Our CA1 Resident Dr Benjamin Chin adopting
the right technique of fiberoptic intubation
No elective is too short or too challenging for us to plan. Whether you have one week or one month to train, we can plan an individualized programme to suit your training needs.
Interests in Electives can range from learning about challenging patient management in wide ranging clinical scenarios to innovative clinical or basic science research, from evidence based audit projects to stimulating Simulator training sessions with our experienced Faculty.
Contact our Program Director A/Prof Raymond Goy at email@example.com for your customized elective now!
Feedback about our Elective Program
Electives are a time to chase your interests, to explore something further without the pressure of exams and end-of-posting-tests. My personal objective was to explore anesthesia in greater depth and breadth, and secondarily to improve my confidence in practical skills, and I’m glad to have achieved that with the conducive environment at NUH. There are a few key reasons for that:
Probably the most prosaic reason will be the sheer range of cases that can be seen at NUH. It is truly a one stop centre where you can watch an anesthetist skilfully bring a fretful child under general anesthesia, and then drop by literally next door to see cardiothoracic surgery done with double lumen intubation and bronchoscopy. It was an efficient way of being exposed to a wide range of cases, and aided by able and helpful administrators such as Ms. Vera Cai who took an interest in ensuring sufficient variety for the students under her care. I also had the opportunity to rotate through the pain service, anesthesia outpatient consultation clinic, acupuncture clinic and surgical intensive care unit, and join the on call team for operations in the middle of the night, experiencing first-hand the fatigue and the pitfalls of performing anesthesia under such conditions.
2. Teaching Culture
To learn quickly and well, one needs both an ample supply of learning opportunities and effective use of each opportunity.
Many of the tutors here were inspiring in that way – they ensured that each opportunity to learn was not wasted, by consciously looking out for learning moments, involving me in their decision making processes, allowing me to discuss and propose my plans, and then challenging my assumptions. This was a realistic way of learning that refined my ability to apply theory correctly to practical situations, rather than allowing my unrefined thoughts to be allowed to escape without scrutiny. For example, I would be quizzed about my proposed choices of anesthetic technique and airway selection, and explore the reasoning behind these decisions. It was a rigorous process that clarified the misconceptions and blind spots that I didn’t even know I had. She could have just gone on doing her clinical duties without sharing her thoughts, but by choosing to share, her generosity enabled safer and clearer practice for others in the future. And that spirit of sharing (and sharing effectively) which pervaded this elective was a true highlight that I am grateful for.
This was also true with regards to practical skills. Tutors were cheerful and willing to let a student have a go, calmly and patiently guiding, in an intelligent manner that again maximised learning opportunities. I wasn’t just told to go and try intubation, after being asked “you know how to do it, right?” Before starting a case, tutors diagnosed my own level of proficiency, discussed the process, mentally rehearsed, and drilled good habits and their own personal practical tips even before I laid my hands on a patient. Instead of being left on my own to figure out the little practicalities that make things work, tutors shared theirs. And afterwards, tutors would debrief, getting me to reflect, in a non-judgmental way that focused on coolly identifying ways to improve and even giving me analogues to practice with these new principles before the next patient, to inculcate it into my muscle memory. My skills improved more quickly this way, and quite a few patients probably benefited from improved performance too. This didn’t just apply to myself, as I saw residents also benefiting from such teaching, applied to more difficult procedures. If one puts in the mental effort to keep actively learning, there is a lot to be gained from such a learning model. It may also represent some personal bias – I learn best from reflection and such reflective/rehearsal methods suited my style very nicely. I leave this posting feeling much more confident about my practical skills.
Students were also welcome to join residents for their evening teaching after their operating theatre duties. This gave me a more realistic look at their lives and a better appreciation of the stresses that they go through. I was there to see their preparation for the difficult anesthesia post graduate exams. They have a tough life preparing for it, but they also have great support for those who want to grab it, with great accessibility to teaching materials, viva training, group tutorials, etc. It is a program and culture from which much is asked beyond the routine of day to day work, and much is given to help reach that goal.
The personalities in of the people in anesthesia are among the most interesting and engaging across the various specialties. The pantry was a glorious example of that, with fresh bread made by anesthetists to share among anesthetists. People weren’t all-out workaholics, and were well-grounded beyond medicine, and generally liked their lives and did what they liked. They were always concerned about their patients’ feelings and individual situations, and were flexible so that they could find the best way to do something comfortable or practical for a patient. It was something at the back of their minds as they evaluated their actions, tailoring anesthesia and counselling for the needs and fears of patients and their families.
From consultants to medical officers, the department was good-spirited, warm and undergirded by a desire to do things well and to do so by helping each other. I was glad to have had the chance to be part of that, and to be inspired by that, for an elective.
- Matthew Low
Holidays are meant for doing what you enjoy. For me, I am very grateful to the department for allowing me the chance to experience NUH anesthesia during my one week break. In the short week, I learnt a disproportionately amount of knowledge compared to my actual anesthesia clinical posting. I have to thank Prof Goy and Dr Poon for letting me acquire a deeper understanding for anesthesia as a career.
Beyond my attachment in the elective OTs, I was rotated through the subspecialities in anesthesia, including pain services, ICU and emergency OTs – an opportunity not available in my previous postings. It was a rather surreal experience to have Prof Lee explaining patiently the acupuncture concepts in English (e.g. meridians), then interjecting names of the various acupoints in Mandarin!
I was also fortunate to go on call in the EOTs and given the chance to perform intubation using RSI, guided CVP and IA lines insertions. Being a very hands-on person, I was very inspired to be actively involved in the anesthetic procedures. However, what I found more inspiring than the variety of experiences was how anesthetists in NUH were so eager to teach. Every operating theatre I was posted to had an exceedingly knowledgeable anesthetist who would take extra time to teach, share their experiences, and at the same time remain amiable enough for a casual conversation. Moreover, they always made it a point to guide me through procedures, even when I prove to be more of a hassle than help. Their patience towards me (and my failures) never waned.
Many people think that anesthetists do not require patient contact, but what I saw this posting will absolutely debunk that belief. I have come to learn that anesthetists require even more communication skills talking to pre-operative patients, who are at their most anxious states. It was amazing to see how they managed to calm crying pediatric patients down and at the same time reassure fearful parents.
It is surprising how much one can learn in a well structured one week programme. For anyone who would like to know gain more insight into anesthesia as a career, I would highly recommend signing up for an elective with NUH anesthesia department!
- Zeng Zhi Yong