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KARACHI: Every
unit and all the medical institutions in the country must conduct their
annual clinical audit which will help them to find out their strength as
well as shortcomings and weaknesses. Since the medical profession has
not provided any forum to the patients to register their complaints
which are also properly investigated, we are now witnessing
accountability of the healthcare professionals and healthcare facilities
by the public and media. This was stated by Prof. Amir Aziz, a noted
orthopaedic and spinal surgeon at Ghurki Trust Teaching Hospital
affiliated with Lahore Medical and Dental College at Lahore. He was
delivering a guest lecture on State of Orthopaedic Postgraduate Training
during SURGICON 2010 at Karachi on January 17th 2010.
He was very critical of the lack of any rotation programme of the
trainees in different units, departments within the institution or in
different cities so that they are exposed to the best and learns, master
different surgical techniques practiced by different consultants. Since
we have no uniform training programme, we are compromising on quality,
he remarked.
Currently we have two systems for postgraduate training i.e. by the
universities which offer MS and MD degrees and the CPSP which awards
FCPS. In the developed world, MS and MD is a higher academic degree
which people earn after having done their fellowship in their respective
disciplines. Universities have been here in Pakistan since our
independence and so far they have just produced sixty MS while the
number of FCPS in orthopaedic surgery produced by the College of
Physicians and Surgeons Pakistan is over five hundred. Now suddenly one
teaching hospital in Lahore has registered thirty seven MS trainees
which are not at all possible to train with the available facilities.
Training slots for FCPS remain vacant at many units as the postgraduates
are not interested to join there since there is no proper teaching and
training and they do not want to waste their time. However, no one has
ever investigates these things as to why the postgraduates do not come
to those units, departments. It is now well known that the postgraduates
are forbidden to handle, manage emergencies and the patients are taken
to their private clinics, hospitals by the consultants. The
postgraduates are not trained in trauma management and there is no
worthwhile orthopaedic training programme in quite a few units,
institutions.
Continuing Prof. Amir Aziz said that while on paper one might present a
different picture but reality on the ground is different. While I was
Assistant Professor I was not allowed to admit any patient. He then
showed a large number of slides of orthopaedic patients mismanaged and
mishandled at some of the teaching hospitals in the country which
depicted non-union, mal-union of fractures, mismanaged compound
fractures resulting in partial disability. Some of these patients had to
be re-operated to correct their fractures, improve mobility but they had
lot of morbidity during this process resulting in lot of wastage of time
and financial resources. If some of these slides are presented in a
court of law, those involved in mismanaging these patients will find it
extremely difficult to escape punishment. We must develop and follow a
proper structured training programme, listen and sort out the problems
faced by the postgraduates and be ready for clinical audit. How many
units and medical institutions, he asked, conduct their clinical audit
regularly. He made a passionate plea that we all the healthcare
professionals should be working for the ailing humanity and concentrate
on teaching and training of the postgraduates so that they become better
and accomplished surgeons. |
