1.4.1 Duration
4 years of which 3 years should be spent
in a Department of Plastic Surgery and 1 year preferably in recognised
centres of training aboard.
1.4.2 Content
The Advanced Trainee must be familiar
with the basic techniques and fundamental aspects of Plastic Surgery. He
should have sound and practical knowledge in the following areas at the
completion of his clinical training:
- Historical aspects of the specialty
- Wound healing and dressing technique
- Principles and practice of
tissue culture and transplantation
- Skin graft and other types of free
grafts
- Principles of various types of flaps
- Management of soft
tissue injuries
- Microsurgery - basic techniques and applications
- Excisional and reparative surgery involved in treatment of skin cancers
and tumours of the face, neck and intraoral region
- Management of
maxillo-facial trauma including the mandible
- Management of burns and
their complications
- Management of pressure sores and chronic ulcers
- Hand surgery - management of acute hand injuries, elective and
reconstructive surgery and hand rehabilitation
- All aspects of
amputation
- Management of lymphoedema and post-irradiation problems
- Block dissection of lymph nodes, radical neck dissection
- Management of head/neck cancers including aspects of resection and
reconstruction
- Reconstructive surgery of the breast
- Cleft
lip/palate and craniofacial anomalies All aspects of management
including surgery, orthodontics, dental and speech therapy
- Management of congenital and acquired deformities of the urogenital
system, spinal cord, upper and lower limbs
- Principles of tissue
expansion and their clinical applications
- Principles of laser
surgery and their clinical applications
- All aspects of aesthetic
surgery
- All the basic sciences related to the above topics including
embryology, surgical anatomy and physiology
He is further encouraged to continue his
research activities during this period of advanced training.
1st Year The Advanced Trainee will assist
in operations and perform simple operations under supervision. He will
commence training in microsurgery in the microsurgical laboratory. In
research, the Advanced Trainee will be given a clinical/basic anatomical
dissection project. The Advanced Trainee will be involved in Journal
Clubs and all other teaching activities of the unit. He should attend
all outpatient specialty clinics in the Department. Training in the 1st
Year emphasises a solid grounding in basic plastic surgery
techniques and their clinical applications.
2nd Year The Advanced Trainee will
receive further training in the sub-specialty areas like Head and Neck
Cancer, Cleft Lip/Palate, Burns, Aesthetic Surgery and Reconstructive
Surgery in all aspects.
Arrangements will be made for the
Advanced Trainee to be posted to the Department of Hand Surgery for 3 -
6 months. During this period, the Advanced Trainee will be exposed to
all aspects of Hand Surgery like Emergency Hand Problems, Reconstructive
Hand Surgery, Free Tissue Transfers and Rehabilitation of the Hand.
Further arrangements will be made with
the Dental Department for some exposure in Orthodontics, Dental
Prosthetics and pre-operative planning in Orthognathic Surgery for the
correction of maxillary and mandibular deformities. The Advanced
Trainees will also be exposed to preoperative treatment of cleft
patients undergoing alveolar bone grafts and orthognathic surgery.
The Advanced Trainee will continue to
assist in operations and operate under supervision but will be allowed
to perform more operations independently. When the Advanced Trainee has
become competent in microsurgery, he will be allowed to carry out some
microsurgical procedures.
The Advanced Trainee will continue his
research activities and will present a basic research paper at a
meeting. The Advanced Trainee will continue to teach the nurses and
junior staff and be involved in Journal Club and inter-departmental
lecturers. The Advanced Trainee will be encouraged to be involved in the
organisation of workshops and conferences.
3rd Year The Advanced Trainee will be
able to handle most of the acute problems like maxillofacial injuries,
acute soft tissue trauma and emergency hand surgery. He is able to
operate independently most of the time and be able to supervise medical
officers during ward rounds and operations. He will co-ordinate most of
the teaching activities in the Department.
The Advanced Trainee will continue both
clinical and basic research. He will present papers at meetings and
publish at least one paper during the year.
At the end of this period, The Advanced
Trainee should be ready to sit for his Fellowship examinations in
Plastic Surgery and seek certification in the specialty with the Academy
of Medicine.
4th Year It is important for the Advanced
Trainee to go overseas for one year to broaden the scope of his training
and also for interaction with fellow trainees. It will be a time to see
and learn new surgical techniques, different approaches to surgical
problems and various concepts in basic and clinical research. The Advanced
Trainee will attend appropriate meetings and seminars abroad and present
his work there. This is also a year of consolidation of his knowledge,
surgical skills and research ability.
1.4.3 Advanced Training Posts
These should be advanced training posts
in accredited government, restructured and university hospitals.
1.4.4 Supervision of Training
Heads of Departments or Consultants
should supervise training.
The Advanced Trainee should communicate
freely with supervisors who will assess his progress at regular
intervals.
All types of surgery performed will be
decided by the supervisors and pre-operative discussion conducted either
in the departmental rounds, outpatient clinic or with the supervisors.
All Advanced Trainees are required to discuss the patients with their
supervisors before listing them for operation.
All cases will be recorded and if there
are complications or deaths, they must be reported and discussed with
the supervisors.
1.4.5 Log Book
The Advanced Trainee must maintain a
log book to record the following:
a. Minor and major surgery performed
either under supervision or alone and where he is
supervising and
teaching junior doctors
b. Research projects and publications
c. Journal
club activities
d. Attendance at local, regional and international
meetings
e. Participation in the organisations of local or regional
conferences
f. Teaching contributions
Advanced Trainees must submit log books to
their supervisors every month and to heads of department every 6 months
for certification.
1.4.6 Practical Training
Practical training involves learning all
the skills as detailed in the syllabus.
1.4.7 Research
The Advanced Trainee is required to
embark on at least 1 research project during his training period and
publish the results.
1.4.8 Courses, Seminars and Lecturers
Attendance at courses, seminars and
continuing medical education lectures is mandatory. The Advanced
Trainees is required to participate actively in these activities.
1.4.9 Teaching Commitments
The Advanced Trainees will be involved in
the teaching medical students and nurses.
1.4.10 Publications and Papers Presented
in the Meetings
The Advanced Trainee must publish at
least 1 paper in a refereed journal for which he is first author. He
should read papers at local, regional and international conferences.
