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The Doctorate of Medicine (DM) in Cardiothoracic Vascular Anaesthesiology and Critical Care is an advanced subspecialty program under the Institute of Medicine (IOM), Tribhuvan University. It has been designed to produce highly skilled anaesthesiologists with specialized expertise in managing patients undergoing cardiac, thoracic, and vascular surgeries as well as interventional cardiology procedures.
This program emerged as a continuation of IOM’s commitment to advancing medical education in Nepal, following the successful initiation of postgraduate programs in Anaesthesiology. With the growing burden of non-communicable diseases and the rapid expansion of cardiac and thoracic surgical services across the country, the need for expert professionals in this specialized area became evident.
The DM CTVA & CC program prepares anaesthesiologists to provide comprehensive perioperative and critical care for patients with complex cardiac and vascular conditions. The curriculum emphasizes advanced clinical practice, academic excellence, and evidence-based research to meet both national and international standards.
Eligibility
- MD Anaesthesiology or Equivalent
- Specialty Registration in Nepal Medical Council (or Medical Council of the respective country)
Curricular Structure
Examination Format
a. Question Type: Single best response multiple-choice questions (MCQs)
b. Options: Four options (A, B, C, D)
c. Number of Questions: 200
d. Full Marks: 200 (0.25 marks deducted for each incorrect response)
e. Pass Marks: 50th Percentile
f. Duration: 3 hours
| S.No. | Area | Content / Domain | No. of Questions |
|---|---|---|---|
| 1 | Applied Basic Medical Science | - Anatomy - Biochemistry - Microbiology - Pathology - Pharmacology and Toxicology - Physiology | 20 |
| 2 | General Subjects | - Preoperative assessment - Premedication - Perioperative documentation - Monitoring during anaesthesia - Airway management - Anaesthesia workstation, breathing system & applied physics - Spinal and epidural anaesthesia - General anaesthesia - Anaesthesia for: • Emergency surgeries • Orthopaedics and trauma • Otorhinolaryngology - Regional anaesthesia - Fluid, electrolyte, and acid-base balance - Blood transfusion | 60 |
| 3 | Subspecialty Subjects | - Anaesthesia for: • Cardiac, thoracic, and vascular surgeries • Obstetrics and gynaecology surgeries • Ophthalmology surgeries • Geriatric patients • Patients with endocrine pathologies • Paediatric and neonate patients • Neurosurgeries • Genitourinary surgeries • Patients with liver, renal, and neuromuscular diseases - Pain management - Non-operating room anaesthesia (NORA) - ERAS (Early Recovery After Surgery) - Advanced Monitoring: • Cardiac output monitoring • Invasive arterial line monitoring • CVP monitoring • Pulmonary artery catheterization • Cerebral oximetry • BIS - Critical Care Medicine: • Sepsis, shock, ARDS • Pneumonia • Oxygen therapy and mechanical ventilation • Nutrition • Transport of critically ill patients • Renal replacement therapies • ECMO - Cardiopulmonary resuscitation - Transthoracic / Transesophageal echocardiography - Patient blood management - Point-of-care coagulation testing (TEG, ROTEM) - Recent advances in anaesthesia and critical care | 90 |
| 4 | Miscellaneous | - Research and biostatistics - Medical ethics and good medical practice - Medical education - Communication skills - Medicolegal issues | 30 |