International Board of Perioperative Medicine

Perioperative medicine is an emerging field of medicine in response to the increasing age and complexity of patients and the increase in the number of surgical procedures being performed. There is a large variation in perioperative medical practice which has led to a worldwide diversity in perioperative outcomes.

The International Board of Perioperative Medicine comprises an international group of medical professionals who are considered experts in their respective areas of Perioperative Medicine. The aim of the Board is to formulate a perioperative medicine syllabus which has worldwide applicability. Furthermore, it aims to deliver and approve cost-effective perioperative medicine education to all countries irrespective of socioeconomic status leading to an improvement in perioperative outcomes.

Proposed Structure for Interim Board (2018-2020)


  • Joint-President – Prof. Monty Mythen, Prof. Paul Myles
  • Vice Presidents – Prof. Lee Fleisher, Prof. Carol Peden
  • Secretaries – Prof. Mike Grocott
  • Treasurer - Dr. Cliff Koh, Dr. Bobby Jean Sweitzer
  • Immediate Past President - TBA

Non-Executive Directors

  • Anaesthesia - Prof. TJ Gan
  • Surgery – Dr. Henrik Kehlet
  • Physicians - Dr. Jugdeep Dhesi, Dr. PJ Devereaux


  • Admissions - Dr. Frances Chung, A/Prof. Richard Urman
  • Information technology - Dr. Maxime Cannesson, Andy Shaw
  • Education – Prof. David Walker, Dr. Joel Symons
  • Research - Prof. Ramani Moonesinghe

Representatives of stakeholder nations

  • UK – Dr. Denny Levett, Dr. Rupert Pearse
  • USA – Prof. Solomon Aronson, Prof. Matt McEvoy
  • Australia – Prof. Dave Story, Dr. Ruth Hubbard
  • Canada - TBA
  • Europe - TBA
  • Africa - Dr. Bruce Biccard
  • Asia - TBA
  • Middle East - TBA

Current Board Members

Professor Paul Myles
Professor Michael (Monty) Mythen
Dr Joel Symons
Professor David Walker
Professor Andrew Shaw
Professor Carol Peden
Professor David Story
Professor Denny Levett
Professor Henrik Kehlet
Dr Jugdeep Dhesi
Professor Lee Fleisher
Professor Matthew McEvoy
Professor Mike Grocott
Professor Mike Irwin
Professor Ramani Moonesinghe
A/Professor Richard Urman
Professor Rupert Pearse
Professor Solomon Aronson
A/Professor Timothy Miller
Professor TJ Gan

Learning objectives

On completion of the syllabus, the learner would be expected to:

  1. Demonstrate a patient centered approach to the integrative multidisciplinary care of patients contemplating or undergoing surgery.
  2. Demonstrate expertise in the clinical management of patients in the perioperative period (i.e. preoperative, intraoperative, acute postoperative and postoperative transition of care periods).
  3. Ensure that perioperative services are fully integrated, consistent, and reliable and make efficient use of resources.
  4. Partner with colleagues in other disciplines, including primary care, surgeons, hospitalists, rehabilitation, geriatricians, nurses and allied health professionals.
  5. Demonstrate an advanced understanding of the importance and functioning of the pre-admission process and/or clinic.
  6. Educate the perioperative physician to risk stratify and optimize care of the patient in the perioperative period.
  7. Develop the expertise to take a lead in collaborative decision making about the suitability of high risk patients for surgery.
  8. Collaboratively manage the patient in the perioperative period, in particular high-risk surgical patients with acute or chronic medical co-morbidities that require optimization and management to improve patient outcomes.
  9. Obtain the managerial skills to lead a multidisciplinary perioperative management team
  10. Be equipped with research skills to understand perioperative medicine research.
  11. Provide teaching to colleagues of all grades (levels) and specialties.

Proposed Syllabus

  • General Topics / Introduction +
    • INT1: Introduction to Perioperative Medicine
    • INT2: The perioperative medicine physician
    • INT3: Health economics
      • INT3.1: Economic burden of healthcare provision (country specific)
      • INT3.2: Resource allocation
      • INT3.3: Impact of funding models in delivered care (e.g. fee for service)
      • INT3.4: Measuring health and economic outcomes
    • INT4: Designing Clinical pathways
      • INT4.1: Enhanced recovery after surgery pathways
      • INT4.2: Precision Perioperative Medicine for High-Risk Surgical Patients
    • INT5: Monitoring and Evaluation of Perioperative Care
      • INT5.1: Risk and case-mix adjustment.
      • INT5.2: Structure-process-outcome framework
      • INT5.3: Clinical outcomes
      • INT5.4: Resource outcomes
      • INT5.5: Patient reported outcomes (PRO) and ongoing QI
    • INT6: Quality measurement
    • INT7: Basics of Operating Room Management
    • INT8: Building and Managing a Preoperative Clinic
    • INT9: The logistics of Running a Perioperative Consult Service
    • INT10: Building and Managing a Postoperative Assessment Clinic
      • INT10.1: Targeting functional recovery
      • INT10.2: Transitions of care
  • Preoperative Assessment and Planning +

    Preoperative assessment

    • PRA1 : Models of preoperative assessment
    • PRA2 : Clinical risk assessment
      • PRA2.1 : Anemia
      • PRA2.2 : Diabetes
      • PRA2.3 : Nutrition
      • PRA2.4 : Pain
      • PRA2.5 : Obstructive sleep apnea (OSA)
      • PRA2.6 : Mental Health
      • PRA2.7 : Fitness
      • PRA2.8 : Smoking
      • PRA2.9 : Anticoagulation
      • PRA2.10 : PCN allergy testing and desensitisation
    • PRA3 : Biomarkers and organ-specific assessment
      • PRA3.1 : Cardiac (cardiac patient for non-cardiac surgery, stress testing, pacemakers)
      • PRA3.2 : Respiratory (include lung function testing)
      • PRA3.3 : Renal
      • PRA3.4 : Endocrine
      • PRA3.5 : Hematologic
    • PRA4 : Perioperative cancer care/ oncoanesthesia (impact of cancer treatments)
    • PRA5 : Perioperative genomics
    • PRA6 : Physical fitness, activity and surgical outcomes
    • PRA7 : Cardiopulmonary (CPX)/ functional capacity
    • PRA8 : Frailty and comprehensive geriatric assessment and disposition planning
    • PRA9 : Cognitive testing and other neurological assessment
    • PRA10 : Collaborative decision making
    • PRA11 : Preoperative investigations

    Preoperative intervention and optimization

    • PRI1: Lifestyle modification (including activity/ exercise, smoking/ alcohol cessation, weight loss)
    • PRI2: Optimizing preoperative nutrition
    • PRI3: Optimization of major comorbidities
      • PRI3.1: Cardiac (HTN, ischemic heart disease, heart failure)
      • PRI3.2: Respiratory (sleep apnoea, asthma, COPD, pulmonary hypertension)
      • PRI3.3: Endocrine (diabetes), preoperative glucose management
      • PRI3.4: Renal (CKD)
      • PRI3.5: Hepatic (cirrhosis)
      • PRI3.6: Anemia: Optimizing hemoglobin and patient blood management
    • PRI4: Prehabilitation- specific interventions
    • PRI5: Optimization of preoperative pain management (including chronic opioid use)
    • PRI6: Medication management (including anticoagulant management, steroids and herbal medications)

    Ethics and advanced care directives and perioperative planning

    • ETH1 : End of life care (including the very young and the very old)
    • ETH2 : Ethics of informed consent and shared decision making
    • ETH3 : Goals of Care Discussions
    • ETH4 : Do not resuscitate procedures
    • ETH5 : Ageing
    • ETH6 : Postnatal depression
  • Postoperative Assessment and Management +

    Postoperative Pain and Sleep

    • POP1: Postoperative triage (postoperative levels of care)
    • POP2: Focusing on Optimal Analgesia to promote functional recovery
      • POP2.1: Relationship of pain/surgical stress management to co-morbidities
    • POP3: Opioid minimization and avoidance – principles and techniques
    • POP4: Management of chronic pain and opioid-dependent patients
    • POP5: Promoting normal sleep
    • POP6: Delirium: assessment, avoidance, and management
    • POP7: Postoperative Cognitive Dysfunction


    • CAR1: Perioperative BP control
    • CAR2: Arrhythmias, pacemakers, AICD
    • CAR3: Aortic stenosis and other valve disorders
    • CAR4: Pulmonary hypertension
    • CAR5: Endocarditis, myocarditis, cardiomyopathy
    • CAR6: Heart and lung transplantation
    • CAR7: Adult with congenital heart disease
    • CAR8: Mechanical assist device management and evaluation
    • CAR9: Basics of echocardiography assessment  (how to read and interpret an echocardiogram)
    • CAR10: Myocardial injury and protection
    • CAR11: Heart failure


    • RES1: Asthma
    • RES2: COPD
    • RES3: Other lung diseases
    • RES4: Airway management and postoperative ventilation strategies

    Fluid, Electrolytes, Nutrition, and Renal

    • FLU1: Fluids and electrolytes/ acid-base
    • FLU2: Nutritional support in the postoperative period
    • FLU3: Goal directed therapy/ advanced haemodynamic monitoring
    • FLU4: Perioperative AKI


    • END1: Glycemic control
    • END2: Management of thyroid diseases
    • END3: Management of pituitary diseases
    • END4: Management of parathyroid diseases
    • END5: Management of adrenal diseases
    • END6: Management of neuroendocrine diseases (e.g. carcinoid)

    Postoperative Patient Blood Management

    • PBM1: Anemia
    • PBM2: Coagulopathy
    • PBM3: Thromboprophylaxis

    Cancer and pain

    • CAN1: Cancer and pain incl. haematological malignancies
    • CAN2: Perioperative acute and chronic pain management
    • CAN3: Perioperative care of the cancer patient

    Other organ systems

    • OTH1: Trauma and Emergency General Surgery
    • OTH2: Perioperative management of obesity
    • OTH3: Perioperative management of neurological diseases
    • OTH4: Psychiatric management
    • OTH5: Myopathies
    • OTH6: Autoimmune diseases
    • OTH7: Porphyria
    • OTH8: Acquired and inherited coagulation disorders
    • OTH9: Perioperative management of the burns patient
    • OTH10: Radiology in the acute setting
    • OTH11: Obstetrics

    Additional Topics in postoperative care

    • ADD1: Postoperative recovery (disability, quality of life, hospital readmission)
    • ADD2: Postoperative care teams (roles and relationships)
    • ADD3: Allergies and anaphylaxis/ allergy testing and desensitisation
    • ADD4: Infectious diseases
    • ADD5: Inflammation (and sepsis)
    • ADD6: Antibiotics
    • ADD7: Wound management/ surgical infection
    • ADD8: Handover
    • ADD9: Discharge disposition planning
    • ADD10: Transition care planning
    • ADD11: Hypothermia and hyperthermia
    • ADD12: PONV
    • ADD13: Alcohol and substance abuse
    • ADD14: Management of intraoperative awareness
  • Improvement Science, Research, and Value for Perioperative Medicine +

    Improvement science

    • IMP1: Leadership and team-building
    • IMP2: Process improvement
    • IMP3: Quality improvement
    • IMP4: Human factors
    • IMP5: Patient safety
    • IMP6: Writing of Institutional Policies

    Statistics, Research and Quality Improvement

    • STA1: Perioperative Medical research: understanding the literature
    • STA2: Introduction to statistics/ research
    • STA3: Ethnography
    • STA4: Research proposal
    • STA5: Research project

    Value and Monetizing (this would be country-specific)

    • VAL1: Billing and management of preoperative and postoperative consultation and services
    • VAL2: Compliance with billing and coding regulations


Department of Anaesthesia and Perioperative Medicine - Monash University

Department of Anaesthesia and Perioperative Medicine - Monash University

University College London

University College London