Globalization of Orthopaedic Globalization of Orthopaedic training: - - PowerPoint PPT Presentation

Globalization of Orthopaedic Globalization of Orthopaedic training: Exchange programme for training of postgraduates in Asia Pacific Region postgraduates in Asia Pacific Region

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• Prof. H.K.T. Raza

President, Asia Pacific Orthopaedic Association Association Past President, Indian Orthopaedic Association

INTRODUCTION

Current status of Undergraduate training

• (a) i. Qualification required for

‐ entry into medical school ‐ entry into medical school.

• ii. Duration of basic medical course

(graduate level) (graduate level).

• (b) Duration of internship

Current status of post‐graduate training in asia pacific region

Questionnaire sent to National delegates of member countries of countries of

• Asia Pacific Orthopaedic Association

QUESTIONS INCLUDED

Q alifications req ired to join a

1.

Qualifications required to join a basic training/certification course for Orthopaedic Surgery for Orthopaedic Surgery. 2 Mechanism of selection of 2. Mechanism of selection of candidates. 3. Duration of the course.

QUESTIONS INCLUDED QUESTIONS INCLUDED

h h h i i f h

• 4. Whether there is any rotation of the

candidates in different institutions.

• 5. Rotation in sub‐speciality units.
• 6. Methodology of evaluation –

formative and summative.

Outcome of information Outcome of information

• wide disparity of qualification required for

basic certification course in orthopaedics. p ‐ The course format is also variable The course format is also variable.

• A. KOREA ‐QUALIFICATION

REQUIRED: REQUIRED:

M di l h l ( d ti ) Medical school (graduation) ‐ 4 year College + 4 year College 4 year Medical – new system. National licensure exam (medical license) compulsory.

• CLINICAL TRAINING

1 year Internship. 4 year: Speciality training. 4 year: Speciality training. Speciality board exam(national exam) Fellowships : 1‐2 years

B INDIA

• B. INDIA

GRADUATION GRADUATION

‐entry :12 standard of school. no further pre‐medical school no further pre‐medical school ‐Medical school: course duration 4‐1/2 years ‐ Internship one year p y ‐Post graduation in orthopaedics ‐3year course. ‐ PG’s rotated in different units in the same department department.

Evaluation

at end of three years

‐at end of three years

‐at single institution or of 3‐5 institutions affiliated to common university. affiliated to common university.

C AUSTRALIA & NEW ZEALAND

• C. AUSTRALIA & NEW ZEALAND
• 4 year of Medical

school (university course of faculty school (university course of faculty

• f medicine )

4 i t hi i i it

• 4 year internship in university

hospital rotating through p g g medical,surgical and emergency department department

• specialty areas.

C AUSTRALIA & NEW ZEALAND(contd)

• C. AUSTRALIA & NEW ZEALAND(contd)

O th di i t f AOA t i i

• Orthopaedic registrar of AOA training

programme:

• duration of courses: four years

(for award of FRACS (Orthopaedics)

• rotations ‐6 months
• in different hospital and different orthopaedic

department at an accredited university training hospital.

D HONG KONG:

• D. HONG KONG:

Q lifi ti Qualification: (a) Registration with medical council

• f hong kong

(b) completion of an accredited basic surgical training programme of the hong kong inter collegiate board of surgical colleges (HKICBSC) (c) holding a recognised intermediate qualification. qua cat o .

COURSE: (fellowship examination of hong kong

college of orthopaedic surgeons(HKCOS) college of orthopaedic surgeons(HKCOS). Duration: 48 months. Duration: 48 months. (a) 39 months ( ) Trauma – 18 mos, General Orthopaedics ‐12 mos Hand surgery ‐3 mos Paediatric Orthopaedics – 3 mos Musculoskeletal rehab 3 mos Musculoskeletal rehab – 3 mos (b) 9 months rotation in subspeciality of (b) 9 months rotation in subspeciality of candidates choice (one or more)

Conclusions Conclusions

Wid di it i th i Wide disparity in the region :

1 lifi ti i d t t di l h l

• 1. qualifications required ‐ to enter medical school.
• 2. duration of the subsequent internship

3 lifi ti i d f f ll hi

• 3. qualification required for fellowship

/masters degree course in Orthopaedics b i lit t i i l h diff t t ti ‐ sub‐speciality training also has a different starting point.

GLOBAL NEED FOR EXCHANGE PROGRAMMES:

Th h f h di i d ( d The exchange of orthopaedic trainees and young (and not so young) Orthopaedic surgeons will help in the following ways. following ways. (a) exchange of experiences. ( ) g p (b) identification of changing trends and changing requirements due to advances in the medical field. (c) curriculum planning and revision based on (a) & (b). (d) global co‐operation and co‐ordination. (e) developing strategies for implementation

• f programmes.

Strategy for starting and implementing an exchange programme

Id ifi i f b fi i i Identification of beneficiaries.

(a) Post graduate trainees. (b) Freshly qualified orthopaedic surgeons (b) Freshly qualified orthopaedic surgeons. (c) Orthopaedic surgeons below 45 years desiring training in orthopaedics desiring training in orthopaedics. (d) Senior Orthopaedic surgeons desiring f h i ifi b i li further exposure in specific sub speciality in centres of excellence.

WHY POST GRADUATES? WHY POST GRADUATES?

• 1. post graduates are most motivated for their

learning learning.

• 2. They are very impressionable and open to ideas.

3 They are also quick to be friend with their

• 3. They are also quick to be friend with their

counterparts in the host institutions and “exchange notes” on the type of training being imparted. This exchange and feedback helps to keep curricula d d i h i i i i i i updated in the participating institutions.

Post Graduate rotations: Post Graduate rotations:

selected post graduates can be se ected post g aduates ca be sent for 4‐6 weeks training in l t d t f ll i selected centres of excellence in Asia Pacific region which run government accredited post graduate courses graduate courses.

The programme can have post graduates going to ‐‐‐‐‐‐ going to

• one institution only
• or rotating to several institutions in the city/

country

• depending upon the host, and funds

t d generated.

IDENTIFICATION OF RESOURCES: IDENTIFICATION OF RESOURCES:

• (a) FUNDS:
• Main tumbling block.

Best working principle—

• to request the candidate to pay for the air travel

q p y

• Accommodation/meals/training ‐ provided by the

local host institution. National Orthopaedic Association ‐‐‐may provide for the air travel plus y p p ‐‐‐a token pocket money for sundry expenses.

(b) HOST COUNTRY/ASSOCIATION /INSTITUTIONS:

• APOA can advertise for national

associations/institutions to volunteer for this / training programme.

• a simple memorandum of understanding
• a simple memorandum of understanding

may be signed for the exchange programme k to work as an ongoing project.

(c) CO ORDINATING BODY: (c) CO‐ORDINATING BODY:

• A committee nominated by APOA
• can co‐ordinate the exchange programme

can co ordinate the exchange programme amongst nations/institutions.

HOW TO MAKE A BEGINNING: HOW TO MAKE A BEGINNING:

C itt b i t d t Core committee can be nominated to work on the project to:

(a) Determine whether APOA would want to be the leader for this activity leader for this activity. (b) Determine feasibility of the project. (c) Identify and correspond with interested National (c) Identify and correspond with interested National Orthopaedic Association and centres of excellence. (d) Prepare a short report for the APOA executive ( ) p p to decide further line of action.

• exchange fellowships for postgraduate

and young Orthopaedic surgeons can also y g p g include exposure to research methodologies to the institutions offering the fellowships to the institutions offering the fellowships

Orthopaedics research Orthopaedics research

• A QUESTIONNAIRE WAS SENT TO:
• Councillors of Asia Pacific Orthopaedic

A i i di h di h Association regarding orthopaedic research in their countries

QUESTIONS INCLUDED: QUESTIONS INCLUDED:

h i h f h di h i

• 1. What is the type of Orthopaedic research in

your country.

• 2. Which are the premier institutions involved

in Orthopaedic research. p

• 3. What is the quantum of Government

funding for such research funding for such research.

• 4. What percentage of post graduate

th /di t ti t bli h d i i d d theses/dissertations get published in indexed journals

• Only one councillor from malaysia has replied

Only one councillor from malaysia has replied to my queries. This could be due to:

• 1. Inadequate information regarding research

activities in various parts of the country. (there is no centralized agency to provide such information in most countries).

• 2. Lack of inclination to share information of
• ngoing research activities for fear of the idea

and information being transferred to other and information being transferred to other countries/institutions.

• 3.There is no organizational governance of

post graduate theses, or direction in which p g such research should be channelized.

• 4 Premier institutions may not be in a
• 4. Premier institutions may not be in a

position to disclose the source or quantum of f f h funding for ongoing research activities.

ROLE OF THE APOA ROLE OF THE APOA

‐ APOA can be a facilitator for exchange programmes which are directly run through it or can also help in which are directly run through it or can also help in developing of exchange fellowships amongst National Orthopaedic Associations and institutions. ‐ Dissemination of information of the exchange fellowships can also be undertaken through the APOA and National Orthopaedic Association newsletters Association newsletters.

• To address all these issues a forum needs to

be established and the “ASIA PACIFIC ORTHOPAEDIC

RESEARCH NETWORK” RESEARCH NETWORK” can be one such

agency g y

CONCLUSION: CONCLUSION:

h hi ll i l ill h l i i ll I hope this small article will help sensitize all like minded colleagues from across the world to join hands and offer better training

• pportunities to our youngsters than what

we have had. The exchange programmes are sure to bring g p g g about a better quality and uniformity of Orthopaedic training as it would be an eye Orthopaedic training as it would be an eye

• pener for those lagging behind.