FNB Pediatric Anesthesia: Admissions, Medical Colleges, fees, eligibility criteria details

FNB Paediatric Anaesthesia or Fellow of National Board in Paediatric Anaesthesia also known as FNB in Paediatric Anaesthesia is a doctoral fellowship program for doctors in India that they do after completion of their postgraduate medical degree course. The duration of the FNB course is for 2 years.

Pediatric anesthesia deals with the anesthetic and perioperative management of children from newborn to 18 years of age. Pediatric anesthesia specialists are proficient not only in providing anesthesia care for neonates, infants, children, and adolescents undergoing a wide variety of surgical, diagnostic, and therapeutic procedures but also in pain management, intensive care & advanced life support.

The course is a full-time course pursued at various accredited institutes/hospitals across the country, the top hospitals are Chacha Nehru Bal Chiktsalaya, Delhi, ESIC Medical College Hospital and Super Specialty Hospital, Hyderabad, and more.

Candidates can get admission to 2 years FNB course after successfully qualifying for the FET (Fellowship Entrance Test) examination which is conducted by NBEMS. FET is conducted annually as per the prescribed schedule. The merit-based counseling for admissions to the FNB Programme after the conduct of FET is administered by NBEMS.

The fee for pursuing FNB Paediatric Anaesthesia varies from accredited institute/hospital to hospital and is around Rs.1,25,000 per year.

After completion of their respective course, doctors can either join the job market. Candidates can take reputed jobs at positions as research fellows, Senior residents, Consultants, etc. with an approximate salary range of Rs. 22 lakhs to Rs. 25 lakhs per year which varies according to experience.

The Nomenclature of the FNB qualification awarded by the National Board of Examinations in Medical Sciences is “Fellow of National Board”. The FNB qualifications are recognized qualifications in terms of the Gazette notification dated 10th August 2016.

What is FNB in Paediatric Anaesthesia?

FNB in Paediatric Anaesthesia is a two-year doctoral fellowship program that candidates can pursue after completing a postgraduate degree.

Pediatric anesthesia deals with the anesthetic and perioperative management of children from newborn to 18 years of age. Although children suffer from diseases that are similar to those in adults, many diseases are exclusive to this age group. Also, the anesthetic management of children is very different from that of adults due to the anatomical, physiological, pharmacological, and psychological differences between the two.

The National Board of Examinations (NBE) has released a curriculum for FNB Paediatric Anaesthesia.

The curriculum governs the education and training of FNB Paediatric Anaesthesia.

Course Highlights

Here are some of the course highlights of FNB Paediatric Anaesthesia

Name of Course	FNB Paediatric Anaesthesia
Level	Fellowship
Duration of Course	Two years
Course Mode	Full Time
Minimum Academic Requirement	Candidates must have a postgraduate medical Degree in DNB/MD 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 (FET) Merit-based counseling administered by NBEMS
Course Fees	Rs.1,25,000 per year
Average Salary	Rs. 22 lakhs to Rs.25 lakhs per annum

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

Name of Fellowship course	Course Type	Prior Eligibility Requirement
Paediatric Anaesthesia	FNB	DNB/MD Anaesthesia

Note:

The admission process contains a few steps to be followed for the candidates for admission to FNB. Candidates can view the complete admission process for FNB Paediatric Anaesthesia mentioned below:

• FET is a qualifying-cum-ranking examination for admission to Fellow of National Board (FNB)/Fellow of National Board - Post Doctoral (FNB-PD) courses.
• The selection of a student will be through an MCQ-based examination namely Fellowship Entrance Test.
• A student can apply for the fellowship courses for which his/her broad or super specialty qualification/ equivalent qualification is eligible, at the time of online submission of the application form.
• The total duration of the question paper will be 105 minutes (Part A - 45 minutes and Part B - 60 minutes).
• QUALIFYING CRITERIA: Students who obtain a minimum of 50th Percentile in their respective question paper/specialty shall be declared as “Qualified”.
• NBEMS shall declare a specialty-wise merit list i.e., there will be a separate merit list for each fellowship course. There shall not be any equating/scaling and normalization. The merit shall be generated strictly based on marks obtained by the student and the application of the prescribed tie-breaking criteria.
• The admission to Fellowship courses in the accredited hospitals shall be undertaken solely based on merit-based counseling conducted by NBEMS.
• Documents required to be produced at the time of counseling: MBBS Degree Certificate and MD/MS/DNB/DM/MCh/DrNB Degree Certificate/Provisional Pass Certificate of eligible Post Graduate Medical Qualification issued.

Fees Structure

The fee structure for FNB Pediatric Anaesthesia varies from accredited institute/hospital to hospital. The fee is generally less for Government Institutes and more for private institutes. The average fee structure for FNB Paediatric Anaesthesia is around Rs.1,25,000 per year.

Colleges offering FNB Paediatric Anaesthesia

FNB in Paediatric Anaesthesia is a two years specialization course that provides training in the stream of Paediatric Anaesthesia.

The course content for FNB Paediatric Anaesthesia is given in the NBE Curriculum released by the National Board of Examinations, which can be assessed through the link mentioned below:

Syllabus

1. Developmental aspects

a) Basic developmental embryology

b) Transition from intrauterine to extrauterine life

c) Neonatal physiology

d) Transition from the neonatal period to infancy

2. Anatomical and physiological differences between small children and adults

a) The airway and respiratory system

b) The cardiovascular system

c) Water, electrolytes, and the kidney

d) The liver and gastrointestinal tract

e) The central nervous system

f) Hematology

g) The immune system

h) The endocrine system

i) Metabolism and temperature control

3. Pharmacological differences in drug kinetics and dynamics

a) Inhalational agents

b) Intravenous induction and maintenance agents

c) Opioids and non-opioid analgesics

d) Local anesthetic agents

e) Muscle relaxants

f) Adjuncts (anti-emetics and antimuscarinics)

4. Preoperative assessment and preparation

a) History taking and clinical examination – Interaction with children

b) Criteria for investigations

c) Blood group and cross match

d) Preoperative management of

URTI

 Heart murmurs

 Bronchial asthma, cystic fibrosis, OSA

 Seizures, cerebral palsy, muscular dystrophy

 GE reflux

 Renal insufficiency, dyselectrolytemia

 Thalassemia, sickle cell disease

 Intraabdominal and thoracic tumors, chemotherapy

 Type 1 diabetes and pheochromocytoma

 Metabolic disorders

e) Selection for daycare and discharge criteria

f) Fasting guidelines

g) Communication with the child and family

 Management of uncooperative children

 Age-related behavior and anxiety

 Anxiolytic medication

 Non-pharmacological interventions

 Consent

5. Equipment, techniques, and monitoring

a) Equipment

 Face masks – anatomical, Randel Baker mask, other types

 Oro- and nasopharyngeal airways

 Supraglottic airway devices – CLMA, PLMA, Igel, etc.

 Tracheal and tracheostomy tubes (plain, cuffed, performed,

armored, Cole, laser)

 Laryngoscopes (curved and straight blades, video laryngoscope)

 Fiberoptic bronchoscope

 Breathing circuits

 Jackson Rees's modification of Ayre’s t-piece

 Circle absorption breathing system

 Anesthesia machine

 Ventilators

b) Techniques

 Anaesthesia for a term and preterm neonate – tracheoesophageal fistula, congenital diaphragmatic hernia, atresia, omphalocele and gastroschisis, necrotizing enterocolitis

 IV access skills

 Routine sizes, sites, and fixation for peripheral cannulae

 Central venous lines: indications, devices, techniques, and complication

 PICC line

 Ultrasound guidance for vascular access

 Intraosseous access

 Care of long-term central venous lines

 Inhalational induction

 Maintenance of anesthesia

 Management of laryngospasm

 RSI and Modified RSI

 Maintenance of body temperature

 Common problems in recovery (including criteria for discharge)

c) Monitoring

 Cardiovascular, respiratory, CNS, neuromuscular, temperature

 Indications for invasive monitoring

6. Management of the airway

a) Assessment of the pediatric airway

b) Identification of the child with a difficult airway

 Congenital syndromes

 Airway obstruction, congenital and acquired

c) Equipment used in the management of the pediatric airway

d) Basic and advanced pediatric airway skills

e) Techniques for management of difficult airway

f) Complications associated with difficult airway management

7. Resuscitation

a) Causes of pediatric arrest

b) Structured approach to assessing critically ill or injured children

 Airway

 Breathing

 Circulation

 Disability

c) Life support algorithms

 Basic Life Support

 Neonatal Resuscitation

 Choking Child

 Advanced Life Support

d) Structured approach to treating the seriously ill child

 Breathing difficulties

 Airway emergencies

 Respiratory failure

 Child in shock:

 Fluid Loss

 Sepsis

 Anaphylaxis

 Heart failure

 Abnormal cardiac rhythm

 Decreased conscious level

 Raised intracranial pressure

 Meningitis

 Convulsions

 Metabolic coma

 A structured approach to treating the seriously injured child

 Airway and C-spine stabilization

 Initial assessment ABCD

 The child with chest injuries

 The child with abdominal injuries

 The child with head injuries

 The child with spinal injuries

 The burnt or scalded child

 Initiation of Intensive Care for the critically ill child.

 Principles of safe transfer of the critically ill child

 Stopping resuscitation

 Role of Parents

 DNR orders

8. Major hazards

a) Management of malignant hyperthermia, anaphylaxis, and major

hemorrhage

b) Communicating risk

c) Risk management

d) Human factors and error

9. Pain management including regional techniques

a) Pain neurophysiology

b) Nociception and the response to injury

c) Analgesic pharmacology

d) Multimodal analgesia

e) Range of drugs, routes of administration, and techniques available for

acute postoperative pain

 Paracetamol, NSAIDs, Opioids

 Oral/PR, Continuous infusions, Patient/Nurse controlled analgesia,

Spinal/Epidural, Caudal, blocks of the upper limb, lower limb,

thoracoabdominal blocks – TAP, ES, Ilio-inguinal block, penile block,

serratus anterior, intercostal

 Use of adjuncts – ketamine, clonidine, dexmedetomidine, fentanyl

 Use of ultrasound guidance

f) Non-pharmacological approaches to pain management

g) Management of common complications of pain management

h) Paediatric Pain Management Services

 Protocols and Guidelines

 Safety

 Monitoring

 Education

10. Congenital and inherited diseases

a) Knowledge and awareness of the anesthetic implications of commonly

presenting pediatric medical conditions

b) Anaesthetic implications of congenital inherited conditions – Down

syndrome, Pierre Robin, Goldenhar, Treacher Collins,

Mucopolysaccharidoses, Apert’s, Charge association, VATER,

Osteogenesis Imperfecta

11. General surgery

a) Common problems of neonatal and small infant anesthesia

b) Acute Abdomen and RSI

c) Laparoscopic surgery techniques and implications

d) Hernia Repair, Orchidopexy, Appendicectomy, Exploratory

Laparotomy for tumors/cyst removal/excisions/resection anastomosis

etc.

e) Brachial sinus/ fistula excision, cystic hygroma, tongue tie release, etc.

12. Urology and renal transplantation:

a) Cystoscopy, PUV Fulguration

b) Nephrectomy

c) D J Stent insertion and removal

d) Pyeloplasty

e) Hypospadias is a repair

f) Orchidectomy

13. Ear, nose, and throat surgery

a) Associated anomalies and airway pathology – choanal atresia

b) General anesthetic considerations – laryngeal papilloma, bronchoscopy

c) The shared airway

d) Laser surgery

e) Post-anesthetic care

f) Obstructive sleep apnoea – adenotonsillectomy

14. Ophthalmic surgery

a) Retinopathy of prematurity

b) Cataract

c) Glaucoma

d) Corneal transplant

e) Vitreoretinal surgery

f) Squint

15. Dental, maxillofacial, and plastic surgery

a) Behavioral issues

b) Temporomandibular joint ankylosis

c) Cleft lip and palate

d) Craniofacial surgery

e) Trauma

f) Reconstructive surgery

16. Orthopaedic surgery

a) Use of tourniquets

b) Cerebral palsy

c) Scoliosis surgery

d) Trauma

e) CTEV Correction

f) Fracture fixations

g) Hip Spica

h) Bone Tumor Excision

17. Neurosurgery

a) Hydrocephalus

b) Meningomyelocele

c) Space-occupying lesions like medulloblastoma, astrocytoma, SDH/EDH

drainage

d) Head injury

e) Trans-sphenoidal surgery

f) VP Shunt insertion/revision

g) Craniosynostosis

h) Tumours

18. Cardiac and thoracic surgery

a) Management of the child with cardiac disease undergoing non-cardiac

surgery

 Endocarditis prophylaxis

 Assessment of anesthetic risk

b) Pathophysiology of common cardiac lesions - Shunts like

VSD/ASD/AVSD/PDA, Cyanotic lesions like Tetralogy of Fallot

(including management of a ‘spell’), Transposition of the Great Arteries,

Coarctation of the aorta, Valve stenosis, single ventricle

c) Preoperative assessment and investigations including the implications

of Cyanotic heart disease, Re-do surgery, Pulmonary hypertension

d) Blood gas analysis

e) Principles of cardiopulmonary bypass and cardioplegia

f) Pharmacology of ionotropic – types, uses & doses, antifibrinolytics,

heparin, hemostasis, and blood product use

g) Thoracic surgery – one-lung ventilation, VATS, thoracotomy

19. Anaesthesia/sedation in a remote location

a) CT, MRI

b) Interventional radiology – DSA

c) Cardiac catheterization

d) Dental Sedation

e) Radiotherapy

f) GE endoscopy

Career Options

After completing FNB Paediatric Anaesthesia, candidates will get employment opportunities in Government and the Private sector.

In the Government sector, candidates have various options to choose from which include Junior research fellow, Teaching at academic medical centers, and Consultants.

While in the Private sector, the options are Fellow (Paediatric Anaesthesia), Junior research fellow (Paediatric Anaesthesia), Senior Research fellow (Paediatric Anaesthesia), and Consultants (Paediatric Anaesthesia).

Frequently Asked Questions (FAQs) –FNB Paediatric Anaesthesia Course

● Question: What is the full form of FNB?

Answer: The full form of FNB is Fellow of National board.

● Question: What is an FNB Paediatric Anaesthesia?

Answer: FNB in Paediatric Anaesthesia or Fellow of National Board in Paediatric Anaesthesia is a doctoral fellowship program for doctors in India that they do after completion of their postgraduate medical degree course.

● Question: What is the duration of an FNB in Paediatric Anaesthesia?

Answer: FNB in Paediatric Anaesthesia is a doctoral fellowship program of two years.

· Question: What is the eligibility of an FNB in Paediatric Anaesthesia?

Answer: The Candidates must have a postgraduate medical Degree in DNB/MD 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 FNB Paediatric Anaesthesia?

Answer: FNB Paediatric Anaesthesia offers candidates various employment opportunities and career prospects.

• Question: What is the average salary for an FNB Paediatric Anaesthesia candidate?

Answer: The FNB Paediatric Anaesthesia candidate’s average salary is between Rs.22 lakhs to Rs. 25 lakhs per annum depending on the experience.

• Question: Can you teach after completing FNB Paediatric Anaesthesia Course?

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