Globalization of Orthopaedic Globalization of Orthopaedic training: Exchange programme for training of postgraduates in Asia Pacific Region postgraduates in Asia Pacific Region Prof. H.K.T. Raza f 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 Qualifications required to join a 1. basic training/certification course for Orthopaedic Surgery for Orthopaedic Surgery. 2 2. Mechanism of selection of Mechanism of selection of candidates. 3. Duration of the course.
QUESTIONS INCLUDED QUESTIONS INCLUDED 4. Whether there is any rotation of the h h h i i f h 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 Medical school (graduation) l h l ( d ti ) ‐ 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 of medicine ) • 4 year internship in university 4 i t hi i i it hospital rotating through p g g medical,surgical and emergency department department • specialty areas.
C AUSTRALIA & NEW ZEALAND(contd) C. AUSTRALIA & NEW ZEALAND(contd) • Orthopaedic registrar of AOA training O th di i t f AOA t i i 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 Qualification: lifi ti (a) Registration with medical council of 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 Musculoskeletal rehab – 3 mos 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 Wide disparity in the region : it i th i 1 1. qualifications required ‐ to enter medical school. lifi ti i d t t di l h l 2. duration of the subsequent internship 3. qualification required for fellowship 3 lifi ti i d f f ll hi /masters degree course in Orthopaedics ‐ sub ‐ speciality training also has a different starting b i lit t i i l h diff t t ti point.
GLOBAL NEED FOR EXCHANGE PROGRAMMES: Th The exchange of orthopaedic trainees and young (and h f h di i d ( d 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 of programmes.
Strategy for starting and implementing an exchange programme Id Identification of beneficiaries. ifi i f b fi i i (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 further exposure in specific sub speciality h i ifi b i li 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 updated in the participating institutions. d d i h i i i i i i
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 selected centres of excellence in l t d t f ll i 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 generated. t d
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 to work as an ongoing project. k
(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 Core committee can be nominated to itt b i t d t 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) (c) Identify and correspond with interested National 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 Association regarding orthopaedic research i i di h di h in their countries
QUESTIONS INCLUDED: QUESTIONS INCLUDED: 1. What is the type of Orthopaedic research in h i h f h di h i 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 theses/dissertations get published in indexed /di t ti t bli h d i i d d 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 ongoing 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 funding for ongoing research activities. f h
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