Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.
A survey of the current status of surgical training in Hong Kong, Malaysia, Singapore, Philippines and Thailand, in comparison with the UK and Australia, was done to explore the possibility of cross border training in South East Asia (SEA).
The existing clinical teaching in small group sessions is focused on the patient's disease. The main dual limitation is that not only does the clinical skill testing become secondary but there is also a slackening of student involvement as only 1 student is evaluated during the entire session. A new methodology of small group teaching being experimented shifted the focus to testing students' clinical skills with emphasise on team participation by daily evaluation of the entire team. The procedure involved was that the group underwent training sessions where the clinical skills were taught demonstrated and practiced on simulated patients (hear-see-do module). Later the entire small group, as a team, examined the patient and each student was evaluated for 1 of 5 specific tasks--history taking, general examination, systemic examination, discussion and case write-up. Out of 170 students, 69 students (study) and 101 students (control) were randomly chosen and trained according to the new and existing methods respectively. Senior faculty (who were blinded as to which method of teaching the student underwent) evaluated all the students. The marks obtained at 2 examinations were tabulated and compared for tests of significance using t-test. The difference in the marks obtained showed a statistically significant improvement in the study group indicating that the new module was an effective methodology of teaching. The teaching effectiveness was evaluated by student feedback regarding improvement in knowledge, clinical and communication skills and positive attitudes on a 5-point Likert scale. Psychometric analysis was very positively indicative of the success of the module.
The life of Lord Moynihan is briefly reviewed. Incidence of stones in Peninsular Malaysia appears to show the same trend as in other industrialised countries. Management of urinary calculi both prior to and after the introduction of ESWL in a personal series is discussed. More than 90% of urinary stones are now treated by ESWL threatening the place of surgery in Urology. The pattern of incorporating renal transplantation into the urological training programme as practised in the Institute of Urology and Nephrology in Malaysia is suggested as a way to assure a place for surgery in Urology.
PIP:
A total of 552 women in 1983 have undergone laparoscopic sterilization under local anesthesia with sedation in the family planning clinic at Maternity Hospital and the Specialist Center at Batu Complex. A review was made to evaluate the risks, benefits, and safety of outpatient surgery in view of the shortage of anesthetic personnel, operating theaters and costs to patients if general anesthesia were to be used instead. Anesthetic complications (0.9%) were found to be of a very minor nature, not requiring hospitalization. Surgical complication was higher at 3.8%. There was a high rate (21%) of difficulties encountered at operation, 15% for medical officers and trainees but only 6% for specialists. In summary, a very low complication rate was encountered with local anesthetics. The use of local anesthesia with sedation is advocated. This cuts down on costs, hospitalization and recovey time and overcomes the perennial problem of shortage of anesthetic staff and operating theaters. The rate of the surgical complications was related to the surgeon's experience.
Study site: family planning clinic at Maternity Hospital and the Specialist Center at Batu Comple
This study assessed the results of robotic thyroidectomy by fellowship-trained surgeons in their initial independent practice, and whether standard fellowship training for robotic surgery shortens the learning curve.
This preliminary report details our experience and also serves to evaluate the risk benefits of office laparoscopy for female fertility assessment in 183 subjects. The patients were admitted at about 8.00 in the morning and discharged at 3.00 to 4.00 in the afternoon after laparoscopy has been performed. Only 7. 7 percent of the subjects required inhalational anesthetic gases along with a combination of intravenous sedation and local anesthetic infiltration. The pick-up rate for pelvic abnormality is fairly high, approximately 22.4 percent. Difficulties and complications encountered during laparoscopy were minimal and easily overcome. The benefits of laparoscopy overrules the risk of complications. It is suggested that all family planning clinics involved in fertility assessment and sterilization feature laparoscopy on an but patient basis as one of its main activities.