Enjoy a stunning array of native species and cultural tours on this perfect combination of land and sea excursions. The Galapagos welcomes you into an environment rich with wildlife and geographical wonders. Get to know the history of Ecuador and Peru when you visit Quito, Machu Picchu, and Lima.


  Day Date City / Port
  Sun Feb 13 Quito, Ecuador
  Mon Feb 14 Quito, Ecuador
  Tue Feb 15 Quito, Ecuador
      Colonial City Tour and Middle of the World
  Wed Feb 16 Quito / Baltra | Galapagos Islands Cruise
      Mosquera Islet
  Thu Feb 17 Galapagos Islands Cruise
      Egas Port (Santiago Island) | Rabida Island
  Fri Feb 18 Urbina Bay (Isabela Island) | Tagus Cove (Isabela Island)
  Sat Feb 19 Espinosa Point (Fernandina Island) | Vicente Roca Point (Isabela Island)
  Sun Feb 20 Baltra – Guayaquil - Lima | Highlands Tortoise Reserve (Santa Cruz Island) | Flight to Lima | Transfer to hotel in Lima
  Mon Feb 21 Lima – Cusco - Sacred Valley
      Flight to Cusco | Sacred Valley - Awanakancha ("The Fabric Palace") | Transfer to hotel in Urubamba
  Tue Feb 22 Chinchero | Raqchi viewpoint | Living Museum of Yucay | Ollantaytambo
  Wed Feb 23 Sacred Valley – Machu Picchu
      Ollantaytambo train to Machu Picchu | Aguas Calientes |
  Thu Feb 24 Machu Picchu - Cusco
      Intipunku "Sun Gate" | Aguas Calientes train to Ollantaytambo |
  Fri Feb 25 Cusco
      Sacsayhuamán Fortress | Qenqo | Puka Pukara | Tambomachay | Coricancha Temple | Cusco Cathedral
  Sat Feb 26 Cusco - Lima
      Tipón | Pikillacta | Andahuaylillas | Cusco flight to Lima
      Lima flight home


Swissotel – Quito

M/V Coral I

Hotel Costa Del Sol Wyndham Lima Aeropuerto

Tambo Del Inka Luxury Collection

Inkaterra Machu Picchu

Palacio Del Inka, Luxury Collection


Day 1 – Sunday, February 13

Arrive in Quito, the capital city of Ecuador. You are welcomed at the airport and transferred to your hotel. The rest of the day is at leisure.

Swissotel – 3 Nights – Swiss Advantage Room

Day 2 – Monday, February 14

Quito (Breakfast & Lunch)
The day is at leisure. (CME All Day)

Day 3 – Tuesday, February 15

Quito - Colonial City Tour and Middle of the World (Breakfast, Lunch)

This morning's tour offers the best of Quito, with its rich cultural legacy, ornate façades and dazzling altars. Visit Independence Square, the Archbishop's Palace, the Metropolitan Cathedral as well as other sites of colonial art and architecture. This afternoon, visit the famous Equatorial Monument marked by geographers as latitude 000'00". You will have the opportunity to stand in two hemispheres at the same time.

Day 4 – Wednesday, February 16

Quito / Baltra - Galapagos Islands Cruise (Breakfast, Lunch, Dinner)

Depart Quito and board a plane for Baltra (2 ½-hour flight). Arriving in the Galapagos, passengers are welcomed at the airport by our naturalists and taken on a ten-minute bus drive to the pier to board the M/V Coral I. https://www.gogalapagos.com/coral-yachts/

Afternoon - Mosquera Islet Wet Landing - Mosquera Islet is located between North Seymour and Baltra Island. This flat sandy island has a large colony of sea lions. It is also an excellent site to observe shorebirds such as herons and lava gulls. There are no trails on the islet; visitors can enjoy the open area. Most of the islet is covered with sand and barren lava rock. Very few sesuviumportulacastrum plants grow on the sand.

Difficulty level: Easy
Type of terrain: Sandy
Duration: 1 ½-hour walk and snorkeling

Day 5 – Thursday, February 17

Galapagos Islands Cruise (Breakfast, Lunch, Dinner)
Morning – Egas Port (Santiago Island)

Wet landing

Egas Port is a black volcanic sand beach, visited by Darwin in 1835. The first section of the trail is formed of volcanic ash (eroded tuff) and the other half is an uneven terrain of volcanic basaltic rock. The unique, truly striking layered terrain of Santiago shore is home to a variety of animals including the bizarre yellow-crowned night heron and marine wildlife including lobster, starfish, and marine iguanas grazing on algae beds alongside Sally light-foot crabs. It is easy to see colonies of endemic fur seals swimming in cool water volcanic rock pools.

Difficulty level: Intermediate
Type of terrain: Flat/Semi-rocky
Duration: 1 ½-hour walk/ 1-hour snorkeling

Afternoon - Rabida Island
Wet landing

Dark-red sand covers the unique beaches of this island, home to sea lion colonies; Rabida is considered the epicenter of the Galapagos Islands due to the diversity of its volcanic geology. Nesting brown pelicans are found from July through September plus nine species of the famous Darwin's finches. Here you'll take a dinghy ride along marine cliffs to better observe nesting seabirds. You may also snorkel off the coast where marine life is particularly active.

Difficulty level: Easy
Type of terrain: Sandy
Duration: 1 ½-hour walk / 1-hour snorkeling / 1-hour dinghy ride

Day 6 – Friday, February 18

Galapagos Islands Cruise (Breakfast, Lunch, Dinner)
Morning - Urbina Bay (Isabela Island)
Wet landing (might be difficult due to the tide)

See a genuine volcanic black sand beach, and depending on the season, you may find giant tortoises, land iguanas, and the occasional flightless cormorant too. After a short walk inland, it's snorkeling time, a chance to swim with sea turtles, sea lions, and countless tropical fish. Urbina Bay features a wide variety of plants with a wide array of colors in flowers, attracting many different insect species, birds, and reptiles. One of the highlights of the island is the uplifted coral reef that resulted from the 1954 seismic activity; here the views of Alcedo Volcano are remarkable.

Difficulty level: Intermediate
Type of terrain: Flat/Rocky
Duration: 1 ½-hour walk / 1-hour snorkeling

Afternoon - Tagus Cove (Isabela Island)

Dry landing on Galapagos’ largest island where we will learn about the eruption of the five volcanoes that form it. The trail leads to Darwin’s salt-water crater lake and excellent views of lava fields and volcanic formations.

We will return by the same path for a dinghy ride along a shoreline full of marine wildlife, where we will admire a variety of seabirds, such as Blue-footed Booby, Brown Noddy, terns, Flightless Cormorant and depending on the season, a large number of Galapagos Penguins which are only 35 cm tall; the only penguin species in the world to live in the tropics.

The population of penguins on the islands is about 2,000 individuals, most of which live on this western portion of Isabela; others are scattered further south. We will have an opportunity to snorkel in deep water. Graffiti believed to have been left by 19th-century pirates is a curious reminder of an intriguing past.

Difficulty level: Intermediate/Difficult
Type of terrain: Steep/Steep
Duration: 2-hour walk / 40-minute dinghy ride / 1-hour deep water snorkeling

Day 7 – Saturday, February 19

Galapagos Islands Cruise (Breakfast, Lunch, Dinner)
Morning Espinosa Point (Fernandina Island)

Dry landing

From Espinosa Point, it is possible to admire a wide view of Isabela Island across the Bolivar Channel, an area that boasts some of the highest diversity of endemic sea fauna in the Galapagos. Here, the largest most primitive-looking marine iguanas are found mingling with sea lions and Sally Lightfoot crabs. Fernandina displays a wonderful opportunity to encounter flightless cormorants at their nesting sites, Galapagos penguins, and the “King” of predators on the islands, the Galapagos hawk. Pa'hoe'hoe and A'A lava formations cover the majority of Fernandina's terrain. Vegetation is scarce inland, with just a few brachycereus cacti and mangroves.

Difficulty level: Intermediate
Type of terrain: Flat/Semi-rocky
Duration: 1 ½-hour walk / 1-hour snorkeling

Afternoon - Vicente Roca Point (Isabela Island)

Enjoy excellent deep-water snorkeling at one of the richest marine havens on Earth, the Bolivar Channel. Accessible by water, you'll take a dinghy ride along the coast to observe a great diversity of sea and coastal birds including Nazca and blue-footed boobies, noddies, brown pelicans, penguins, and flightless cormorants. The upwelling of cold water currents in this part of the Galapagos gives rise to an abundance of marine life and a perfect place for deep snorkeling.

Difficulty Level: Moderate / High
Type of terrain: Water
Duration: 1-hour snorkeling / 1-hour dinghy ride

Day 8 – Sunday, February 20

Galapagos Island Cruise - Baltra – Guayaquil - Lima (Breakfast)
Morning Highlands Tortoise Reserve (Santa Cruz Island)

Dry landing

In the mountains of the Galapagos, admire different kinds of birds such as tree and ground finches, vermillion flycatchers, paint-billed crakes, yellow warblers, and cattle egrets (usually perched on a tortoise's shell). The journey to the reserve offers great opportunities to see the contrasts that the island offers in reference to the variety of ecosystems. The road travels from the coast through the agricultural zone and up into the dense humid forests. Often, Galapagos Giant Tortoises are also seen on the way, wandering through pastures in the paddocks. This spot is a birdwatcher's haven since almost every land bird present on the island lives or migrates here.

Difficulty level: Easy
Type of terrain: Flat/Muddy
Duration: 45-minute drive / 1 ½-hour walk

After the visit, passengers will be transferred to the airport for their onward flight to Lima via Guayaquil.

Welcome in Lima upon arrival and assistance to transfer to your hotel located just across from the airport.
Accommodation: Hotel Costa Del Sol Wyndham Lima Aeropuerto

Day 9 – Monday, February 21

Lima – Cusco - Sacred Valley (Breakfast, Lunch, Dinner)
Return to the Lima Airport this morning for your flight to Cusco.

You will be transferred from the airport to the Sacred Valley where you will visit Awanakancha ("The Fabric Palace"), a South American textile and exhibition center. It is considered a living museum where you can appreciate the Andean camelids, learn the techniques of wool-work, and acquire finely crafted and decorated garments. After this visit, you will continue to your hotel in Urubamba. Dinner at your hotel.

Accommodation: Tambo Del Inka Luxury Collection

Day 10 – Tuesday, February 22

Sacred Valley (Breakfast, Lunch, Dinner)

In the morning, you will be picked up from your hotel in Urubamba to visit the town of Chinchero, a traditional Cusco urban center located at an elevated point with a beautiful view of the valley. The inhabitants of this area preserve the artisan traditions and the inherited knowledge of the Incas and display them in their clothes and customs. In Chinchero there are also archaeological remains and a beautiful seventeenth-century church, one of the first Catholic buildings in Peru. Then, transfer to the Living Museum of Yucay, making a stop at the Raqchi viewpoint. The museum is a center for Andean tradition interpretations, where demonstrations of the making of textile work, adobe, pottery, and silverware are performed in the same way they were historically; it is a faithful recreation of Inca traditions.

Also, the permanent residents of the museum include llamas, sheep, and alpacas—and yes, you can even feed them! Next, transfer to Ollantaytambo where you have free time for lunch. After this, visit the town and local archaeological site, continuously inhabited since the reign of the Incas, and climb the iconic fortress built at the foot of a mountain. This activity will conclude the day as you are transferred back to your hotel. Lunch at Rancho Wayra. Dinner at your hotel.

Day 11 – Wednesday, February 23

Sacred Valley – Machu Picchu (Breakfast, Lunch, Dinner)

Transfer from your hotel in Urubamba to the Ollantaytambo train station. Your tour to Machu Picchu begins with an approximately two-hour train ride to Aguas Calientes. This town is also known as "Machu Picchu pueblo" and is the last stop before entering the remains of the most important archaeological site in Peru. Aguas Calientes has a train station, a craft market, restaurants and hotels of different categories for those who prefer to spend the night at the foot of the mountain and climb it early. Finally, after a short transfer by bus, you will reach Machu Picchu, a masterpiece of engineering and architecture that served as a sanctuary and retreat for the Inca Pachacutec. Machu Picchu, which means "Old Mountain", is considered a UNESCO World Heritage site and one of the new seven wonders of the world. Enjoy a delicious lunch at Belmond Sanctuary Lodge. Dinner at your hotel. Overnight in Aguas Calientes.

Accommodation: Inkaterra Machu Picchu

LUGGAGE NOTICE: Please pack an overnight bag for this journey. Due to luggage restrictions aboard the trains to/from Machu Picchu, passengers may only take one (1) small handbag weighing no more than 5 kg (11 lbs). Your luggage will be transferred to Cusco separately.

Day 12 – Thursday, February 24

Machu Picchu - Cusco (Breakfast, Lunch, Dinner)

Today we return to Machu Picchu and visit more of the attractions of the citadel. Visit the Intipunku, which in Castillian means "Sun Gate" and is the last stop before entering Machu Picchu if you follow the Inca trail from Ollantaytambo. This place served as something of a travel checkpoint, and as its name implies, the sun rises every day through this door if viewed from the most important buildings of the citadel. Finally you will be able to see the Inca Bridge, an incredible stone building that served as entrance and exit of the citadel and halfway has a gap of several meters above which where two large wooden tables. Thus the Incas could isolate the city by simply withdrawing them and thus remain protected.

In the afternoon head to the train station of Aguas Calientes and from there take the train back to Ollantaytambo train station. Transport will be arranged for tansfer to Cusco. Dinner at a local restaurant. Overnight at the hotel in Cusco.

Accommodation: Palacio Del Inka, Luxury Collection

Day 13 – Friday, February 25

Cusco (Breakfast, Lunch)

You will start the day touring the Sacsayhuamán fortress, one of the emblematic Inca constructions (located a few minutes away from the built-up area), built by Inca Pachacútec in the 15th century. It is a huge fortress made of very large stones, and the manner in which they were transported and cut is still a mystery. The IntiRaymi Festival, which worships the Sun, is reenacted on June 24 of each year, during the winter solstice. You will then go to Qenqo, located four kilometers away from Cusco city, which is a mainly religious archaeological complex where it is believed that propitiatory agricultural rituals were carried out.

Continue to Puka Pukara, located seven kilometers away from Cusco. Puka Pukara, which means "red fortress", was an architectural complex presumably used for military purposes; it has many rooms, squares, aqueducts, walls, and towers, and it is believed that the Inca's entourage used it while resting at Tambomachay. Next, explore the fountains of Tambomachay, a construction that has fine stone finishings and a fine command of hydraulic engineering with aqueducts that supply clear water. This archaeological complex is located eight kilometers away from Cusco City. Also known as the "Inca Bath", Tambomachay was probably a place of leisure. The construction seems to have a special interest in water, which was worshipped, and aqueducts fed by groundwater aquifers and neighboring hot springs. Lunch at local restaurant.

In the afternoon, participate on a walking tour starting at the Coricancha Temple, one of the most important buildings in the city. It was one of the most important centers of worship to the Incan Sun God that was converted into a convent after the arrival of the Spanish. Next visit the wonderful Cusco Cathedral, built between 1560 and 1664, and end the tour visiting the San Pedro market, a pantry of thousands of products from different areas of the region. Finally, return to the hotel.

NOTE: The visit to San Pedro market can be replaced by a visit to Casa Concha, an old colonial mansion that houses an impressive collection of Incan pieces from Machu Picchu.

Day 14 – Saturday February 26

Cusco - Lima (Breakfast, Lunch)

This morning visit Tipón, a perfectly preserved archaeological site, located 27 kilometers from the city of Cusco. Near the village of the same name, where an impressive rural colony mansion stands (1650), there are 12 terraces still cultivated, some enclosures, and an irrigation system considered a masterpiece of hydraulic engineering, still used by the surrounding population. Then continue to Pikillacta, corresponding to the Wari culture, and considered one of the best preserved pre-Inca cities of Peru. Among its 700 structures, covering more than 3,000 hectares, there are stone and mud buildings of two and three floors, distinct terrace work, and the head of a condor carved in a rock. It is estimated that 10,000 people lived in this city, whose streets can still be transited.

Finally, visit Andahuaylillas, a town located 40 kilometers from Cusco that has the Church of Andahuaylillas as its main attraction. Also called "The Sistine Chapel of America", due to the impressive quality of the art pieces found in it. The structure was built in the sixteenth century on sites of possibly Wari territory. Today it has an original pipe organ recently restored. From here start your return to Cusco. Lunch at local restaurant.

Transfer this afternoon to the Cusco Airport for the flight to Lima.

Arrive in Lima and connect with your flight home. Flights from Lima to home city must depart after 7:30PM

Email us at info@nwas.com or call us (800) 222-6927 • (509) 547-7065


This course is designed for physicians, certified registered nurse anesthetists, physician assistants, nurse practitioners, registered nurses and other medical care providers who must maintain state-of-the-art knowledge of the anesthesia specialty or are impacted by it.


The practitioner of anesthesiology must possess the scientific background for clinical practice; maintain state-of-the-art knowledge of not only the specialty, but also of all additional related disciplines which may impact it; maintain an up-to-the-minute armamentarium of knowledge and skills for the selection and use of complex equipment, pharmacological agents, and procedures necessary for the provision of quality patient care; manage self and colleagues to function toward common goals in the clinical setting, the clinical and educational institutions, and the community in which the practice resides; serve as an expert in matters involving health care delivery; serve as an informed manager of clinical and educational services provided, including the acquisition and distribution of resources necessary in meeting professional goals; and provide assistance with and support of other service providers, departments, institutions, and organizations dependent upon the professional expertise of the practitioner. Presentations are designed to facilitate the healthcare provider in reviewing, updating, and/or expanding knowledge and abilities in one or more of these areas vital to the practicing professional.


At the conclusion of this activity, the participant will be able to:

Apply the pertinent physical and behavioral sciences - to include but not be limited to advanced anatomy and physiology, pathophysiology, chemistry, physics, psychology, and social sciences - as they impact and are affected by the planning, delivery, and monitoring of anesthesia and related services inherent in the anesthesia professions.

Explain the selection, dosing considerations with methods of administration, safe use, and contraindications and precautions of presented pharmacological agents through the understanding of their physico-chemical properties, pharmacokinetics and pharmacodynamics, updated uses, and more recently developed additional, related, and similar drugs.

Outline comprehensive management plans for the group of patients discussed, whether related in age, physical status, cultural background, invasive procedure, anesthetic or analgesic requirements, clinical setting, adverse reactions, and/or goals of care.

Apply the principles of safety and asepsis in the performance of anesthetic procedures and administrations, equipment use, and other applications encountered during the provision of anesthesia and analgesia whether in the surgical unit, the labor and delivery suite, the pain management clinic, or other more remote location of anesthetizing services.

Incorporate the appropriate recommendations and/or requirements of pertinent external organizations, institutions, and professional groups - recognized as serving as the authority for and/or holding the responsibility to compile and approve such tenets - in the provision of anesthesia and related services, whether medical, legal, philosophical, ethical, or health care management standards.

Apply the new techniques in the clinical setting of the participant.

Clinical Concerns in Anesthesia
Galápagos and Machu Picchu Tour
February 13-26, 2022

Sunday, February 13 - Arrive in Quito, Ecuador

To Be Announced

20 CME

20 CEC

Pharmacology Hours†



To Be Announced


This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health and Northwest Anesthesia Seminars. The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the ACCME to provide continuing medical education for physicians.

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this live activity for a maximum of 20 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Board of Anesthesiology: CME credit will be sent directly to The American Board of Anesthesiology to fulfill the Part 2 requirement for the Maintenance of Certification in Anesthesiology Program (MOCA®).

Canadian Physicians: This activity is eligible for Section 1 credits in the Royal College’s Maintenance of Certification (MOC) Program. Participants must log into MAINPORT to claim this activity.

Certified Registered Nurse Anesthetists: This program is designed to meet requirements for Class A CE credit. Once approved by AANA, this will be indicated.

Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) and the American Nurses Credentialing Center (ANCC) accept CME from organizations accredited by the ACCME.

Osteopathic Physicians: This program is eligible for Category 2 credit with the American Osteopathic Association (AOA).

Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 20 hours of Category I credit for completing this program.

Registered Nurses: NWAS is an approved provider for the following state nursing boards: Arkansas State Board of Nursing (Provider Number 50-7480), California Board of Registered Nursing (Provider Number 4833), District of Columbia Board of Nursing (Provider Number 50-7480), Florida Board of Nursing (Provider Number 50-7480), Georgia Board of Nursing (Provider Number 50-7480), and the South Carolina Board of Nursing (Provider Number 50-7480). This program offers 20 contact hours.

†Pharmacology hours subject to change.


Mark T. Murphy, MD, MSN Education, LLC, Treasure Island, Florida, Medical Director, Northwest Anesthesia Seminars, Pasco, Washington


Factors beyond our control sometimes necessitate changes in the schedule and faculty. If time permits, we will inform all registrants of any changes prior to the program. Changes on site due to local conditions will be announced in class.


We reserve the right to cancel a course for any reason. In such case, a minimum of 30 days notice will be given to those registered and 100% of tuition paid will be refunded. NWAS and NWWT will not be responsible for any non-refundable airfare, hotel, or other liabilities you may incur. We highly recommend purchase of travel insurance. Travel at your own risk.


$100 December 15, 2021 to January 14, 2022. No refund after January 14, 2022; however, 50% of tuition paid may be applied toward tuition for another NWAS program within the next 12 months. Cancellation must be made in writing.


No penalty prior to October 10, 2020. 100% non-refundable after October 10, 2021.

FAP (Frequent Attendee Points)

FAP lets you accumulate points based on dollars spent with NWAS including net hotel and tuition booked through NWAS (but not air). Once you have enough points to cover a full tuition they can be redeemed for tuition (no cash value). A great program to reward you for supporting NWAS! Click here for more information.

Lecture notes will be provided via download in PDF format.

You must sign-in every day you attend to receive credit.

While we strive for accuracy at all times with our published information, we cannot be responsible for typographical and other errors.

Please note that children and non-registered guests are not allowed to attend the lectures. The concierge can provide you with childcare information.

Travel at your own risk.

Airfare available through Universal Travel. Be sure to mention Northwest Anesthesia Seminars when booking (booking fees may apply.) Contact Kellee Gray: Phone number: (858) 456-7962 - Email: kellee@universaltravel1.com


We recommend that you register early to assure your spot. We reserve the right to close registrations to a course at any time without notice. We may not be able to accommodate onsite registrations.

Click here for course and hotel registration (COMING SOON)