DNB Anaesthesiology

completion of their MBBS. The duration of this postgraduate course is 3 years,
and it focuses on the study of various concepts related to the field of Anaesthesia such as General Anaesthesia, Sedation, and Regional Anaesthesia. It deals with the relief of pain and sensation in the brain of the surgical patient before, undergoing, and after surgery.

Admission to this course is done through the NEET PG Entrance exam
conducted by the National Board of Examinations, followed by counselling based
on the scores of the exam that is conducted by DGHS/MCC/State
Authorities.

The course is a full-time course pursued at various accredited
institutes/hospitals across the country. Some of the top accredited
institutes/hospitals offering this course are 7
Air Force Hospital-Kanpur, Aadhar Health Institute-Haryana,
Aakash Healthcare Super Specialty Hospital-Delhi, and more.

The
fee for pursuing DNB (Anaesthesiology) from accredited institutes/hospitals is Rs.
1,25,000 to Rs. 3,15,000 per year.

After completion of their respective course, doctors can either join the
job market or pursue a super-specialization course where DNB Anaesthesiology
is a feeder qualification. Candidates can take reputed jobs at positions as
Senior residents, Junior Consultants, Consultants, etc. with an approximate salary
range of Rs. 4 Lakh to Rs. 18 Lakh per year.

DNB is
equivalent to MD/MS/DM/MCh degrees awarded respectively in medical and surgical
super specialties. The list of recognized qualifications awarded
by the Board in various broad and super specialties as approved by the
Government of India are included in the first schedule of the Indian Medical
Council Act, 1956.

The Diplomate
of National Board in broad-specialty qualifications and super specialty
qualifications when granted in a medical institution with the attached hospital
or in a hospital with the strength of five hundred or more beds, by the
National Board of Examinations, shall be equivalent in all respects to the
corresponding postgraduate qualification and the super-specialty qualification
granted under the Act, but in all other cases, senior residency in a medical
college for an additional period of one year shall be required for such
qualification to be equivalent for the purposes of teaching also.

What is DNB in Anaesthesiology?

Diplomate of National Board in Anaesthesiology,
also known as DNB (Anaesthesiology) or DNB in Anaesthesiology is a three-year postgraduate
programme that candidates can pursue after completing MBBS.

Anaesthesiology is the branch of medical science that is focused on the relief of pain in the perioperative period (i.e. before, during, or after a surgical
procedure).

The National
Board of Examinations (NBE) has released a curriculum for DNB in Anaesthesiology.

The curriculum governs the education and training of DNBs in Anaesthesiology.

PG education intends to create
specialists who can contribute to high-quality health care and advances in
science through research and training.

The required training done by a
postgraduate specialist in the field of Anaesthesiology
would help the specialist recognize the community’s health needs. The student
should be competent to handle medical problems effectively and should be aware
of the recent advances in their speciality.

The candidate should be a highly
competent specialist in Anaesthesiology possessing a broad range of skills that will enable her/him to practice Anaesthesiology independently. The PG
candidate should also acquire the basic skills in teaching
medical/para-medical students.

The candidate is also expected to
know the principles of research methodology and modes of the consulting
library. The candidate should regularly attend conferences, workshops, and CMEs
to upgrade her/ his knowledge.

Course Highlights

Here are some of the course highlights of DNB in Anaesthesiology

Name of Course	DNB in Anaesthesiology
Level	Postgraduate
Duration of Course	Three years
Course Mode	Full Time
Minimum Academic Requirement	MBBS degree obtained from any college/university recognized by the Medical Council of India (now NMC)
Admission Process / Entrance Process / Entrance Modalities	Entrance Exam (NEET PG)
Course Fees	Rs. 1,25,000 to Rs. 3,15,000 per year
Average Salary	Rs. 4 Lakh to Rs. 18 Lakh per year

Eligibility Criteria

The eligibility criteria for DNB in Anaesthesiology are defined as
the set of rules or minimum prerequisites that aspirants must meet in order to
be eligible for admission, which includes:

• Candidates must be in possession of an
  undergraduate MBBS degree from any college/university recognized by the Medical
  Council of India (MCI) now NMC.

• Candidates should have done a compulsory rotating internship of one year
  in a teaching institution or other institution which is recognized by the
  Medical Council of India (MCI) now NMC.

• The candidate must have obtained permanent registration of any State
  Medical Council to be eligible for admission.

• The
  medical college’s recognition cut-off dates for the MBBS Degree courses and
  compulsory rotatory Internship shall be as prescribed by the Medical Council of
  India (now NMC).

• Candidates
  who have passed the final examination, leading to the award of a Post Graduate
  Degree (MD/MS) from an Indian University, which is duly recognized as per
  provisions of the National Medical Commission (NMC) Act, 2019 and the first
  schedule of the IMC Act can apply for the DNB Final examination in the same
  broad specialty.

Admission
Process

The admission process contains a few steps to
be followed in order by the candidates for admission to DNB in Anaesthesiology. Candidates can view the complete admission
process for DNB in Anaesthesiology
mentioned below:

• The NEET PG or National Eligibility Entrance Test for Post
  Graduate is a national-level master’s level examination conducted by the NBE
  for admission to MD/MS/PG Diploma Courses.
• The requirement
  of eligibility criteria for participation in counselling towards PG seat
  allotment conducted by the concerned counselling authority shall be in lieu of
  the Post Graduate Medical Education Regulations (as per the latest amendment)
  notified by the MCI (now NMC) with prior approval of MoHFW.

S.No.	Category	Eligibility Criteria
1.	General	50th Percentile
2.	SC/ST/OBC (Including PWD of SC/ST/OBC)	40th Percentile
3.	UR PWD	45th Percentile

Fees Structure

The fee structure for DNB in Anaesthesiology varies from
accredited institute/hospital to hospital. The fee is generally less for
Government Institutes and more for private institutes. The average fee structure for DNB in Anaesthesiology is Rs. 1,25,000 to Rs. 3,15,000 per year.

Colleges offering DNB in Anaesthesiology

Various
accredited institutes/hospitals across India offer courses for pursuing DNB (Anaesthesiology).

As per the
National Board of Examinations website, the following accredited
institutes/hospitals are offering DNB (Anaesthesiology)
courses for the academic year 2022-23.

Syllabus

A DNB
in Anaesthesiology is a three years specialization course that
provides training in the stream of Anaesthesiology.

The
course content for DNB in Anaesthesiology is given in the NBE Curriculum released by the National Board of Examinations, which can
be assessed through the link mentioned below:

During the course, the candidate should be exposed to the following areas of clinical anaesthesia practice:

 Pre anaesthesia clinic

 Pain clinic

 Recovery and Post anaesthesia care unit (PACU)

 All Surgical specialty theatres- Surgery, Gynae & Obs, Orthopaedics, ENT, Eye

 Surgical super-specialty theatres: Urology, Pediatric Surgery, Burns & Plastic Surgery, Neurosurgery, CTVS, Oral & Maxillofacial Surgery, Oncosurgery

 Intensive Care Units

 Dialysis and transplant

 Induced hypotensive techniques

 Daycare Anaesthesia

 Anaesthesia outside the OT and in remote locations (like- ECT, Radiology, IVF, Dental, Palliative /Radiotherapy, Endoscopy/ERCP, Orthopaedic reductions in Trauma Centre/ A&E)

 Anaesthesia at high altitude and in difficult terrains

 Robotic surgery (preferable)

 Monitored anaesthesia care/ conscious sedation

The course content shall include the following:

A. 1st Year Theory

 Anatomy – Anatomy of the Heart, Coronary Circulation, Lung, and Broncho- pulmonary segments. Diaphragm, larynx, upper and lower airway; cranial nerves; relevant anatomy for regional anesthesia. The special anatomical area of interest to the anesthesiologist, e.g., Orbit of the eyes, Base of the Skull, Vertebral Column, Spinal Cord and meninges, Intercostal Space, Nerves and Nerve Plexuses ,e.g., Brachial, Coeliac, Superior Hypogastric, etc.

 Physiology – Pertaining to Anaesthesia. Respiratory, Cardiovascular, Central Nervous System, Autonomic Nervous System, Hepatobiliary, Renal and Endocrine System, Pediatric and Geriatric Physiology, Pregnancy, Blood Groups, Blood Transfusion, Muscle and Neuro Muscular Junction, Regulation of temperature & Metabolism, Stress response, Acid-Base Homeostasis, Fluid and Electrolytes

 Biochemistry–

i. Biochemistry relevant to fluid balance & blood transfusion, artificial blood, and perioperative fluid therapy.

ii. Acid-base homeostasis in health and diseases.

iii. Interpretation of blood gases, electrolytes, and other relevant biochemical values. Various function tests related to systems, e.g., LFT, KFT, and basics of measurement techniques.

 Medical physics as applied to the practice of Anaesthesiology

i. Anaesthesia workstation/ machine – checking the machine and assembly of necessary items.

ii. Airway Management equipments including Tracheostomy – Anaesthesia face masks, different types of laryngoscopes like Macintosh, McCoy, etc., supraglottic airway devices (SGAD) like LMA, I GEL, PLMA, Aura gain, etc., video laryngoscopes like C-MAC, Airtraq, Kingvisionetc, Flexible intubating laryngoscopes, adjuncts like styles, bougies, airway exchangers, equipments for cricothyroidomy and percutaneous tracheostomy, self-inflating bag (AMBU bag).

iii. Breathing system continuous flow systems, draw over the system – Assembly and checking, vaporizers, Gas laws.

iv. Monitoring in Anesthesia with concepts of minimal monitoring.

v. HR, ECG, NIBP, EtCO2, SpO2, Temp, RR, NM Monitoring, BIS, IBP, CVP, PAP, Agent Gas Monitoring, Anaesthesia machine ventilator monitoring, scavenging system, Negative/ neutral/ positive pressure Operation Theatres

vi. Safety in Anesthesia equipments.

vii. Medical gases – storage and central pipeline system, Cylinders, liquid oxygen, pipleline, gauge, and pressures.

viii. Air Conditioning in OR

ix. Laminar Flow

x. HFNC / HFOT/ Jet Ventilation

xi. Suction- Central/ Portable/ Foot suction

xii. Principles of electrocautery & diathermy

xiii. Defibrillator / AED

 Pharmacology– including but not limited to

i. General pharmacological principles.

ii. Concepts of pharmacokinetics and pharmacodynamics of various Drugs used during Anaesthesia and relevant to Anaesthesia practice.

iii. Uptake and distribution of inhaled anesthetics agents.

iv. Intravenous anaesthesia agents

v. Opioids and non-opiod analgesics

vi. Neuro Muscular Blockers, anti-cholineesterase agents,

vii. Anti- sialogogue agents, anticholinergic agents

viii. Drugs used in common medical disorders like HT& IHD, Asthma, DM, Thyroid disorders, etc.

ix. Emergency drugs, e.g., Adrenaline, Atropine, Inotropes, Diuretics, Antiarrhythmic drugs, alpha & beta agonists/ antagonists, etc.

x. Antacids and Antiemetic agents, Prokinetics

xi. Benzodiadepines, sedatives, and hypnotics

xii. Concept of TIVA/ conscious sedation

xiii. Drugs affecting coagulation- pro and anticoagulants

xiv. Local anaesthetics, including toxicity, intralipid

xv. Drugs acting on the autonomic nervous system

xvi. Use of steroids in anaesthesia and ICU

xvii. Malignant hyperthermia and dantrolene

xviii. Immuno modulators/ immunosuppressants

xix. Drug interaction in Anesthesiology.

xx. Obstetric Drugs- oxytocin, methergin, etc

xxi. Drugs used in Neurosurgery: Mannitol, anticonvulsants, steroids, etc.

 Anaesthesiology:

General Aspects

i. History of anaesthesia with specific reference to Indian scenario

ii. Role of anaesthesiologists in a wider perspective

iii. Introduction to the operation theatre, recovery rooms (concepts of PACU), ICU, Pain clinic, Pre-anesthetic check-up (PAC)room

iv. Preoperative assessments and pre-medication –general principles.

v. Introduction to anatomical, physiological, pharmacological, and biochemical aspects of pain and pain management, both Acute and Chronic

vi. General principles of Prevention of Hospital Acquired infection to Healthcare workers and communicable diseases

vii. Theoretical background of the commonly used anesthetic techniques of general and regional anesthesia viz.

viii. GA –Intravenous, Inhalational, Endotracheal, etc., using spontaneous and controlled mode of ventilation.

ix. RA –Spinal, epidural, CSE, and Nerve block

x. MAC (Monitored Anaesthesia Care)

Medicine related to:

i. Cardiovascular System.

ii. Respiratory System.

iii. Hepatobiliary System.

iv. Genitourinary System.

v. Endocrine system,

vi. Obstetrics

vii. Nervous System

 Documentation, aspects of medico-legal care, informed consent, and record keeping

i. Documentation and medico-legal aspects of anaesthesia.

ii. Emphasize the importance of accurate documentation.

iii. Details of consent- informed, written, recorded, the local language, witnessed Adult patient, unknown patient, pediatric patient, etc

 Introduction to research methodology, Randomized Controlled trials, etc. Basics of biostatistics.

 Resuscitation

i. Cardiopulmonary Resuscitation; both BCLS/ BLS & CCLS/ ACLS,

ii. Theories of the cardiac pump, thoracic pump

iii. Recent Advances/ Guidelines

iv. Defibrillation & AED

v. Resuscitation & ICU management of a patient with an overdose of drugs/ poisoning/ snake bite/ management of unconscious patients, severely injured / polytrauma patient.

vi. Neonatal Resuscitation

vii. Obstetric Resuscitation.

• Critical Care

General ICU Care

i. Introduction to artificial ventilation

ii. General nursing care of a patient in the ICU

iii. Care of patient on a mechanical ventilator.

iv. Oxygen therapy- Ventimask, Non-Rebreathing Mask, HFNC/ HFOT, etc

v. Basic Modes of ventilation: NIV & Invasive

vi. Ventilatory strategies in different medical & surgical conditions

vii. Weaning & Extubation

viii. Nutrition & Alimentation: enteral & parentral, etc

ix. Fluids & Electrolytes

x. Antibiotics

xi. Sedation, analgesia & role of NM Blockers in ICU

xii. Biochemical, Hematological Investigations and monitoring

xiii. VAP, Nosocomial infections

xiv. Breaking the bad news

xv. Counseling

xvi. End of Life care

xvii. Organ donation- counseling, medico-legal issues, certification of brain death, anaesthesia for organ donation

xviii. PCT & Care of tracheostomy

• Recovery from anaesthesia

i. Causes of delayed recovery

ii. Management of Delayed Recovery and prolonged unconsciousness.

iii. Recovery criteria for Day Care Procedures

• Shock – pathophysiology, clinical diagnosis, and management

• Pulmonary function tests – Principles and application.

i. Bedside PFT

ii. Lab PFT- interpretation and clinical correlation and treatment modification

• Effects of positioning on the OT table and ICU bed.

i. Different positions, adverse effects & prevention

ii. Diathermy burns

• Principles of USG in anaesthesia practice:

• Regional anaesthesia

• ICU- FAST, Lungs, Heart, Vessel, etc

• Vascular access

• Airway management

• PCPNDT Act requirements and regulations

• Type of Probes

• Physics of equipment used in anaesthesia.

• Medical gases –gas plant, central pipeline, scavenging system.

• Pressure Reducing valves.

• Anesthesia machine,

• Humidifiers.

• Flowmeters

• Safety measures related to anesthesia equipments

B. 2nd Year Theory

• Applied anatomy of each system.

• Vaporizers –characteristics and functional specifications.

• Breathing systems/ anaesthesia circuits -Assembly, functional analysis, flow.

• Requirements of APL and flow directional valves.

• Minimum monitoring standards.

• Sterilization of equipment

• Computers, Utility, Computer-assisted learning, and data storage. Computerized anaesthesia records.

• Pharmacology of drugs used in cardiovascular, respiratory, endocrine, renal diseases, and CNS disorders.

• Principles of monitoring equipment used for assessment of:

i. Cardiac function viz. Rhythm, pulse, venous and arterial pressures, and cardiac output.

ii. Temperature.

iii. Respiratory function viz. Rate, volumes, compliances, resistance, blood gases.

iv. Intracranial pressure, depth of anesthesia and

v. Neuromuscular block.

• Working principles of ventilators.

• Special anaesthesia techniques as relevant to outpatient anaesthesia, hypotensive anaesthesia, anaesthesia in abnormal environments, and calamitous situations.

• Anaesthetic management in special situations – Emergency, ENT, Ophthalmology, Obstetric, Obstetrics analgesia, Plastic, Dental, Radio-diagnosis, and Radio therapeutic procedures and patients with systemic diseases.

• Training in research methodology and Medical statistics with special relevance to data collection, analysis, comparison, and estimation of significance.

i. Principles of pediatric anaesthesia. Management of neonatal surgical emergencies, RA in infants. Pediatrics – Prematurity, Physiology, anatomy of the neonate in comparison with an adult.

ii. Associated Medical disorders in surgical patient – Anaesthetic implications and management.

iii. Basics of orthopedic anaesthesia.

iv. Daycare anaesthesia.

v. Rural anaesthesia – anaesthesia for camp surgery.

vi. Anaesthesia for otorhinolaryngology with special emphasis on difficult airway management.

vii. Blood and blood component therapy.

viii. Anaesthetic implications on coagulation disorders. Role of TEG/ ROTEM

ix. Massive blood transfusion, Autologous blood transfusion techniques

x. Maintenance of haemostasis and fluid and fluid management

xi. Monitored anaesthesia care (MAC).

xii. Recovery from Anaesthesia: Management of Delayed Recovery and prolonged unconsciousness.

xiii. Anaesthetic implications in diabetes mellitus, thyroid, and parathyroid disorders. Phaeochromocytoma, cushings disease, etc.

xiv. Management of acid-base disorders.

xv. Principles of geriatric anaesthesia.

xvi. Role of an anesthesiologist in a Pandemic

xvii. Extended universal precautions in infectious diseases (special reference to COVID-19)

xviii. Anaesthesia outside the OR and in special situations

xix. Principles of management in Trauma and mass casualties.

xx. Basics and principles of ICU

xxi. Design and functional Utility of Operation Theatre and ICUs

xxii. Application of USG in Anaesthesia Practice

Principles of Regional Anaesthesia

Central Neuraxial Blockade (CNB)

• Spinal anaesthesia: all approaches: Midline, paramedian, Lumbo sacral

• Epidural anaesthesia & Analgesia: Interlaminar, Caudal, Thoracic, parasaggital

• Combined Spinal & Epidural Anaesthesia & Analgesia

• Brachial plexus block-all approaches

• Superficial and Deep Cervical plexus block

• Awake craniotomy blocks

• Awake Intubation Blocks

• Stellate Ganglion Blocks

• Intercostal Blocks

• PEC I & II Block

• Paravertebral block

• Erector Spinae block

• Quadratus Lumborum block

• Celiac Plexus block

• Lumbar Sympathetic block

• Sup & Inf Hypogastric Plexus Block

• Sciatic nerve block- all approaches

• 3-in-1 block

• TAP Block: all approaches

• Ilio-inguinal & ilio hypogastric block

• Rectus sheath block

• Field Block

• Surface anaesthesia

• Use of adjuvants with local anaesthetics

• Complications & Side Effects and management

• Conversion from RA to GA

• Requirements of the setup for administering RA

• Role of Nerve Stimulator and USG

• IVRA: Lower & Upper Limb

C. 3rd Year Theory

• Anaesthesia for patients with cardiac, respiratory, renal, hepatobiliary, endocrine disorders posted for surgery.

• Principle of one lung anaesthesia

• Principles of anaesthetic management of neuro/cardiac/thoracic/vascular

• /urology / transplantation/ burn and plastic surgery.

• Principles of anaesthetic management of surgery in neonatal, paediatric, Obstetric, and geriatric patients.

• Principles of Anaesthesia for Bariatric surgery

• Management of patients in shock, renal failure, critically ill, and/ or on a ventilator.

• Management of patients for cardiac surgery / CPB beating heart surgery.

• Principles of neonatal ventilation and critical care.

• Chronic pain therapy and therapeutic nerve blocks.

• Selection and maintenance, and sterilization of anaesthesia and related equipment.

• Principles of human resources and material management.

• General principles of the medical audit.

Anaesthesia Non-Technical Skills

• Orders and prioritize appropriate investigations

• Biostatistics, Research Methodology and Clinical Epidemiology

• Medico-legal aspects relevant to the discipline

• Health Policy issues as may be applicable to the discipline

• Medical Ethics &Communication Skills:

i. Principles of informed consent

ii. Principles of crisis management, conflict resolution, negotiation, and debriefing

iii. Understand nonverbal communication with critically ill patients

iv. Principles of delivering bad news to patients and families

v. Strategies to communicate complicated critical care issues to the general population

Career Options

After
completing a DNB in Anaesthesiology,
candidates will get employment opportunities in Government as well as in the
Private sector.

In the Government sector, candidates have various options to
choose from, including Registrar, Senior Resident, Demonstrator, Tutor, etc.

While in the Private sector the
options include Resident Doctor, Consultant, Visiting Consultant (Anaesthesiology), Junior Consultant, Senior
Consultant (Anaesthesiology), Consultant Anaesthesiology
Specialist, etc.

Courses
After DNB in Anaesthesiology Course

DNB in Anaesthesiology is a specialization course that can be pursued after
finishing MBBS. After pursuing a specialization in DNB (Anaesthesiology), a candidate could also pursue super
specialization courses recognized by NMC, where DNB (Anaesthesiology) is a feeder qualification.

DM Cardiac Anesthesia, DM Critical Care Medicine are the courses that require DNB (Anaesthesiology) as a feeder qualification.

Frequently Asked Questions (FAQs) – DNB in Anaesthesiology Course

Question: What is a DNB in Anaesthesiology?

Answer: DNB Anaesthesiology or
Diplomate of National Board in Anaesthesiology also known as DNB in Anaesthesiology is a Postgraduate level course for doctors in India that is done by them
after completion of their MBBS.

Question: Is DNB in Anaesthesiology equivalent to MD in Anaesthesiology?

Answer: DNB in Anaesthesiology is equivalent to MD in Anaesthesiology,
the list of recognized qualifications
awarded by NBE in various broad and super specialties as approved by the
Government of India are included in the first schedule of the Indian Medical
Council Act, 1956.

Question: What is the duration of a DNB in Anaesthesiology?

Answer: DNB in Anaesthesiology is a
postgraduate programme of three years.

Question: What is the eligibility of a DNB in Anaesthesiology?

Answer: Candidates must be in possession of an undergraduate
MBBS degree from any college/university recognized by the Medical Council of
India (now NMC).

Question: What is the scope of a DNB in Anaesthesiology?

Answer: DNB in Anaesthesiology
offers candidates various employment opportunities and career prospects.

Question: What is the average salary for a DNB in Anaesthesiology postgraduate
candidate?

Answer: The DNB in Anaesthesiology candidate’s average salary is between Rs. 4 Lakh to Rs. 18 Lakh per year depending on the experience.

Question: Are DNB Anaesthesiology and MD Anaesthesiology
equivalent for pursuing teaching jobs?

Answer: The Diplomate of National Board in broad-speciality
qualifications and super speciality qualifications when granted in a medical
institution with attached hospital or in a hospital with the strength of five
hundred or more beds, by the National Board of Examinations, shall be
equivalent in all respects to the corresponding postgraduate qualification and
the super-speciality qualification granted under the Act, but in all other
cases, senior residency in a medical college for an additional period of one
year shall be required for such qualification to be equivalent for the purposes
of teaching also.