general hand surgery talk2
DESCRIPTION
a general talk on the scope of hand surgery its training and educationsTRANSCRIPT
The Birmingham Hand Centre
Hand Surgery for the
uninterested
Recent advances, practice, training and
accreditation
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Mr Vaikunthan Rajaratnam
MBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),
MBA(USA),Dip Hand Surgery(Eur),
PG CertMedEd(Dundee),FHEA(UK)
Consultant Hand Surgeon Birmingham Hand Centre
University Hospital Birmingham NHS Foundation Trust
Royal Orthopaedic Hospital United Kingdom
www.handsurgerymanual.com
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Birmingham Hand Centre
•UHB NHS FT
•QEHB
•ROH NHS FT
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Bones joints distal to radius
•Soft tissues
•Nerves & brachial plexus
•Vessel distal to the wrist
Defining Hand Surgery
Berretini anastomosis
Neuroanatomy [2009] 8: 15–19
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Sub speciality of orthopaedic and plastic
• Independent speciality – Norway, Sweden
and Singapore
•Orthopaedic, plastic surgery, vascular surgery
and microsurgery
Speciality
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Fellowship 1 year
Core Specialty 6 years
CT 2 years
FY 2 years
Medical School 5 years
Training Ladder
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Hand Sub Speciality 2 years
Hand Surgery 4 years
CT 2 years
FY 2 years
Medical School 5 years
Proposed UK Training Ladder
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Hand Sub Speciality Fellowship 1 year
Hand Surgery R3 - 6
Core Residency R1 & 2
Pre Reg HO (Intern)
Medical School 5 years
Future Training Ladder
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Musculoskeletal disorders most common work
related ailment in Great Britain
•30% of WRMSD is Upper Limb
•4.7 million working days were lost in 2003/04
•estimated 18.3 days off in 1 year
• 2005/06 - 374 000 people in Great Britain
suffered from an WRMSULD
The Need
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
• Trauma
•Fractures
•Finger tips
•Burns
•Tendon/nerve/skin loss
•Elective
•Compressive Neuropathy
•Tumours
•Arthritis
•Deformities
•Congenital
Current Practice
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Moving from trauma to more elective
•Nerve entrapments
•WRMSD rather than industrial accidents
•Sports injuries
• Infections
•Assault/self inflicted
•DIY
Hand Surgery Practice
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Congenital
•Brachial Plexus and Peripheral Nerve
•Wrist
•Spastic Hand
•Microsurgical reconstruction
Sub Speciality
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•Patience
•Fine motor coordination
• Inquiring mind
• Innovative
•Community orientated
•Self critical
•Strive for mastery
Qualities
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Some examples
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Hand Fractures
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
28 , Male, R Hand dominant
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Stake Holders
•Regulators
•Educators – University,
Professional bodies
•Patients/Community
•Funders of health
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Needs analysis
•Challenges of
developing and rural
community
•Fit for purpose
•Delivering the service
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Training vs Education
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Political
•Regulation
•University vs
Professional bodies
•Credentialing
•Accreditation
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Economy
•Time
•Service Commitments
•Teacher supply
•Funding
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Social
•Adult learning styles
• Self paced
• On demand
• Experiential
• Work based
•Teaching styles
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Technology
•Curriculum 2.0
•On line resources
•On line skill acquisition
•On line assessment
•Digital Video
•Tele medicine
•On line mentoring
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Opportunity in developing community
•Patients
•Training Time
•Teachers
•Technology
•University backed
•Green field
•Demand for education
• Infrastructure
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
The Ideal Surgeon
•Wide Knowledge Based
•Holistic & Ethical
•Right Thinking
•Highly Skilled
• Innovative
•Surgical wisdom
•Teacher
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
What to teach?
•Surgical thinking
•Curriculum
•Surgical practice
• Integrating and applying
propositional knowledge
•Careful perception
•Opportunistic LEARNING
•DISCIPLINE
•Assessments –
summative and formative
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
Accreditation
•Quality
•Patient Safety
•Education
•Advancement
•Research
•Orthopaedics
•Plastics
•A&E
•General Surgeons
• Inclusive not exclusive
The Birmingham Hand Centre
University Hospitals Birmingham NHS Foundation Trust
•www.handsurgerymanual.com
•http://handsurgery.moodlehub.com/
•http://www.bssh.ac.uk/
•http://www.sshs.org.sg
•http://www.fessh.com/
•http://www.ifssh.info/
Thank you