Alexandria/SICOT Fellowship Report
SICOT Associate Member - Mogadishu, Somalia
I am always eager to learn and was definitely excited when I learnt I had been selected for the Alexandria/SICOT Fellowship. It has been an honour for me to be the first fellow granted the Alexandria/SICOT Fellowship. I arrived in Alexandria, Egypt, on 16 July 2016 and commenced the posting with an introduction to the Head of the Department on 17 July 2016.
My postings involved a rotation through the 4 units in the Department. I had a special interest in trauma and took part in fixation of forearm and wrist fractures, ankle fractures, foot fractures, paediatric fractures, complex head and neck fractures of the femur, and difficult intraarticular distal humeral fractures.
Strengths/advantages of the training
The choice of Al-Hadra (Nareman) Hospital as an orthopaedic training programme centre was very good for the following reasons: Nareman University Hospital is the biggest orthopaedic hospital located in the north coast region of Egypt and serves millions of people with a high number of patients visiting the outpatient clinics and the emergency department daily, which makes it a very good centre for training.
The first thrilling experience is the number and rich variety of cases done on any operation list, as well as in the trauma unit on any working day. This provides repeated exposure to many procedures and reinforces learning. Even in those cases where the trainee has had some experience, he sees things done in a way that may point out his mistakes in the past and the repeated exposure positively reinforces the new tactics and methods to which he has been exposed.
The greatest advantage of the Alexandria/SICOT Fellowship is that the training and surgeries are taking place in a setting much like what he faces at home. The challenges of poverty are the same, yet things get done, and properly too. The trainee learns to improvise and use very basic equipment to achieve good results in orthopaedic and trauma care.
Weaknesses of the training
I think such a training should be under the supervision and guidance of permanent designated trainers who are known to the trainees, so that they can leave them to do some operations under the various conditions already listed. Secondly, the designated trainers should provide counselling and guidance on all aspects of the trainee's fulfillment of the training objectives. This includes rostering of clinical work during the training period and ensuring that the rostered duties have been carried out.
The accommodation at Nareman Hospital is basic. Boarding hygiene can be improved upon.
Every working system can benefit from changes to ensure improvement. Therefore, I wish to recommend as follows:
It would be interesting if the Training Director nominated somebody to be a trainer according to the fellow's plan.
Most of the fellows are eager to transfer this experience to their countries, so I would suggest some supervised hands-on training keeping in mind the medicolegal limitations.
Review of some accommodation conditions and diet.
I wish to thank the International Society of Orthopaedic Surgery and Traumatology (SICOT), Prof Ahmed Hassan, the management and staff of the Al-Hadra (Nareman) University Hospital; Prof Osama Ahmed, Hospital Director, and the entire staff and members of the Department of Orthopaedics and Traumatology for this opportunity.
My overall impressions and experiences during the last six months have been very positive.
I found joining this programme satisfactory and I hope it will continue especially for the benefit of African orthopaedic surgeons whose countries still have some difficulties in updating the management of orthopaedic surgery and traumatology. I hope to be a good ambassador of this training programme everywhere and I thank SICOT again on behalf of all Somali patients who might be helped through the positive experience I had in Alexandria.