SEMINAR
ON PG TRAINING SURGERY
-Dr.K.
Laksman
Introduction
: The Association of Surgeons of India (ASI) and the Rajiv
Gandhi University of Health Sciences (RGHU) jointly took the
initiative to organize a seminar on Post graduate Training
in Surgery. The need for drawing up on comprehensive curriculum
for the MS Degree Course in Surgery was organized some time
ago. The Medical Council of India had sent out a circular
in November 1998, urging the Universities to draw up a detailed
Curriculum. It was decided that a national level seminar be
held for this purpose. The seminar took place on 14th and
15th April 2000 at Bangalore. Wide participation of Professors,
teachers from universities and the army, educationists, administrators
and practicing surgeons was ensured. Around 80 delegates including
two Vice Chancellors, Director of AIIMS, Delhi and Director
of Health Services (Defense) took part in the deliberations.
The Executive Committee of the ASI took an active part.
Preparation
of Background Paper : A background paper was prepared
with due care and distributed to the delegates for their perusal
and opinion. The draft proposal for the curriculum was prepared
and included in the Background Paper. This proposal was made
on the basis of a situation analysis carried out by surveys
done among students, teachers and practicing surgeons. The
surveys included postal questionnaires, informal and formal
group discussions. Each of these groups were asked about the
deficiencies (if any) of the present system and possible remedies
that they would suggest to correct these deficiencies.
There
was unanimity among all groups about certain deficiencies
in the present system. A wide range of suggestions for improvement
were offered by various groups. Issues and suggestions that
had some consensus among the groups, were included in the
background paper. Another important input in drawing up the
proposals was a study of the current patterns of training
in UK,USA and Canada.
Contents
of Background Paper : The background paper had proposals
drawn up in a structured manner. The goals and objectives
of the MS course were defined. The topics to be discussed
were considered under the following headings :
- Essential
Knowledge - the theory topics that the student must know.
- Essential
Skills - The procedures that the student should be able
to do at the end of the course; the procedures he should
be familiar with in the form of assisting or watching.
- Teaching
and Learning activities -The process by which the essential
knowledge and skills are acquired.
- Year
wise schedule - the distribution of the various aspects
of learning in the three years of training; the concept
of graded responsibility.
- Training
in Basic and allied specialties - the amount of applied
aspects of basic science knowledge to be acquired and the
training in allied specialties like anaesthesia, orthopaedics
and Obstetrics and Gynaecology to be acquired.
- Training
in other (Super Specialties) - the type of training in other
branches of surgery that a general surgeon should be familiar
with.
- Internal
Assessment - Continuing internal evaluation of the student's
progress.
- University
Examination - the final MS examination.
- Post
MS training - the need for (if any) further training after
completion of MS and the kind of and mechanisms of such
training.
In
addition to these core proposals, the background paper contained
the MCI circular, MCI recommendation, Student and teacher perception,
PG subcommittee report, Patterns in USA summary of patterns
in the west and the perception of a rural surgeon. General topics
on the design of a curriculum and papers by selected specialists
in the allied and super specialties were included.
The
Seminar : The morning session on Day 1 of the seminar included
the inauguration and short talks. The seminar was inaugurated
by Dr. S. Chandrashekar Shetty, Vice Chancellor of Rajiv Gandhi
University of Health Sciences (RHUHS), Karnataka, Bangalore
and the President of Association of Surgeons of India, Dr. K.S.
Shekar presided.
The
Seminar - Group Discussions : The afternoon of Day 1 was spent
in group discussions. Nine groups were formed to discuss each
of the nine topics outlined above.
Each
group met under the Chairmanship of a senior surgeon. Members
were selected with de attention to the topic assigned to the
group. Two rapporteurs in each group took detailed notes of
the proceedings and prepared a summary. This summary was presented
the next day for discussion by the participants of the Seminar.
The
Seminar - Consensus : Detailed and lively discussions took place
and a consensus arrived at, on the morning of Day 2 of the Seminar.
Each group presented a summary of the proposals pertaining to
the topic assigned to the group. Modifications were suggested
for a the proposals given in the background paper. The proposals
were discussed by the whole house and a consensus was arrived
at. The major issues arrived at, are incorporated in the "Recommendations".
These
recommendation are being put up to the various universities
and the MCI. It is hoped that these recommendations will be
actively implemented and followed by all the postgraduate institutions
in the country. Only then can we hope to have uniformly good
training programmes in the country.
