Nara Multidisciplinary approach for well-being

Speaker

Geraldine Raphaela B. Jose

Name: Geraldine Raphaela B. Jose MD

Professional Qualifications
  • Diplomate of the Philippine Board of Anesthesiology
    (DPBA) Manila, Philippines 2001
  • Doctor of Medicine (MD) 1994 University of the East
    Ramon Magsaysay Medical Center
    Manila, Philippine
  • Bachelor of Science (BS) in Biology 1990
    University of the Philippines
    College of Arts and Sciences
    Manila, Philippines

PRESENT APPOINTMENTS

•ACADEMIC APPOINTMENTS

Year Position Organization
2018- present Secretary, Board of Examiners Philippine Board of Anesthesiology
2014- present Member, Board of Examiners (Written and Oral Examination Committee) Philippine Board of Anesthesiology
2013- present President Society for Neuroanesthesia of the Philippines, Inc. (SYNAPS)
2010- present Member, Core Organizing Committee Asian Society of Neuroanesthesia and Critical Care (ASNACC)
2008- present Member, Residents’ Training Committee in Anesthesiology Department of Anesthesiology University of the Philippines Philippine General Hospital

•UNIVERSITY AND CLINICAL APPOINTMENTS

PERIOD POSITION SUBSPECIALTY/PROGRAM UNIVERSITY/HOSPITAL
2016- present Associate Professor Anesthesiology Univeristy of the Philippines Philippine General Hospital
2004– present Clinical Associate Professor Anesthesiology University of the Philippines Philippine General Hospital
2004 – present Chief Neuroanesthesia University of the Philippines Philippine General Hospital
2004– present Consultant Staff Cardiac Anesthesia, Thoracic and Vascular Anesthesia, Critical Care University of the Philippines Philippine General Hospital
2004– present Consultant Staff Anesthesiology, Cardiac Anesthesia and Neuroanesthesia The Medical City Manila, Philippines
2009– present Consultant Staff Cardiac Anesthesia Manila Doctors Hospital Manila, Philippines
2010– present Consultant Staff Anesthesiology, Cardiac Anesthesia and Neuroanesthesia Makati Medical Center Makati, Philippines

•POSTMEDICAL EDUCATION

FELLOWSHIPS

PERIOD POSITION PROGRAM UNIVERSITY/HOSPITAL DIRECTOR/ SUPERVISOR
2003- 2004 Clinical and Research Fellow Neuroanesthesia University of Toronto Toronto Western Hospital Toronto Ontario, Canad Pirjo Manninen MD/ Jacob Lai MD
2001- 2003 Clinical and Research Fellow Cardiac Anesthesia and Intensive Care University of Toronto Toronto General Hospital Toronto Ontario, Canada Jacek Karski MD/ Gerald O’Leary MD
2000- 2001 Research Fellow Anesthesia University of the Philippines Philippine General Hospital Merle F. de la Cruz- Odi MD

CLINICAL ATTACHMENT

PERIOD POSITION PROGRAM UNIVERSITY/HOSPITAL DIRECTOR/ SUPERVISOR
FEB 2004 Clinical Observer Anesthesia Manchester Royal Infirmary Manchester, UK Brian Pollard MD

SCHOLARSHIPS

PERIOD POSITION PROGRAM UNIVERSITY/HOSPITAL DIRECTOR/ SUPERVISOR
2000- (thesis lacking) Masters of Science (MS) in Physiology University of the Philippines College of Medicine University of The Philippines Philippine General Hospital Xenia Tigno MD

RESIDENCY IN ANESTHESIOLOGY

PERIOD POSITION PROGRAM UNIVERSITY/HOSPITAL DIRECTOR/ SUPERVISOR
1999 Chief Resident Anesthesiology University of the Philippines Philippine General Hospital Merle F. de la CruzOdi MD
1998 Assistant Chief Resident Anesthesiology University of the Philippines Philippine General Hospital Merle F. de la Cruz- Odi MD
1996- 1998 Resident Anesthesiology University of the Philippines Philippine General Hospital Virgilio T. Genuino MD

INTERNSHIP

PERIOD POSITION PROGRAM UNIVERSITY/HOSPITAL DIRECTOR/ SUPERVISOR
1994- 1995 Medical Intern Medical Internship Medical Center Manila, Philippines Asuncion AbayaMurido MD

•CERTIFICATES

  • Advanced Cardiac Life Support, (accredited by the American Heart Association) 2002, 2004, 2008, 2011, 2013, 2015, 2017, 2019
  • Emergency Neurologic Life Support (ENLS) 2016
  • Basic Life Support, The Medical City (accredited by the Philippine Heart Association) (2008)

•AWARDS

  • High Rank, Philippine Board of Anesthesiology Board Examination DPBA (2001)
  • Second Place, Philippine Board of Anesthesiology Written Examination (2000)
  • Plaque of Recognition as Chief Resident of the Department of Anesthesiology, awarded by the Administrative Staff of the Philippine General Hospital (1999)
  • Most Outstanding Anesthesiologist, given by the Department of Surgery, University of the Philippines Philippine General Hospital (1998)
  • Second Place, Quiz Contest Philippine Society of Anesthesiologists (1998)
  • Most Outstanding Medical Intern, Medical Center Manila Manila, Philippines (1996)
  • Most Outstanding Surgical Intern, Medical Center Manila Manila, Philippines (1996)

•CONVENTIONS ATTENDED

  • Asian Society of Neuroanesthesia and Critical Care Organizing Committee Meeting Nara, Japan (2018)
  • Society of Cardiovascular Anesthesia Annual Meeting Arizona, USA (April 2018)
  • Asian Congress of Anesthesiology Siem Reap, Cambodia (November 2017)
  • Asian Society of Neuroanesthesia and Critical Care Meeting Singapore (June 2017)
  • American Society of Anesthesiologists Meeting Chicago, USA (October 2016)
  • Asian Society of Neuroanesthesia and Critical Care Organizing Committee Meeting Singapore (April 2016)
  • European Association of Cardiothoracic Anesthesiologists Florence, Italy (September 2014)
  • 3rd Asian Society of Neuroanesthesia and Critical Care Conference in Bali, Indonesia (February 2013)
  • 2nd Asian Society of Neuroanesthesia and Critical Care Conference in New Delhi, India (February 2011)
  • 38th Society of the Neurosciences in Anesthesiology and Critical Care Annual Conference San Diego, USA (October 2010)
  • 105th American Society of Anesthesiologists Annual Convention San Diego, USA (October 2010)
  • 104th American Society of Anesthesiologists Annual Convention New Orleans, Louisiana USA (October 2009)
  • 37th Society of Neuroanesthesia and Critical Care Annual Conference New Orleans, Louisiana USA (October 2009)
  • 30th Society of Cardiovascular Anesthesia Meeting Vancouver, Canada (June 2008)
  • 35th Society of Neuroanesthesia and Critical Care Annual Conference San Francisco, California USA (October 2007)
  • 102nd American Society of Anesthesiologists Annual Convention San Francisco, California USA (October 2007)
  • 34th Society of Neuroanesthesia and Critical Care Annual Conference Chicago, Illinois USA (October 2006)
  • 101st American Society of Anesthesiologists Annual Convention Chicago, Illinois USA (October 2006)
  • 13th World Federation of Neurosurgical Societies International Convention Marrakesh, Morocco Africa (June 2005)
  • 99th American Society of Anesthesiologists Annual Convention Las Vegas, Nevada USA (October 2004)
  • 32nd Society of Neuroanesthesia and Critical Care Annual Conference Las Vegas, Nevada USA (October 2004)
  • 25th Canadian Anesthesiologists Society Annual Conference Quebec City, Quebec Canada (July 2004)
  • 25th Society of Cardiovascular Anesthesia Meeting Miami, Florida (April 2003)
  • 2nd Post-Graduate Course: Muscle Relaxants in Focus: University of the Philippines-Philippine General Hospital Manila, Philippines (2000)
  • 1st Post-Graduate Course: Inhalational Anesthesia: University of the Philippines-Philippine General Hospital Manila, Philippines (1999)
  • 3rd Mechanical Ventilator Workshop University of the Philippines-Philippine General Hospital (1999)
  • 10th Asean Congress of Anesthesiologists Kuala Lumpur, Malaysia (1999)
  • Philippine Society of Anesthesiologists Midyear Convention, Philippines (1999)
  • American Society of Anesthesiologists Annual Convention Orlando, Florida USA (1998)
  • Philippine Society of Anesthesiologists Midyear Convention, Philippines (1998)

•SOCIETIES

  • President, Society For Neuroanesthesia of the Philippines, Inc (2013-present)
  • Affiliate Member, American Society of Anesthesiologists (2006-present)
  • Member, Society for the Neurosciences in Anesthesiology and Critical Care (2006 -present)
  • Country Representative, Asian Society of Neuroanesthesia and Critical Care (2010- present)
  • Member, Philippine Society of Cardiothoracic Anesthesiologists (2016-present)
  • Member, Society of Cardiovascular Anesthesiologists (2003-present)
  • Member, International Anesthesia Research Society (2003-present)
  • Member, Philippine Medical Society (1998-present)
  • Member, Philippine Society of Anesthesiologists (1997-present)

•EXPERIENCE AS A NEUROANESTHESIA CLINICAL AND RESEARCH FELLOW AT THE UNIVERSITY OF TORONTO TORONTO WESTERN HOSPITAL

The Toronto Western Hospital is a tertiary care hospital with several designated priority programs: Neurosurgery, Neurology, and Spine Research. I have spent 80% of the time in the operating theatre and 20% on non-clinical activities such as teaching and research. As a clinical fellow, I have been given the opportunity to provide anesthesia to patients with various neurologic issues for neurosurgery in the main operating theatre as well as in the radiologic suites for embolization procedures under minimal supervision. Stereotaxic procedures are performed regularly including deep brain stimulation procedures for patients with tremors. Nowadays, the trend is to do awake craniotomy surgeries for intracranial tumors such as glioblastomas and astrocytomas. I was introduced to several total intravenous techniques in anesthesia for awake craniotomy procedures. This shift to minimally invasive neurosurgical techniques have also influenced the evolution of the anesthetic management for such cases which I was given the opportunity to learn. I also provided anesthesia to patients for cervical spine surgery who require either an awake or asleep fiberoptic intubations. I was also exposed to Somatosensory Evoked Potential monitoring. Knowledge of which is essential in providing excellent anesthesia for spine surgeries. As a research fellow, I was involved in outcome studies on cervical spine surgeries and the use of a novel intubating device, the GlideScope for difficult airway.

•EXPERIENCE AS A CARDIAC ANESTHESIA AND INTENSIVE CARE CLINICAL AND RESEARCH FELLOW AT THE UNIVERSITY OF TORONTO TORONTO GENERAL HOSPITAL

The Toronto General Hospital is a primary Cardiac Centre in Ontario, Canada. Other priority programs include oncology and transplantation. In the cardiac aspect, the hospital does approximately 2,500 cardiac cases a year involving Coronary Artery Bypass Grafting, Repair of Adult Congenital Cardiac Anomalies, Left Ventricular Assist Device Implantation and Heart Transplant.

As a clinical fellow, I became more confident and comfortable in handling high risk cardiac patients for cardiac and non-cardiac surgeries and critically ill Intensive Care Unit (ICU) patients requiring procedures such as tracheostomies, insertion of invasive lines for monitoring, among others.

I gained experience in the anesthetic management of cardiac procedures such as coronary artery bypass grafting, valve repairs and replacements, left ventricular assist device implantation and heart transplant under direct supervision. I gained experience in providing anesthesia for the “off pump” revascularization in which the center performs 250 cases per year.

I became familiar with coagulation management options and the use of cell saver devices in intraoperative cardiac surgery cases. I gained experience in administering anesthesia to patients for pacemaker insertions and automated Internal Cardioverter Defibrillator (AICD) implantations with staff guidance. I had approximately 1 rotation per week in this theatre doing 4 to 5 cases per day for 2 years. Occasionally, I was assigned to do cases at the cardiac catheterization laboratory to anesthetize patients for repair of coarctation of the aorta and atrial septal defect closure.

I rotated in the Cardiovascular Intensive Care unit (CVICU) with a 1 to 2 24-hour period calls per week. It is a 24 bed capacity where I gained experience in the management of post cardiac surgery patients including patients with intra-aortic balloon pump (IABP), post congenital heart surgery repair, post left ventricular assist device (LVAD) implantation and post heart transplant. I gained efficiency in central venous line insertion and arterial cannulation. I also gained experience in the use of bronchoscopy in the ICU as well as different ventilator modalities in the management of patients with respiratory, renal and neurologic complications post cardiac surgery.

I have spent 80% clinical time in cardiac anesthesia and intensive care. Non-clinical time was approximately 20% and was spent in clinical research. I also had a blocked time training in Intraoperative Transesophageal Echocardiography (TEE). We had weekly lectures and seminars on cardiac anesthesia and transesophageal echocardiography. I have participated in teaching anesthesia residents in clinical settings.

•MANAGERIAL SKILLS

As an assistant chief resident in anesthesia, I was given the responsibility to assist in the organization of the theory and clinical exposure of medical students and anesthesia residents to different surgical subspecialties.

As a chief resident in anesthesia, I participated in the supervision of elective surgical cases daily to make sure that all cases are going on smoothly with proper assignment of residents in the operating theatre. I have seen the importance of teamwork and harmonious communication between colleagues to achieve a goal.

I have functioned as a senior house officer at the Philippine General Hospital during my last year of residency. I have participated in administrative decision making during on call hours including the release of blood products in the blood bank for trauma and emergency obstetric cases.

•TEACHING EXPERIENCE

I have taught and supervised the techniques of airway management and regional anesthesia specifically, spinal and epidural anesthesia to clinical anesthesia students at the University of the Philippines Philippine General Hospital.

I have participated in the organization of lecture modules and examinations for clinical anesthesia students at the same hospital.

I was involved in the teaching of the clinical practice of anesthesia during theatre sessions of various surgical subspecialties.

•CONTRIBUTIONS TO SCIENCE

I am the Philippine Representative to the Core Organizing Committee of the Asian Society of Neuroanesthesia and Critical Care (ASNACC). During the 2018 ASNACC Organizing Committee Meeting in Nara, Japan, I delivered a lecture on the Current Status of the Neuroanesthesia Program in the Philippines.

The following are the other lectures I have delivered so far:

  1. Anticoagulation in a Neurosurgical Patient: Current Updates, PSA Philippines 2018
  2. Science of Flow: Basic Principles in Anesthesia, PSA Philippines 2018
  3. Updates on Neuroprotection in Traumatic Brain Injury UP Anesthesia Postgraduate Course 2018
  4. Airway Management of Special Neurosurgical Cases: Acromegaly and Craniofacial Anomalies, ASNACC Singapore 2017, Makatimed 2017
  5. Weaning and Liberation from the Mechanical Ventilator
    Academic Lecture Series, University of the Philippines-Philippine General Hospital 2015, 2016
  6. Multiple Organ Failure
    Academic Lecture Series, University of the Philippines-Philippine General Hospital 2015, 2016
  7. Protective Ventilation Strategies in Anesthesia
    Academic Lecture Series, Department of Anesthesiology, Makati Medical Center 2015 Academic Lecture Series, University of the Philippines-Philippine General Hospital 2015, 2016, 2017
  8. The Cardiopulmonary Management of the Neurosurgical Patient
    Philippine Society of Anesthesiologists – Society for Neuroanesthesia of the Philippines
    Annual Meeting, November 2014
    Neuroanesthesia Meeting Tan Tok Seng Hospital, 2013
  9. The Heart and the Brain
    Philippine Society of Anesthesiologists Annual Meeting, November 2013
  10. Intraoperative Management of Conjoined Twins
    Academy of Neurosurgeons Meeting, November 2011
  11. Awake Craniotomy
    Academic Lecture Series, Department of Anesthesiology, University of the Philippines-Philippine General Hospital, 2014, 2013, 2012, 2011, 2013, 2015, 2016, 2017
  12. Vascular Anesthesia
    Academic Lecture Series, Department of Anesthesiology, University of the Philippines-Philippine General Hospital, 2014, 2013, 2012, 2011
  13. Pharmacology of Anesthetics
    Academic Lecture Series, Department of Anesthesiology, Makati Medical Center April 2011
  14. Cardiac Physiology
    Academic Lecture Series, Department of Anesthesiology, Makati Medical Center April 2010, 2013, 2018
  15. Intra-operative Awareness
    Post Graduate Course in Anesthesiology: “Not On My Watch”: The Anesthesiologist as a Crisis Manager, Department of Anesthesiology University of the Philippines-Philippine General Hospital, January 2010
  16. Preoperative Evaluation
    Academic Lecture Series, Department of Anesthesiology,
    University of the Philippines-Philippine General Hospital, February 2009, January 2010
  17. Neurophysiology
    Academic Lecture Series, Department of Anesthesiology,
    University of the Philippines-Philippine General Hospital, November 2006
  18. Sedation in the Intensive Care Unit
    American College of Chest Physicians, Philippine Chapter Annual Scientific Meeting:
    “Scaling New Heights in Chest Medicine”
    Baguio City, Philippines, June 2006
  19. Airway Management
    Academic Lecture Series, Department of Anesthesiology,
    University of the Philippines-Philippine General Hospital, February 2006
  20. Acute Coronary Syndrome and Acute Stroke
    Thoraco-Cardiovascular Anesthesia Service ACLS Lecture Series
    Department of Anesthesiology, University of the Philippines-Philippine General Hospital,
    January 2006
  21. Physiologic Effects of Anesthesia
    Department of Medicine Lecture Series,
    University of the Philippines-Philippine General Hospital, November 2005
  22. Neurophysiology
    Academic Lecture Series, Department of Anesthesiology,
    University of the Philippines-Philippine General Hospital, October 2005
  23. Effects of Propofol on the Intracranial Pressure of Patients for Awake Craniotomies
    Fellows Rounds Department of Anesthesia Toronto Western Hospital
    University Health Network University of Toronto, September 2004
  24. Outcomes and Complications of Cervical Spine Surgery
    Fellows Rounds Department of Anesthesia Toronto Western Hospital
    University Health Network University of Toronto, April 2004
  25. Colloids vs Crystalloids for Fluid Resuscitation in Critically Ill Patients
    Fellows Rounds Department of Anesthesia Toronto General Hospital
    University Health Network University of Toronto, July 2003
  26. Anesthetic Management of the Displaced Heart and Outcomes of Off Pump Cardiac Surgery
    Fellows Rounds Department of Anesthesia Toronto General Hospital
    University Health Network University of Toronto, June 2003

RESEARCH

2016 (invited member) Korean Journal of Anesthesiology

The following are my other research interests and publications:

  1. Cardiopulmonary Management in a Neurosurgical Patient: A Review
  2. Updates on Neuroprotection: A Review
  3. The Evolution of Awake Craniotomy Practice in the Philippine General Hospital: A 15- year experience
  4. What Factors Influence The Technique of Intubation in Patients with Cervical Spine?(Abstract)

Department of Anesthesia, University of Toronto, Toronto Western Hospital Venkat Raghavan MD L, Jose MD GR, Lukitto MD K, El-Beheiry MD H, Manninen MD presented in the 34th Annual Meeting of The Society of Neuroanesthesia and Critical Care, Chicago, Illinois USA in October 2006

  1. Incidence of Complications of Cervical Spine Surgery: A Prospective Study (Abstract)
    Department of Anesthesia, University of Toronto, Toronto Western Hospital
    Manninen MD P, Jose MD GR, Mak MD P
    presented in the 25th Canadian Anesthesiologists Society Quebec City, Canada July 2004 abstract published in the Canadian Journal of Anesthesia July 2004
  2. Updates on Minimally Invasive Cardiac Surgery, a Chapter in the Fellow’s Cardiac Manual 2003
    Department of Anesthesia, University of Toronto, Toronto General Hospital
    Jose MD GR, Catalan MD G, Djaiani MD G published by the University of Toronto 2003
  3. Blood Transfusion Practices in Off Pump Cardiac Surgery in Toronto General Hospital (Abstract)
    Jose MD GR, Varadarajan MD B, Mukherji MD J, Djaiani MD G, Cusimano Md RJ, Karski MD J, Cheng MD D presented in the Society of Cardiovascular Anesthesia Conference Florida, USA, April 2003
    published in Anesthesia and Analgesia April 2003
  4. Outcomes of Off Pump Cardiac Surgery in Toronto General Hospital (Abstract)
    Mukherji MD J, Jose MD GR, Djaiani MD G, Cusimano MD RJ, Karski MD J, Cheng MD D
    presented in the Society of Cardiovascular Anesthesia Conference 2002 published in Anesthesia and Analgesia April 2002
  5. A Comparison of Intubating Conditions and Duration of Activity of Cis-Atracurium and Atracurium in Filipinos for Surgery at the Philippine General Hospital. A

Randomized Double-Blind Clinical Trial
Odi MD TR, Jose MD GR, Evangelista MD E, de la Cruz-Odi MD M presented in the 10th Asean Congress of Anesthesiologists Kuala Lumpur, Malaysia, July 1999
presented in the Philippine Society of Anesthesiologists Research Forum in Manila, Philippines, November 1999
presented in the Philippine General Hospital Research forum in Manila, Philippines 2000 (third place)

  1. A Comparison of Epidural Bupivacaine with Clonidine vs Epidural Bupivacaine alone for Intraoperative and Postoperative Analgesia for Gynecologic Patients for Surgery at the Philippine General Hospital. A Randomized Double-Blind Clinical Trial Odi MD TR, Jose MD GR, Evangelista MD E, de la Cruz-Odi MD M

presented in the Philippine Society of Anesthesiologists Research Forum in Manila, Philippines
November 1997 (first place)

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