing patients' data. Laser in cardiac surgery, robotic technique

 EQUIPMENT: Computer application, Maintenance monitoring techniques, Equipment in OT, Equipment for transport of patients,

 ICU equipment

MONITORING IN ANAESTHESIA

Invasive & Non-Invasive monitoring techniques for Pre-peri & Post-operative periods in the cardiothoracic centre:

 Understanding of basic concepts of monitoring

 Indications, cost-effectiveness, complications

 Equipment usage & knowledge of accessories

Knowledge of the following monitoring —

 Cardiac functions: ECG, ABP, Vent. Pressures, Calculation of cardiac output, resistance, Flow, Echo, Doppler’s & (CAT, PET, NMR)

 Pulmonary functions: PFT, Blood gases, Acid-base Pulm. Airway mechanics.

 Coagulation Profile: Temp. renal, B. Sugar, Enzymes. ACT Heparin & Protomine regulation, thromboelastography.

 Neuromuscular blockade: And other Recent advances in monitoring. BIS cerebral oximetry evoked potential monitoring, and CNS monitoring during CPB.

CLINICAL SCIENCES

 PAEDIATRIC: history of pediatric cardiac anaesthesia, pediatric heart disease in developing world

 DEVELOPMENT ISSUES: intrauterine development of the cardiovascular system, intrauterine development of the cardiovascular system, pediatric anaesthesia pharmacology

 PREOPERATIVE EVALUATION: preoperative evaluation and preparation of pediatric patients with cardiac disease, cardiac catheterization and other radiographic examinations, pediatric electrocardiography and cardiac electrophysiology, and pediatric echocardiography.

 PRINCIPLES OF PER OPERATIVE MANAGEMENT: anaesthetic and perioperative management, monitoring of the pediatric cardiac patient, physiology and techniques of extracorporeal circulation in a pediatric cardiac patient, profound hypothermia and circulatory arrest, vital organ preservation during surgery for congenital cardiac disease, management of post bypass myocardial dysfunction, hemostasis, coagulation and transfusion in a pediatric cardiac patient, management of post bypass pulmonary hypertension and respiratory dysfunction.

 ANESTHESIA FOR CARDIAC SURGICAL PROCEDURES: septal and endocardial cushion defects, tetralogy of Fallot, transposition of great vessels, anomalies of aortic arch and valve, anomalies of the pulmonary valve and right ventricular outflow tract, tricuspid atresia, hypoplastic left heart syndrome, double outlet right ventricle, truncus arteriosus, anomalies of systemic and pulmonary venous return, abnormalities of atrioventricular valves, coronary artery anomalies, cardiomyopathies, pulmonary hypertension, persistent fetal circulation and Eisenmengers syndrome, pediatric cardiac and lung transplantation, secondary vascular anomalies and cardiac tumours, anaesthesia for non-cardiac surgery in children and adults with congenital heart disease.

 Postoperative care: General principles, cardiovascular dysfunctional and pharmacological support, postoperative respiratory dysfunction and its management, renal, hepatic, gastro and neurological dysfunction, postoperative pain management in pediatric cardiac patients, anaesthesia for cardiac procedures in pediatric ICU.

 ADULT: PREOPERATIVE ASSESSMENT AND MANAGEMENT:

Preoperative assessment of cardiac risk, The cardiac catheterization laboratory:

Diagnostic and therapeutic procedures in the adult patient, Anti-ischemic drug therapy, Chronic Treatment of congestive heart failure, Antihypertensive therapy, Etiology and treatment of perioperative cardiac arrhythmias.

 PHYSIOLOGY AND MOLECULAR BIOLOGY: Advances in cardiovascular physiology, Coronary physiology and Atherosclerosis, Molecular cardiovascular medicine, and Systemic inflammation.

 MONITORING: Hemodynamic Monitoring, Advances in Electrocardiographic monitoring, Intraoperative echocardiography, Central nervous system monitoring, and coagulation monitoring.

 ANAESTHETIC PHARMACOLOGY: Effects of inhalation anaesthetics on systemic hemodynamics and the coronary circulation, opioids in cardiac anaesthesia, Pharmacology of intravenous anaesthetic induction drugs, Muscle relaxants and cardiovascular system, Pharmacokinetics and principles of drug

infusions in cardiac patients

 ANESTHETIC TECHNIQUES FOR CARDIAC SURGICAL PROCEDURES:

anaesthesia for myocardial revascularization, Valvular heart disease, Anesthesia for patients with congenital heart disease, Thoracic aortic disease, Anesthesia for electrophysiological procedures, Uncommon diseases and cardiac anaesthesia, Cardiac pacing and electro version, Anesthesia for heart, Lung, and heart-lung

transplantation

 MANAGEMENT OF CARDIOPULMONARY BYPASS AND ASSOCIATED

PROBLEMS: Extracorporeal devices and related technologies, Cardiopulmonary bypass and the anesthesiologist, Transfusion medicine and coagulation disorders, Pharmacologic management of perioperative left and right ventricular dysfunction, techniques of circulatory assistance.

 POSTOPERATIVE CARE: Postoperative respiratory management, Postoperative cardiovascular management, Central nervous system dysfunction after cardiopulmonary bypass, Critical care medicine for the cardiac patient

 PRACTICE MANAGEMENT: The impact of managed care on cardiac anaesthesia, cost containment in anaesthesia and cardiac surgery, quality of life and patient satisfaction surrounding cardiovascular surgery measuring and improving the outcomes of coronary artery bypass graft surgery.

 THORACIC ANAESTHESIA AND ONE-LUNG VENTILATION

o Indications for thoracic surgery

o Preoperative assessment

o Anesthetic management

o Preoperative preparation

o Investigation, premedication, intraoperative management

o One lung ventilation: indications, contraindications, positioning of the patient in thoracic surgery,

o Physiology of one-lung ventilation

o Methods for separation of lungs

o DLT: types, positioning, placement checking, possibilities of DLT malposition, checking with FOB

o Management of OLV

o Postoperative management

CARDIOPULMONARY BYPASS

o Historical development

o Blood pumps in CPB

o Circuitry and cannulation techniques

o Principles of oxygenator function

o Ultrafiltration and dialysis

o Mechanical circulatory support devices

o Cardiopulmonary bypass for minimally invasive cardiac surgery

o Temperature management in cardiac surgery

o Embolic events

o Endocrine, metabolic and electrolyte responses

o Cardiopulmonary bypass and lung

o Immune system and inflammatory response to CPB

o Kidney function and cardiopulmonary bypass

o Neurologic effects of CPB

o Hemodilution and priming solutions

o The blood surface interface

o Hematologic effects and coagulopathy

o Coagulation testing

o Anticoagulation for CPB

o Heparin neutralization

o Pharmacologic prophylaxis for post-CPB bleeding

o Conduct of CPB

o Patient safety in CPB

o Unusual problems in CPB

o Termination of CPB

o ECMO for respiratory support in adults

o Perfusion for thoracic aortic surgery in adults

o Noncardiac surgical application of CPB

o Pediatric cardiopulmonary bypass an overview- state of art and future

o Myocardial protection and preservation for neonates and infants

o Brain injury following infant cardiac surgery and neuroprotective strategies

o ECMO for infants and children

o Circulatory assist devices for infants and children

o Subsystem care - cerebral, Renal Hepatic protection, Cerebral protection, cerebral monitoring

o Total circulatory arrest, left heart bypass

o Anaesthesia management during CPB

o Pharmacokinetics & Pharmacodynamics of drugs during CPB

INTENSIVE CARE MANAGEMENT

 Organizational aspects

 Shock

 Acute coronary care

 Respiratory failure

 Gastroenterological emergencies

 Acute renal failure

 Neurological disorders

 Endocrine disorders

 Obstetric emergencies

 Infection and immune disorders

 Severe and multiple trauma

 Environmental injuries

 Pharmacological considerations

 Metabolic hemostasis

 Haematological management

 Transplant

 Pediatric intensive care

INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY

 Principles of echocardiography: physics, digital echocardiography, imaging artefacts, and pitfalls, optimizing 2D echo

 Intraoperative examination: surgical anatomy correlated with echocardiographic imaging planes, assessment of global ventricular function, right ventricular function, regional ventricular function, mitral valve, aortic valve, tricuspid and pulmonic valves thoracic aorta and prosthetic valves. Assessment of congenital heart disease in adults

 Decision-making in critical care TEE in a critical care setting, assessment of perioperative hemodynamics

 Surgical decision making in coronary artery disease: assessment of myocardial viability, assessment in higher risk myocardial revascularization, assessment of mitral valve in ischemic heart disease, assessment in off-pump myocardial revascularization.

 Surgical decision-making in valvular heart disease: surgical consideration in mitral and tricuspid valve surgery, assessment in mitral valve surgery, surgical consideration in aortic valve surgery, assessment in aortic valve surgery.

 Surgical decision making in major vascular surgery: Assessment of surgery of Aorta

 Surgical decision-making in congestive cardiac failure: Pathophysiologic, assessment of cardiomyopathy, surgical considerations in nontransplant surgery for congestive cardiac failure, assessment in surgical procedures for CHF, assessment of cardiac transplantation

 Surgical decision making in Interventional Cardiovascular Medicine and Non-cardiac surgery: Assessment in cardiac intervention, assessment in noncardiac surgery.

BRONCHOSCOPY

 History of rigid bronchoscopy

 History of flexible fibreoptic bronchoscopy

 Anatomy of larynx trachea, bronchi and classification of lung segments.

 Indications for FOB

 Anaesthesia for diagnostic and therapeutic bronchoscopy

 Interventional bronchoscopy

 Tracheal stents

 Percutaneous dilatational tracheostomy and bronchoscopy

 Technique and equipment care for FOB

 Virtual Bronchoscopy

RECENT ADVANCES

Knowledge of recent developments in the field of Cardiothoracic & Vascular surgery

 Cardiology - PTCA, Balloon embolectomy etc.

 Heart-lung transplant - physiology, pharmacology (Anaesthetic consideration) -

Donor–recipient selection

 Immunosuppression etc.

 Cardiac assisting devices - Artificial heart, IABP, LHAD

 Advances Pulm. support - ECMO, H.F. Ventilation

 Blood substitutes

 Current advances and concepts in drugs, equipment, and monitoring methods

 Virtual bronchoscopy

Career Options

After completing a DM 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 which include Registrar, Senior Resident, Demonstrator, Tutor, etc.

While in the Private sector, the options include Resident Doctor, Consultant, Visiting Consultant (Cardiac Anaesthesia), Junior Consultant, Senior Consultant (Cardiac Anaesthesia), and Cardiac Anaesthesia Specialist.

Courses After DM in Cardiac Anaesthesia Course

DM in Cardiac Anaesthesia is a specialisation course which can be pursued after finishing a Postgraduate medical course. After pursuing a specialisation in DM in Cardiac Anaesthesia, a candidate could also pursue certificate courses and Fellowship programmes recognised by NMC and NBE, where DM in Cardiac Anaesthesia is a feeder qualification.

Frequently Asked Questions (FAQs) –DM in Cardiac Anaesthesia Course

· Question: What is the full form of DM?

Answer: The full form of DM is a Doctorate of Medicine.

· Question: What is a DM in Cardiac Anaesthesia?

Answer: DM Cardiac Anaesthesia or Doctorate of Medicine in Cardiac Anaesthesia also known as DM in Cardiac Anaesthesia is a super speciality level course for doctors in India that they do after completion of their postgraduate medical degree course.

· Question: What is the duration of a DM in Cardiac Anaesthesia?

Answer: DM in Cardiac Anaesthesia is a super speciality programme of three years.

· Question: What is the eligibility of a DM in Cardiac Anaesthesia?

Answer: The candidate must have a postgraduate medical Degree in MD/DNB (Anaesthesia) obtained from any college/university recognized by the Medical Council of India (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 DM in Cardiac Anaesthesia?

Answer: DM in Cardiac Anaesthesia offers candidates various employment opportunities and career prospects.

· Question: What is the average salary for a DM in Cardiac Anaesthesia candidate?

Answer: The DM in Cardiac Anaesthesia candidate's average salary is between Rs. 3 lakhs to Rs. 48 lakhs per year depending on the experience.

· Question: Can you teach after completing DM Course?

Answer: Yes, the candidate can teach in a medical college/hospital after completing the DM course.