Department of Surgery

4

Master of Medicine in Anaesthesia

COURSE STRUCTURE AND DURATION

1. The course leading to the award of the Degree of Master of Medicine in Anaesthesiology (M.Med Anaesthesia) shall extend over a minimum period of 4 years and a maximum period of 8 years of fulltime training.
2. The degree program shall be offered on fulltime basis in two parts – Part I (one year) and Part II (3 years).
3. Part I will consist of the following courses: Medical Physiology, Pharmacology and Physics & Clinical Measurements. Introduction to practical anaesthesia for operative theatre work and clinical intensive care rotation.

Introduction to clinical practice and logbook.

4. Part II covering years two to four shall consist of the following:

4.1  Year two (junior residency in clinical anaesthesia), Principles and Practice of Anaesthesia; Principles and Practice of Surgery and Medicine; Principles and Practice of Critical Care Therapy and Pain Management. Each candidate shall be expected to select a research topic leading to a dissertation. The approved project proposal shall be completed at the end of the second year of study.

4.2  Years three and four.  Senior residency in clinical anaesthesia and critical care; anaesthesia related  clinical rotations  in the following; General Surgery, Orthopaedic surgery, Neurosurgery, Cardiac Anaesthesia, Paediatrics, Otorhinolaryngology, Ophthalmology, Plastic Surgery, Oral & Maxillofacial surgery, Obstetrics, Trauma and Critical Care. Candidate shall be expected to complete the dissertation work by the end of third year.

4.3  During the third year candidate shall be expected to complete a three month external rotation in a facility approved and recognized by the Kenya Medical Practitioners and Dentist Board under supervision by faculty from the anaesthesiology unit.

4.4  Continuous assessment shall be carried out throughout the four years of the course and during journal club meetings. Teaching shall be in form of lectures, tutorials and supervised practical demonstrations in operating theatres, critical care areas, emergency department and wards.

C. OTHER CHARGES:

1. Late Application fee: Kshs.4,000/=

2. Extended Registration period: Kshs.3,000/= p.a.

3. Extended Correction period: Kshs.1,000/= per three months.

4. Extended Revision period: Kshs.3,000/= p.a.

5. Extended Supervision: Kshs.6,000/=

6. Examination for Revised Thesis/Project Report: Kshs.9,000/=

D. All fees due should be paid before registration can be effected.

E. * These are the minimum recommended research funds.

F. Appropriate field work fee shall be charged separately.

G. Foreign students to add 25% on all the charges.

ADMISSION REQUIREMENTS

1. The common regulations for admission to the Master of Medicine Degree of the University of Nairobi shall apply.
2. An applicant shall be required to;

2.1  be holders of the Degree of Bachelor of Medicine and Bachelor of Surgery (M.B.Ch.B) of the University of Nairobi or equivalent from a university recognized by the Senate.

2.2  be registered by the Medical Practitioners and Dentists Board of Kenya or any other regulatory body.

2.3  have passed a pre-entry interview organized by the Board of the School of Medicine. 

2.4  have certificate of good standing from the regulatory body.

2.5  have letter of reference from two academic referees.

2.6  have a valid medical indemnity cover throughout the training period.

2.7  Foreign applicants shall provide certificate of proficiency in English and may be required by the school to appear for a pre-entry interview.

INTRODUCTION

Anaesthesia is an essential service in modern medical practice and health delivery systems all over the world. It is one of the most important scientific discoveries in recent times and has revolutionized the practice of surgery and related subjects.

It was introduced in October 1846 in Massachusetts, in the United States of America.  Since then, it has undergone a lot of changes and made it possible to get access to any part or cavity of the body safely while looking for disease, and come out safely.  In recent times, its safety and reliability has been enhanced by the introduction of electronic monitoring equipment. 

Anaesthesia is practiced hand-in-hand with critical care and pain relief services in most countries. Critical care medicine came into existence towards the end of the Second World War when it was realized that war victims with multiple organ failure may benefit from temporary technical support while giving time for their failed organs to recover well enough to resume their normal physiological functions. In Kenya, both these services were in the past provided by non-physicians (clinical officers) and very few well trained physician anaesthetists.

The first critical care facility was started at the Infectious Diseases Hospital - IDH (now Mbagathi Hospital) for treatment of patients with bulbar poliomyelitis, using iron-lung ventilators.  It is this rudimentary unit which was moved to its present site at ICU-KNH in 1972.  It was developed to what it is with the technical and personnel help from Japan.  It is now a fully functional unit with 21 beds.

The Department of Surgery developed and launched a postgraduate course for the Degree of Master of Medicine in Anaesthesia in 1978.  In this programme postgraduate students are trained in all aspects of a safe practice of Anaesthesia at par with similar courses in other medical specialties such as paediatrics, internal medicine and surgery and have to date graduated 140 local and foreign anaesthesiologists, some of whom have been lost through natural attrition and immigration leaving only 115 registered physician anaesthetists. Going by the Kenyan population of about 40 million, there is one physician anaesthetist catering for about 350,000 people. Currently there is no World Health Organisation recommendation although the government of Italy recommends 1:130,000.

A great majority of these physicians are concentrated in the big cities like Nairobi and Mombasa. The National Health Sector Strategic Plan 2005-2010(Ministry of Health) recommends 3 physician anaesthetists in each Level 5 hospital. Currently there is only one and in some hospitals none, hence there is an acute shortage physician anaesthetists particularly in the outlying regions.

The revision from three to four years will allow longer clinical exposure in different surgical specialties and external rotations. This will also be in tandem with the regional training programmes and the recommendations of the external examiners. It will in effect meet the international standards for safe practice of anaesthesia adopted by the World Federation of Societies of Anaesthesiologists (WFSA) in 1992.

Objectives;

1. To train anaesthesiologists with adequate knowledge, skills and professional attitudes essential for safe practice of anaesthesiology, critical care medicine and pain management.
2. To train anaesthesiologists with adequate knowledge in clinical problems encountered in surgery and medicine.

Lecturers for part 2 (years 2 and 3)

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