DR. ASHISH ALEXANDER
(An Anaesthetist and an Intensivist)
- Personal details and qualifications
- Last post held and employment history
- Personal statement
- Clinical experience
- - Academic achievements and ongoing endeavours
- - Research
- Paper presentations
- Conferences & CME
- Membership of specialist societies
- Information technology skills
Permanent and Communicating Address:
Penthouse B, Diamond plaza
Muthoor P.O., Thiruvalla
Indian Mobile No: 0091-960-***-****
Primary Email: email@example.com
Alternate Email: firstname.lastname@example.org
Date of Birth: 27th September, 1982
Age & Gender: 35, Male
Marital Status: Single
Qualification Year Institution
Member of the Faculty of
Intensive Care Medicine
2017 FICM (Faculty of Inten-
sive Care Medicine), Lon-
European Diploma in
Anaesthesia and Intensive
2015 ESA (European Society of
DNB (Anaesthesiology) -
Diplomate of National
2013 Lourdes Hospital
(650 bedded tertiary care
teaching hospital) ; Certifi-
cate awarded by National
Board of Examinations,
New Delhi, India.
Post Graduate Diploma
2010 Jawaharlal Nehru Med-
ical College (2200 bedded
tertiary care teaching hos-
pital) ; KLE University,
Belgaum, Karnataka, India.
(Bachelor of Medicine,
Bachelor of Surgery)
2006 Universal College of
Medical Sciences (700
bedded tertiary care teach-
ing hospital) ; Tribhuvan
Date Position Institution Job Profile / Responsibilities April 2016
- July 2018
Played a major role in filling a challenging gap
in the department rota that involved:
1) A period of four weeks in the Operating
Theatres (averaging 44.5 hours a week) wherein
I performed independently with/without appro-
• Pre-operative evaluation & optimisation of
patients for scheduled surgery
• Administer anaesthesia for both scheduled and
emergency operative procedures
• Post-operative management of patients in the
recovery unit/PACU/Surgical ICU
2) A period of 4 weeks in the ITU (averaging
44.5 hours a week) wherein I:
• Attend all ITU consultant led ward rounds or
occasionally lead the evening ward round.
• Was available to ITU fellows for senior advice
and to oversee all bedside interventions to-
ward the day to day management of the pa-
tients on the unit.
• Work to cover ward based critical care refer-
rals and carry out critical transfers both within
the hospital and between hospitals with con-
sultant as required.
• Deliver Intensive Care support to the emer-
gency department and attend all cardiac arrest
and major haemorrhage calls in the institute.
• Provide anaesthetic escort and support for ra-
diology transfers and trauma calls as well as
for procedures in the Interventional Radiology
and Interventional Cardiology suites.
• Provide airway and anaesthetic cover for the
entire hospital other than the theatres during.
• Play an active role in the teaching sessions on
Date Position Institution Job Profile / Responsibilities May 2013
ala, India. (a
1) Independently responsible for the:
• Pre-anaesthetic evaluation and optimisation of
patients posted for a wide variety of proce-
• Administration of anaesthetics to an amalgam
of speciality and super-speciality cases with a
special interest in Vascular, Orthopaedic,
Bariatric and Neurosurgery.
• Management of critically ill patients admitted
to the post operative ICU.
• Management of critically ill patients in the
Medical ICU and other Speciality ICUs (both
level II and III). An entire week every month
was dedicated to the delivery of such care in
the field of critical care medicine.
2) Active involvement in the teaching (bedside
and class based) of post graduate medical stu-
dents enrolled for the DNB programme(Anaes-
thesia and Medicine) in the hospital.
3) Active involvement in the teaching (bedside
and class based) of students enrolled for the
Anaesthetic Nurse/Technician and the General
Nursing courses in the hospital.
4) Took up lead roles in arranging various insti-
tute based Continuous Professional
Date Position Institution Job Profile / Responsibilities January
2011 - May
ala, India. (a
1) Performed independently under appropriate
• The pre-anaesthetic evaluation and optimisa-
• The delivery of tailored anaesthesia and peri-
operative care to patients scheduled for elec-
tive and emergency procedures of a variety of
• The post-operative management of patients in
a dedicated ICU.
2) Active participation in all teaching pro-
grammes and academic activities including reg-
ular written assessments towards successful
completion and passing of the DNB (Anaesthe-
3) Active involvement in the teaching sessions
for students enrolled in the Anaesthetic Nurse/
technician programme of the hospital.
June 2010 -
1) To perform independently:
• Pre-anaesthetic evaluation and optimisation of
patients posted for various Oncosurgeries.
• The delivery of anaesthesia and peri-operative
care of patients subjected to a variety of major
and minor Onco-surgical procedures.
• The post-operative management of patients in
a dedicated ICU.
2) Actively participate in all teaching pro-
grammes and academic activities in the institute.
The past nine years in the field of Anaesthesia and Intensive Care, saw me initially training in these fields in premier institutes in India and then further working in various positions in In- dia and abroad. This journey saw me serving in a number of different Hospitals and Teaching Institutions each catering to a broad spectrum of patients with many institutes delivering cer- tain specific specialist services.
As an individual I have an undying spirit to gain further knowledge and acquire finer skills and expertise to further enhance patient safety and comfort and to deliver high end evidence based healthcare whist always ensuring the optimal use of resources. This also directly re- flects on the flow of knowledge to my juniors towards which I always focus a significant amount of time and energy. In every position I served, having supportive and comfortable working relationships with my peers was always one of my strengths and I found myself working well as a team member.
Over time, I have also found myself at my best, working in high-pressure environments and caring for patients experiencing extreme physiological and pathological stresses of complex surgeries in the peri-operative scenario and/or of critical illnesses on an Intensive Care Unit. I have always envisioned serving various positions where I am part of a world class team that develops and delivers evidence based clinical services with an emphasis on patient outcome and safety with improved efficiency.
Having trained and worked as an Anaesthesiologist and an Intensivist at leading institutions in India and just completed a tenure that involved working and training in London on my first ever job abroad, I am on the lookout for further challenges to expand my personal and profes- sional horizons. With the ongoing professional and academic advancement I’m pursuing, I intend to use my academic acumen and my entire experience to enhance the services provid- ed by any institution interested in absorbing me.
Date Position Institution Job Profile / Responsibilities April 2006
- July 2007
To assist consultants in the Department of
General Surgery in the delivery of individualised
care to surgical patients in this 610 bedded spe-
My role as a Clinical Fellow/Speciality Doctor in London had given me the opportunity to continue to expand my experience in the delivery of safe anaesthesia to patients of various surgical specialities as well as in the care of patients on an Intensive Care Unit in settings quite different from those in India. I do seem to have successfully adapted to the new settings and continued to deliver patient care at high standards as per the feedback received during my last appraisal on the job and my self assessment. The experience gained from my earlier positions in India included an extensive exposure to numerous major and minor, elective and emergency surgery with a significant percentage of the patients having a range of co-morbidities requiring careful planning and a combination of anaesthetic techniques to ensure safe peri-operative care. Through my sessions in pre-assessment in various institutes, I was part of the team responsi- ble for optimising patients and ensuring a streamlined and efficient patient journey prior to their operation. My anaesthetic sessions involved regularly anaesthetising patients for Neuro- surgical, Vascular, Orthopaedic, Urologic, Gynaecological & Obstetric, Otolaryngological, Paediatric, Onco-surgical, Bariatric, Oro-maxillofacial, Robotic and Plastic and reconstruc- tive procedures as well as General and Paediatric surgery patients. The case mix included both major inpatient and day care cases requiring a range of anaesthetic techniques including advanced regional anaesthetic techniques. I have had to work through long theatre sessions enabling me to nurture a team based approach to work which in turn helped in improving staff efficiency, staff morale and the maintenance of various patient safety standards all aim- ing to improve patient outcome.
In my various capacities in various institutes I have put in an extra effort in the following areas of interest:
My interest in regional anaesthesia started very early in my career. As a senior resident at KLE HOSPITAL I received excellent training in traditional landmark approaches to regional blockade. Later, having attended a number of lectures and workshops including a certification course in USG-RA, I passionately applied my knowledge of anatomy and sonoanatomy and utilised my interests to introduce ultrasound guided nerve blocks in my department in Lour- des Hospital. As a result ASA grade 3& 4 patients with complex medical problems could have their operations under regional anaesthesia safely, effectively and comfortably and fur- ther more peri-operative delivery of analgesia took a huge leap in the right direction. Over the last two years of my tenure at Lourdes Hospital, I contributed significantly to the furthering of the practice of USG guided regional anaesthesia and supervised and taught all basic ultrasound guided blocks to all my interested colleagues as well as all trainees at the institute. Further down the line, I was part of a teaching workshop as faculty in training in- house consultants and trainees in Northwick Park Hospital of London Northwest University Hospitals in London. Feedback from colleagues and postgraduate trainees suggest that they got excellent awareness and exposure to the various techniques, enough to change their prac- tise for the better.
In my last job, being a Member of the Faculty of Intensive Care Medicine (MFICM), salient critical care work includes attending and assisting all ITU consultant led ward rounds, being available to ITU fellows for senior advice and for the day to day management of the patients on the unit. It also involves working with the consultants to cover ward referrals and critical care transfers (both intra and inter hospital transfers) as well as delivering critical care sup- port for the emergency department, for all cardiac arrest, for all major haemorrhage and trauma calls and radiology transfers and procedures. I also provide airway and anaesthetic cover for the ITU team and wards during on call hours. Intensive care sessions I had in India, involved delivery of optimised critical care to patients admitted to the General Medical as well as speciality ICUs (Cardiology, Nephrology, Medical Gastroenterology, Neurosurgical and Neuromedical) requiring Level 2 and Level 3 care. This was on a rotational basis (one week every month) on my last job in India. I was however involved in the care of most post- operative patients requiring Level 2 and Level 3 care on almost a daily basis because of my personal interest and my firm belief that an Anaesthetists’ role extends a great deal into the post operative period.
At the bedside my advanced skills and training in Critical & Intensive Care that I employed included: advanced airway management techniques, bronchoscopies, placement of centrally and peripherally inserted central line catheters under ultrasound guidance, arterial line se- curement, advanced monitoring, ionotrope and vasopressor management and advanced venti- latory management including prone ventilation. My interest in ultrasound in general had me pioneering the regular use of bedside ultrasound in the ICUs of Lourdes Hospital as well as for the patient referrals in the Emergency department. This involved the employment of lung ultrasound, trans-thoracic echocardiography and the E-FAST scan for the management of var- ious case scenarios. The practise was effectively extended to my work in London. Trauma ; Acute and Remote Anaesthesia
I have always been involved in the care of critically ill and major trauma patients, employing the art of triaging followed by accurate protocolled examination and administration of treat- ment decisively and rapidly. Specific skills employed involved emergency airway manage- ment including percutaneous cricothyroidotomies, emergency vascular access including ve- nous cut downs and intercostal drains placements on an emergency basis and region specific ultrasound guided nerve blocks or central neuraxial blocks to provide pain relief in trauma patients. My exhaustive anaesthetic training has given me confidence to manage most anaes- thetic emergencies that an acute operative list may provide, including major neurosurgical and vascular cases, as well as in the practise of remote site anaesthesia e.g. for radiological procedures etc.. I am often involved in the pre-assessment and pre-optimisation of emergency patients with life threatening conditions. I have frequently worked in an emergency theatre, where a high turn-over of theatre personnel and surgeons always exists and I have been able to effectively work with such a multidisciplinary team, to provide optimal patient care with high efficiency in the emergency setting. This demonstrates that I have acquired excellence in team leadership and communication skills. I also enjoy supervising trainees attending to these acute cases to increase their confidence in the management of emergencies out of hours and to improve their clinical management skills in general. During my on-call commitment at the various institutes, I made it a point to supervise trainees as they actively got involved in the delivery of safe peri-operative care to emergency cases for all surgical specialities including obstetrics and in the management of patients in the Intensive Care setting.
Alongside my clinical commitments I have organised Continous Professional Development programmes, workshops and conferences in all of the institutions I worked at, which enabled me to share my experiences with my colleagues and my contemporaries and in turn get essen- tial feedback from them. These endeavours also helped trainees posted with me to acquire new skills and knowledge. I made a personal effort at all times including out of hours to help trainees in the field in any way possible when it came to acquiring new knowledge and skills. The following are the different surgical specialities I dealt with in my various capacities and the clinical experience I gained in each speciality. Neurosurgery
With a neurosurgical team at Lourdes Hospital doing a wide range of procedures, I was in- volved with many of the procedures performed because of a special interest in Neuroanaes- thesia. This involved delivery of tailored anaesthesia for craniotomies, craniectomies, awake craniotomies, procedures requiring monitoring with SSEPs, MEPs etc., a wide spectrum of spine (cervical, thoracic, lumbar and sacral) surgeries, endoscopic endonasal procedures and aneursymal surgery to name a few.
With Vascular Surgery being a department in the process of developing in Lourdes hospital, I showed considerable interest and went about employing my advanced skills in delivering customised anaesthesia as well as in the post-operative management of patients subjected to various advanced vascular surgeries including Peripheral Vascular bypass procedures, Open Thoracic and Abdominal Aneurysmal surgeries, Hybrid Surgeries, Endovascular repairs and various Venoplastic procedures. I was regularly involved in the management of vascular surgery cases requiring significant post procedural ICU care. My skills in performing bedside trans-thoracic echocardiography was quite handy in the management of those patients with significant cardiac illness; something that commonly co-exists in this cohort of patients. Orthopaedic and Joint Replacement/Corrective Surgery Lourdes Hospital having a very busy Orthopaedic department, I was involved in various elec- tive and emergency procedures. I was instrumental in introducing ultrasound guided nerve blocks from inter-scalene, supra-clavicular blocks and individual nerves blocks of the upper limb to femoral nerve, adductor canal and individualised nerve blocks of the lower limb ei- ther to facilitate surgery itself or for intra-operative and post-operative analgesia. In associa- tion with one of the Orthopaedic Consultants and a Neurosurgeon, we were delivering ultra- sound guided trans-laminar steroid injections for selected cases of Low Back Pain with good results.
Urology and Renal transplantation
Lourdes Hospital has an active urology list with regular renal transplant cases. I have anaes- thetised both donors and recipients alongside my mentors. I further provided peri-operative care independently for all types of urological procedures including those in renal transplant recipient patients. Further, I introduced a new service for patients with renal failure un- dergoing vascular access surgery at Lourdes Hospital. These patients having signifi- cant co-morbidities have a high risk of morbidity and mortality, Regional anaesthe- sia is an excellent alternative and hence I employed region specific ultrasound guided nerve blocks.
Gynaecological Surgery and Obstetrics
My experience in this field covers all aspects of patient care, from pre-assessment and prepa- ration to anaesthetising and post operative care. During my time at KLE hospital as a trainee and in my capacity at the other hospitals, I regularly anaesthetised for major gynaecological surgery including laparoscopic procedures as well as obstetric cases. I have been trained in labour analgesia and have delivered the same to a number of patients effectively and have further successfully managed a number of peri-operative obstetric complications. On my last job in Lourdes Hospital, I was regularly involved in the care of Obstetric patients as a result of my flexible work sessions.
Head and Neck Surgery
I have staffed major Otolaryngologic, Maxillofacial and Head and Neck Onco-surgery lists on a regular basis. In the process, I gained extensive experience of the management of very challenging airways in both elective and emergency patients with difficult airways for major/ minor surgery. This included patients with massive retrosternal thyroids (many requiring sternotomies), patients requiring tracheal reconstruction and patients with TMJ ankylosis. My advanced airway skills include blind nasal intubations, fibreoptic intubations and tra- cheostomies and in the process I have had the opportunity to teach my trainees the skills I gained. On my last job in Lourdes Hospital, I was also involved in delivering tailored anaes- thesia to children scheduled for cochlear implants which has challenges of their own. Plastic and Reconstructive Surgery
At KLE hospital which is a major plastics tertiary referral centre, where I carried out a major proportion of my training,. I used to anaesthetise these cases on a regular basis as well as during my on-calls for emergency surgeries. I continued to anaesthetise such patients and my case mix covered all aspects of major reconstructive surgery including cleft-lip, palate, breast and other cosmetic corrective procedures, both adult and paediatric trauma, reconstruction following resection in Oncosurgery involving free-flaps, pedicle flaps etc. in addition to max- illofacial surgery. I utilised a variety of anaesthetic techniques including intravenous sedation and regional anaesthesia under ultrasound guidance, which I enjoyed teaching to the trainees who attended my lists. I was also involved in delivering anaesthesia at a private Plastic Surgery centre that mainly dealt with hair transplant under regional anaesthetic techniques. Oncosurgery including Robotic Procedures
Although being involved in delivering Onco-anaesthesia in all the institutions I worked in, I was exposed to numerous complex specific Oncosurgical procedures in the state government cancer centre (Malabar Cancer Centre) where I worked for some time.The case mix included Upper GI, Lower GI, Urogenital, Limb salvage, Head and Neck and Breast once-surgery and reconstructive surgeries along with complex surgeries including hepatic and skull based metastatic resections. My experience was further enhanced in London, where I was involved in the peri-operative care of patients of the world renowned St.Marks hospital that performed various complex procedures including robotic procedures in the area of Colorectal surgery. General Surgery including Bariatric and Thoracic Surgery From my training and onto my work in various institutions and my work as a freelance anaes- thetist has given me a really handy experience in the delivery of tailored anaesthesia for a va- riety of laparoscopic and open conventional general surgeries. Further with experts in the surgical team in Lourdes Hospital, I had the opportunity to be involved in the peri-operative care of a number of bariatric procedures as well as a number of thoracic procedures (lung based procedures as well as upper GI procedures) which specifically required the delivery of one lung ventilation.
Having being trained initially in KLE and later working in institutes performing paediatric surgery, I was exposed to the delivery of tailored anaesthesia to children of all ages from neonates onwards for a range of surgeries including correction of congenital diaphragmatic hernias, trachea-oesophageal fistulas, hernias, intussceptions, cleft lips and palates etc. I also gained quite an experience with anaesthetising numerous children subjected to Otolaryngolo- gy procedures.
Academic achievements and ongoing PDP
1) Secured the highest mark in the University for the final examination of my Post Graduate Diploma in Anaesthesiology.
2) Won the best Post-graduate paper presentation at the Kerala State Anaesthesiology Conference held at Kasargod, Kerala in October 2012. 3) Cleared the both parts of the EDAIC (European Diplomate of Anaesthesiology and Intensive Care) exam in the first attempt with a credible percentile rank. 4) Completed an extensive Diploma course on Trans-thoracic Echocardiography cer- tified by the Medical University of Venice and whose credits are recognised by various societies including the British Cardiology Society. 5) In the process of becoming an instructor of the BASIC (Basic Assessment and Support in Intensive Care) Course conducted world over primarily by The Chi- nese University of Hong Kong along with various institutions across the globe including those in Australia, New Zealand, United Kingdom, Portugal, Malaysia, India etc.
6) In the process of attempting and completing the final FRCA and final FFICM exams over a period of six months to one year starting from mid 2018. Research and Publications
• “A Prospective Randomised Trial Comparing the Proseal Laryngeal Mask Airway and the Endotracheal Tube in Patients Undergoing Laparoscopic Cholecystectomies Under General Anaesthesia” (DNB, Ashish A, 2013). During my initial training in anaesthesia in India I was the principal investigator of a randomised study of two techniques for airway securement in patients undergoing Laparoscopic Cholecystectomies. Under the close su- pervision of the professor of anaesthesia at Lourdes Hospital I conceived the study, ob- tained ethical approval, wrote the study protocol, recruited patients, conducted the study, analysed the data and wrote the report of the findings. The final thesis was published and submitted to the National board of Examinations, in partial fulfilment of the requirement for the DNB examination in Anaesthesia.
• “ Prone Position Craniotomy in Pregnancy without Fetal Heart Rate Monitoring” -
(Jean Jacob MD, Ashish Alexander DA DNB, Shoba Philip MD, Anoop Thomas MCH
(2016) Prone Position Craniotomy in Pregnancy without Fetal Heart Rate Monitoring. J Clin Anesth 2016; 13: 119-122 ; http://dx.doi.org/10.1016/j.jclinane.2016.02.034)
• “An Epidural Blood Patch for Spontaneous Intra-cranial Hypotension - A Case Re- port” - (Alexander A, Philip S, Varghese P (2016) An Epidural Blood Patch for Sponta- neous Intra-cranial Hypotension - A Case Report. J Anesth Crit Care Open Access 4 (4): 00146, DOI: 10.15406/jaccoa.2016.04.00146)
• “ Plasmodium Vivax Cerebral malaria - A Rare Cause of Multi Organ Dysfunction.” (Thomas R, Alexander A, Paul A, Philip S, Rajeev I (2015) Plasmodium Vivax Cerebral malaria - A Rare Cause of Multi Organ Dysfunction. J Anesth Crit Care Open Access 3(3): 00097.DOI: 10.15406/jccoa.2015.03.000097)
• Was one of the foot soldiers in a Multicentric Study in the UK titled the “pRrotective vEnti- lation with veno-venouS lung assisT in respiratory failure”, the REST study. Paper presentation
1. Presented a paper titled “Effect of rectal diclofenac suppositories on post operative pain in cleft palate repair” at the South Zone Anaesthesiology Conference held at Hyderabad, India in September 2009.
2. Presented “ Onco-anaesthesia - An Upcoming Paradigm in Anaesthesia” at the ISA City Branch, Kannur, Kerala, India.
3. Presented a paper titled “A Prospective Randomised Trial Comparing the Proseal Laryn- geal Mask Airway and the Endotracheal Tube in Patients Undergoing Laparoscopic Cholecystectomies Under General Anaesthesia” at the Kerala State Anaesthesiology Conference held at Kasargod, Kerala in October 2012 and won the best Post-Graduate Presentation Award in the state for that year.
4. Presented “Interdental Wire Fixation of the Endotracheal Tube in a Paediatric Facial Burns Patient” at the ISA City Branch, Kochi, Kerala, India. 5. Presented “ Peri-operative Management of a Hybrid Vascular Procedure” at the ISA City Branch, Kochi, Kerala, India.
6. Presented “Awake Craniotomy - An Oxymoron? “ at the ISA City Branch, Kochi, Kerala, India.
I have contributed to medical student and anaesthetic resident teaching, adopting a variety of methods including lectures with audiovisual aids, bed-side tutorials and medical simulation. I have also been involved in teaching of allied health professionals like anaesthesia techni- cians. Further, I have helped organise and co-ordinate four CMEs, workshops and confer- ences during my tenure at various institutions. I continue to look forward for opportunities to enhance my knowledge and skills and to share them with my colleagues and trainees as learn- ing is a lifelong process.
Conferences, CMEs, Workshops and Certification courses towards CPD
• National Workshop in Obstetric anaesthesia 2008
• Annual CME-PG EXCEL (KLE University) 2009
• CME on “Anaesthesia for elective orthopaedic surgery” 2009
• Annual South Zone Anaesthesiology Conference (Hyderabad, India), Sep- tember 2009.
• CME- Workshop “Difficult Airway Management”, 2010
• CME on Pediatric anesthesia, 2010
• Midterm CME and Conference ISAMIDKON, March 2011
• CME RACE 2012
• CME and Annual State Conference, ISACON- Kerala, October 2012
• CME on Anaesthesia Machine and Monitoring Equipment, Bangalore, March 2013
• Midterm CME and Conference ISAMIDKON, Kerala, April 2013
• Live Ultrasound Guided Regional Anaesthesia workshop, Attingal, Kerala, July 2013.
• CRITICARE UPDATE 2013, Kochi, Kerala, September 2013.
• Conference ISAMIDKON 2014
• Critical care CME & Workshop on Use of ultrasound in the critically ill, Kochi, Kerala, May 2014
• Certification Course on Ultrasound Guided Regional Anaesthesia and Chronic Pain Management (CME and Workshop), Coimbatore, Tamil Nadu, August 2014
• CME and Workshop on Pain and Ultrasound Guided blocks (Organised and attended) - LAPCON, Lourdes Hospital, Kerala, 2014
• GASMAN Certification Programme, across a period from August 2014 to February 2015
• CRITICARE 2015, 21st annual conference of ISCCM, Bangalore, India, March 2015
• Advancements In Operating Room Technology - Developing Smarter OR Nurses, Lourdes College of