Clinical Observership in General Paediatric Surgery

I About The Programme
II Assessment and Evaluation
III Target Audience and Eligibility Requirements
IV Other Information

I About The Programme

Name of Programme

Clinical Observership in General Paediatric Surgery (3-6 months)

Overview

A key gap in the advancement of pediatric surgical outcomes is the lack of skilled professionals in geographical areas where the needs are most pronounced. Low- and middle-income countries (LMIC) see a disproportionate volume of paediatric and congenital neonatal surgical conditions. This observership programme aims to address this gap by exposing junior paediatric surgeons from these LMICs to the practices in a tertiary paediatric surgery centre at KK Women’s and Children’s Hospital, Singapore.

The programme builds on the Department’s past general paediatric surgery cum paediatric urology programme which has trained clinical fellows and observers from Southeast Asia since 2013. In a similar vein, doctors who complete the training will return to their home countries with the newly gained expertise and experience to contribute towards enhancing their countries’ clinical and research capabilities.

For more information on the services provided by the Department of Paediatric Surgery, click here.

Aim of Programme

The aim of this clinical observership is to provide junior paediatric surgeons, particularly those coming from resource-challenged settings, with exposure to tertiary-level paediatric surgical services.

Duration of Programme

This is a 3- to 6-month programme.

Number of Training Places

One trainee will be accepted into this programme at any one time.

Main intake is in July. Entry into the programme at other times is subject to availability.

Learning Outcomes

On completion of the programme, clinical observers should be able to:

• describe the elective and emergency management of general paediatric and neonatal surgical conditions including diagnoses, steps of surgical operations, perioperative care and long term follow-up;
• understand and apply principles of evidence-based medicine in patient care;
• identify the multidisciplinary team and systems involved in the care of the surgical patient;
• be competent in performing routine surgical procedures.

Content Areas

The training content is as outlined below:

1. Clinical training

• Patient care
  The observer will participate in daily ward rounds, outpatient clinics and operative sessions with the surgical team he/she is assigned or rotated to. This will allow the observer to gain a good appreciation of preoperative evaluation and pre-surgical optimisation, postoperative assessment and follow-up, and performance of operative procedures. This includes elective and emergency, outpatient and inpatient cases.
  
  
• Procedural skills
  The observer can scrub to assist in the performance of operative procedures to learn and be familiarised with the operative management of common paediatric and neonatal operations, including cystoscopy, laparoscopy and thoracoscopy;
  
  
• Infection control
  Sessions with Infection Control nurse to learn about infection control systems and audit will be arranged.

2. Education

The observer is expected to actively participate by attending and sometimes presenting at educational meetings. These include:

• weekly mortality and morbidity rounds;
• weekly journal club meeting;
• monthly combined x-ray rounds;
• bi-monthly anomalies vascular malformation meeting;
• quarterly combined urology-nephrology meeting;
• quarterly combined clinico-pathological rounds;
• quarterly trauma conference.
  

3. Research

• This is optional. If interested, the observer may seek the guidance and mentorship of senior staff of the department to embark on and complete a Research project, with the aim of (i) submission of abstract and presentation at a scientific meeting, and (ii) completion of manuscript on research project for publication.
  

Training Methods

The observer will learn up-do-date clinical and practical skills through:

1. exposure to clinical work in the wards, clinics and operating theatres;
2. formal didactic programmes, participation in journal club discussions, morbidity and mortality meetings,
multidisciplinary meetings and bedside teaching;
3. self-directed learning via recommended reading and online resources.

The training location will be the Department of Paediatric Surgery, KK Hospital. Rotation to different surgical teams (with special interest in Urology, Hepatobiliary, Oncology or Minimally Invasive Surgery) can be arranged based on the observer’s area of interest, where possible. In addition, short external rotations to the Neonatology Intensive Care Unit or other services can be arranged if specific areas of interest or need are identified.

Past and Present Fellows

The Department of Paediatric Surgery at KKH has had a prior track record of training clinical fellows and observers in general paediatric surgery and paediatric urology. Under the past programme, the Department has trained 8 clinical fellows and clinical observers from 2013-2015.

Clinical fellows and clinical observers trained at the Department of Paediatric Surgery, KKH from 2013-2015:

Team of Experts

The Paediatric surgery observership programme is managed by the following experts:

II Assessment and Evaluation

Assessment Approaches

• The observer will be assessed by direct observation and will receive a certificate on completion of the period of observership.
• The observer is expected to maintain a logbook of cases which will assist the supervisor in assessing his/her progress in the programme.

Clinical observers must remain under Level 1 supervision for the entire duration of their training. They will have regular meetings with their supervisor where formative feedback will be shared. Both supervisor and HOD will submit the feedback on clinical observers’ performance to SMC every 3 months, using SMC online assessment system.

Evaluation Process

The observer will receive a certificate of observership on successful completion of the programme (CMP) according to the criteria laid out as follows:

III Target Audience and Eligibility Requirements

Target Audience

This observership programme aims to provide general paediatric surgery exposure to junior paediatric surgeons, particularly those coming from resource-challenged settings. The candidate who will benefit most from this programme will be a junior surgeon working in a children’s hospital, and should have completed post-graduate training in paediatric surgery in his/her country of origin, and may have some experience working as a junior paediatric surgeon in his/her hospital.

Pre-requisite/Eligibility Requirement(s)

Candidates must:

• be recommended by their respective Head of Department OR at least two referees chosen by the applicant;
• conversant in English;
  
• provide a letter of good standing from own country’s licensing authority;
• return to their parent hospital in their country upon completion of the fellowship, with the aim of imparting the new skills and knowledge learnt, for the good of their community.

IV Other Information

Course Fees

There is no separate course fee.

Funding

Candidates should be self-funded or have funding from external sources/institutions.

Certification

Certificate of observership will be awarded after completion at the end of the attachment.