Learn More about our Vascular and Perioperative Hemodynamic Echocardiography (PHE) Fellowship with the Department of Anesthesiology and Pain Medicine.

Program Overview

Our fellow works primarily with a core group of staff specialized in vascular anesthesia and/or perioperative hemodynamic transesophageal echocardiography. This enables the fellow to learn various vascular anesthesia approaches and techniques.

A typical week is organized as such: two-three days of vascular anesthesia (with a mentor), two-three days of independent practice (performing anesthetics for a wide variety of urological, gynecological, orthopaedic, general, and ENT surgeries) and depending on the week, a day of non-clinical time (to work on academic projects). There are no overnight calls during this fellowship but if an interesting case occurs during the late hours or during the weekend, the fellow is expected to come in if available (e.g. for emergency TEVAR ). The fellow has four weeks of vacation per year plus up to 7 days off over the December holiday period. The fellow is also expected to work one weekend every four weeks. 

For the echo training, the fellow is responsible for examining the indications for the echo, preparation of the echocardiography machine, and performing the echocardiography under supervision of a certified echocardiographer. The image quality and the interpretation of the findings will be discussed with the fellow during performance of the exam. It is expected that the fellow will produce an echo report at the end of the case. The report will be then reviewed by the supervisor and finalized.

A series of echo tutorials and discussions will be conducted on a regular basis and will focus on:

  • Physics and basics of the ultrasounds

  • Hemodynamics (systolic and diastolic function)
  • Cardiac hemodynamic measurement and Calculations
  • Valve lesions and impact on hemodynamics

Each fellow is expected to keep a log of all echo cases performed and reviewed during his/her training to assess the fellow's exposure and knowledge. 

The fellow is expected to be actively involved in a research, teaching or QI project.

Goals and Objectives

The main objective of the fellowship is to allow the fellow to acquire the practical and intellectual skills necessary to care for high-risk vascular patients. It also allows the fellow to develop the academic skills necessary to become a leader in the specialty.

As part of the training, the fellow will receive specialized training in Perioperative echocardiography. This mainly refers to the use of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) for hemodynamic monitoring and management in patients undergoing non-cardiac surgery. 

Our fellow works primarily with a core group of staff specialized in vascular anesthesia and/or perioperative hemodynamic transesophageal echocardiography. This enables the fellow to learn various vascular anesthesia approaches and techniques.

By the end of the fellowship year, the fellow is expected to independently manage patients undergoing surgically complex vascular procedures including:

  • Aortic surgeries (open and endovascular)

  • Peripheral vascular surgeries

  • Carotid end-arterectomies

  • Femoral or iliac end-arterectomies

  • AV fistula creations

  • Amputations

  • Angioplasties

  • First rib resection (e.g., thoracic outlet syndrome)

 By the end of the Fellowship, the fellow will be able to utilize echocardiography for optimal patient management with the following objectives:

  • Acquire cognitive and technical skills in advanced-level perioperative transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE).

  • Develop proficiency in performing qualitative echocardiographic assessment of the hemodynamics.

  • Acquire specialized expertise in the performance and interpretation of echocardiographic findings.

  • Understand the indications, contraindications, clinical applications and quality assurance of the perioperative echocardiography.

  • Ability to perform quantitative echocardiographic exams at different settings (pre-op, intra-op and post-op) with the specific goal of attaining the Basic National Board of Echocardiography's Certification in perioperative echocardiography at completion of fellowship training.

  • Provide leadership in perioperative echocardiography.

Key Faculty

  • Dr. Asad Mir Ghassemi
  • Dr. Elizabeth Miller
  • Dr. Mohamed Eissa

Applications

Postgraduate Medical Education - PGME | Faculty of Medicine (uottawa.ca)

For more details about application requirements, please click our Fellowship Application Instructions dropdown on the previous page.

Contact Us

Dr. Elizabeth Miller
Vacular and PHE Fellowship Lead

Jo-Anne Villeneuve
Fellowship Program Administrator
Department of Anesthesiology and Pain Medicine
[email protected]