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SICOT e-Newsletter

Issue No. 4 - January 2009

Committee Life: Education Committee Report

Prof Charles Sorbie

Prof Sorbie spoke of the function of all SICOT committees and the importance of their work. He believes that if the committees are to be effective and the members willing to serve, their opinions and advice must inform the decisions of the Executive and Board of Directors. While decisions are made by the Executive Committee, it is important that its members receive the considered opinion of the standing committees on which to base executive actions.

Prof Sorbie summarised the development of Education Centres, the Diploma Exam and the Manual of Education Objectives, the main topics for the study and recommendations of the Education Committee.

The SICOT Diploma Examination

The Diploma Examination continues to be a needed and a successful effort on the part of SICOT. Twenty-five trained, young surgeons applied to sit in Hong Kong on August 24, 2008 at the Academy of Medicine. They came from the following countries:

United Kingdom – 11
India - 6
Pakistan - 2
Saudi Arabia - 2
Afghanistan - 1
Bahrain - 1
Iraq - 1

The examination costs either 300 or 600 Euros depending on the origin of the candidates. Those from the “less well-off” countries pay 300 Euros. The allocation of costs is made at SICOT Headquarters using United Nations criteria.

Dr Tony Hall, Chief Examiner, has indicated that he would like to be replaced. Dr. Sorbie will continue to organize the exam and it was suggested that Dr. Marc Patterson be approached to join the Exam Organizing Team. Dr. Patterson has much experience in conducting examinations in the United Kingdom. He has the endorsement of Dr. Hall.

The first Diploma Exam took place in Cairo in 2003. Since then, the Diploma exam has been held in conjunction with congresses or conferences in Havana (2004), Istanbul (2005), Buenos Aires (2006), and Marrakech (2007). The average pass rate is between 75 and 80 percent. The multiple choice questions are derived from the 4,000+ listed on the HYPERGUIDE. Correct answers are backed by published references. All candidates who are not necessarily members of the SICOT but who are encouraged to join, receive password access to the HYPERGUIDE six months prior to the examination. They therefore have the opportunity to see in advance the 4,000 MCQ questions with correct answers. If they remember correct answers to 4,000 questions, they deserve to pass.

The Education Committee discussed the possibility of holding the exam each year in two separate locations, one with a congress or conference and one at the opposite side of the world in a place where there are large regional populations. For example, as a conference and exam will be held at Pattaya in 2009, an exam could take place somewhere in Europe. If the congress/conference is in the European side of the world, an examination could take place in Hong Kong. Recruiting experienced examiners could be done locally. While feasible, it may be too soon to have two exams a year.

The range of case presentations for the oral part of the exam will be regularly upgraded for quality and variety.

The recommendation being made by the Education Committee is that the proposal for two examinations each year should be given more time to develop depending on the interest of candidates and an increase in the number of applicants.

The Committee gives thanks to and felt it important to publicly acknowledge the generosity of, the German Orthopaedic Association through Prof Dr Eulert. The Association provides a four week tour of German orthopaedic surgical centres for the two candidates gaining the highest marks in the SICOT Diploma Exam.

Education Centres

Our innovative Education Centres have become a major activity and purpose for SICOT. Since the model centre in Lahore has continued to improve in worth and importance and with the global efforts of Dr. Chad Smith and Dr. Maurice Hinsenkamp, there has been an almost overwhelming interest in applying for Education Centres by a number of countries. At this time, another Education Centre has been established at the Assiut University Teaching Hospital and University Centre in Egypt and one is developing at the Frank Pais Orthopaedic Centre in Havana, Cuba. A request has been received for one at Sao Paulo in Brazil, Moscow in Russia, Dar as Salaam in Tanganyika, Lagos in Nigeria and for other centres in Egypt.

Prof Hinsenkamp has had contact with the World Health Organization (WHO) which has shown a strong interest in furthering the development of our Education Centres and a figure of 650,000 Euros has been mentioned as possible support for them. In addition to that, there is interest from the Bone and Joint Decade through Mr. Tom Fullan, one of the BJD international ambassadors. Mr. Fullan has agreed to have further talks with Dr. Waddell and Dr Sorbie on November 6th 2008 as there is interest from the World Bank, and several orthopaedic industries with which he has contacts. Mr. Fullan has been put in touch with Dr Meena Chernian of WHO for further talks there.

The Education Committee spent much of its time discussing the benefits to the fundamental goals of SICOT and to the quality of education in the cities in which the Education Centres are established. There is a financial cost to SICOT for each Centre although the bulk of the cost is derived locally. It is of great importance that the quality of the Centres be maintained and the protocol for their creation and conduct be followed. In principle they provide a place for orthopaedic surgeons and allied personnel, to meet, to learn and to socialize. While we have a protocol for their establishment and structure, it needs to be reviewed and upgraded as a result of experience and the wider interest. An application process must be developed which, for a request to be considered, would depend on the suitability of the geographic location, local leadership, the available facilities and the commitment of the director. These are essential requirements. When established, Centres must be fully supported by SICOT which should include at least one ‘SICOT Visiting Professor’ spending time at the Education Centre each year. Funding can be developed for these visits through the SICOT Foundation and from some of the sources mentioned above.

The Education Committee believes it is the most appropriate screening tool to make recommendations to the Executive Committee for their decision on granting Education Centres to particular cities. The National Delegate should be involved in this process and the Vice President of the region.

Points to consider include:

  • Should there be only one Education Centre in any country?
  • Can SICOT ensure the presence of a visiting professor at least once a year in the Centre?
  • How many resources can SICOT provide each year to the less advanced centres?
  • What mechanism can be applied to ensure contact with each centre, by ongoing linkage to SICOT through annual reports, etc.?
  • The SICOT Education Centres are a great and unique idea for a society or association like SICOT and the Executive Committee should give them much attention.

Education Objectives Manual Update

The Education Objectives Manual for training in Orthopaedic Surgery and Traumatology is based on a system developed in Canada. The objectives have served that country well and since they were modified, have served SICOT well. Professor Syed Awais has used them in Pakistan as a basis for training by dividing them into ten modules. The modules are covered each week, section by section so that the full manual is followed. Training progress is based on the Objectives over a three year period for which it was devised. In Pakistan, it has been linked to the HYPERGUIDE and training can end with a diploma exam.

The Education Objectives need review and updating. Knowledge is constantly changing in, for example, spine surgery, trauma, arthroplasty and paediatrics. The Education Committee proposes to develop a new version of the objectives, which will be available from HQ at a small cost within the next year or two.. "Experts" (that fine body of men and women!) will be asked to re-write sections of the manual. Names of suitable individuals are requested.

Other Business and Summary

Dr Walker noted the development of the College of Surgeons in East Africa which is now in existence at Arusha, North Tanzania. It is linked with South Africa and with a former professor, Chris Lavy, who is now in Oxford,. The College consists of eight centres plus representation from South Africa. It is hoping to develop an orthopaedic exit examination.

It is strongly recommended again that the protocol for Education Centres be upgraded and a mechanism developed by the Executive and Education Committees for setting policy for the endorsement of Education Centres which would include the number of centres in any country, the number of centres developed in any year, the screening of Centre leadership, the liaison with WHO and BJD, a program of SICOT professorial visits to the centres and a planned, “bells and whistles” opening ceremony for all new centres.

The Committee recommends that a member of the Trauma Committee be added to its membership.

The Education Committee is pleased to receive comments and ideas for its consideration at any time during the year. Please feel free to contact directly any member of the committee.