General surgery is a term for the management of patients presenting with elective or emergency abdominal disease. It includes surgery of the gastro-intestinal tract (oesophagus, stomach, small and large bowel) and the repair of hernias. General surgery also encompasses liver, biliary tree and pancreas, breast, transplant procedures such as for the liver, pancreas and kidney, and endocrine glands, which will be covered in a separate report next year. Emergency general surgery concerns the treatment of patients presenting with acute abdominal pain, infections, bleeding and trauma.
The training program will provide a broad educational experience in recognition and treatment of surgical disorders. Upon completion of training, the candidate is expected to be a competent specialist in General Surgery capable of independent practice. During training, the resident will have acquired a thorough knowledge of the theoretical basis of General Surgery, including its foundations in the basic medical sciences and be exposed to research activities. The candidate will be able to access, apply relevant knowledge and skills to clinical practice, and provide effective consultation services with respect to patient care, education and medico-legal issues.
The resident in General Surgery must acquire: –
• Knowledge and expertise in clinical and operative management of diseases of the alimentary tract, breast and endocrine systems, trauma and critical care, general surgical oncology and ambulatory patient care for general surgical disorders
• Mastery of surgical skills of open cavity surgery, endoscopy, minimal access surgery, endocrine surgery, breast surgery, trauma surgery & soft tissue surgery including abdominal wall surgery; a basic training in orthopedic surgery
• Skills in effective clinical judgment and decision making in dealing with general surgical problems based on sound surgical principles.
• The knowledge, skills and attitudes relating to gender, culture and ethnicity pertinent to General Surgery and incorporate these in research activities.
• The resident in General Surgery is required to attain sufficient training and knowledge of: – Basic science related to General Surgery including relevant clinical applied anatomy.
• The pathophysiology, differential diagnoses and management of surgical disease Appropriate skills in instrumental diagnostic procedures (endoscopy of alimentary tract, ultrasound of thorax, abdomen and laparoscopy)
• Indications for either surgical or conservative treatment
• Laboratory investigation for surgical disorders
• Pharmacological agents and contrast medium used in surgical practice
• Clinical and operative competence in both emergency and elective settings
• Intensive care, management of shock and resuscitation
• Local and regional anesthesia
• Enteral and parenteral nutrition
• Particular requirements of day case surgery
• Quality control of surgical procedures
• Palliative care and quality of life issues
• Clinical audit – Medical ethics, health economics, medico-legal matters, risk management, medical statistics, information technology and health service management
• Research methods
• Teaching and training others in general surgery
• Making oral presentations at professional meetings effectively.
– Surgical therapy and hormone therapy for benign and malignant breast disease
– Parathyroid surgery/conservative therapy
– Upper GI surgery; closure of perforated ulcer
– Control of upper GI bleeding – Stomach resection
– Bile duct and gall bladder surgery
– Operative cholangiography/endoscopy
– Small bowel surgery
– Principles of liver and pancreatic surgery
– Colon resection
– Hartmann’s procedure
– Hernia Surgery
– Soft tissue surgery
– Surgical therapy of anal disorders (sepsis, hemorrhoids, fissure)
– Circumcision/ Reduction of paraphimosis
– Exploration for testicular torsion
– Basic course in laparoscopy
– Physiology of pneumo-peritoneum
– Dangers of pneumoperitoneum
– Principles of diathermy
– Informed consent for laparoscopic procedures
– Diagnostic laparoscopy
– Laparoscopic appendicectomy
– Laparoscopic hernia repair
– Informed consent
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