St. Joseph’s Health Care provides services mainly to Ambulatory patients but at present short stay inpatient beds are also provided. For 2006-2007 the Department of Anesthesia & Perioperative Medicine at St. Joseph's provided care to:

• 3711 Inpatient cases            
• 9589 Ambulatory cases      
• 4063 Cataract unit cases      

Patients included :

• % ASA 3      24%
• % ASA 4      3%
• % 70-79      14%
• % > 80       7%     

Facilities include ten “state of the art” modern Operating rooms, a Lithotripsy suite, two cataract suites and Obstetric rooms.  Occasional Anesthetic services are also provided in Radiology.  Services may also be offered in the Urology and Gastroenterology clinics.

Case mix at St. Joseph's includes ambulatory and inpatient anesthesia services for:

• Specialty services in hand and upper limb surgery, shoulder and elbow arthroplasty, lower limb arthroplasty. Approximately 1,600 regional blocks are performed each year
• Plastic and microvascular surgery including digit re-implants
• Urology including Lithotripsy.
• ENT
• Oral and maxillofacial surgery
• General surgery
• Gynecology with an emphasis on surgery for urinary incontinence.
• Eye surgery including vitreoretinal surger.
• St. Joseph's has one of only four Robotic Operating systems in Canada;  Robotic surgery is regularly performed for Prostate and Gynecological malignancies.
• Neonatal anesthesia in support of the Neonatal ICU
• Obstetric anesthesia and analgesia

The preadmission clinic screens approximately 1,500 patients per month.  Anesthesia staff perform approximately 100 preoperative consults per month.  Fellows will spend time attached to the preadmission clinic and provide anesthetic input into the whole ambulatory care process.

Depending on the Candidate’s interests, opportunity will be given for experience in regional anesthesia during their time in London and there is also the potential for ambulatory fellows to combine their fellowship with an Obstetric fellowship.

Fellows will spend approximately 30% of time in research and educational activities. Fellows are expected to participate in at least one research project during their training period.  Suggested areas of research include outpatient pain management techniques, sedation techniques and outcomes.

Fellows will be expected to provide approximately two-three service days per week in the OR and may be expected to assist with the on call rotation if required.

Educational objectives will be discussed at the start of the fellowship and ongoing evaluation provided by Anesthesia staff.

For further information contact Dr. Ian McConachie at St. Joseph’s Health Care or review the Department website at http://www.uwoanesthesia.ca.