Core skills in orthopaedic surgery
Authors: Sara Dorman
Publication date: 26 May 2012
Core skills in orthopaedic surgery is a three day course run by the Royal College of Surgeons of Edinburgh. The course emphasises development of competency in basic emergency department, outpatient, and operative procedures in trauma and orthopaedics.
Who is it for?
The course is aimed at foundation year 2 doctors who wish to pursue a career in trauma and orthopaedics and year 1 and 2 specialty trainees currently working in a surgical post. Most participants are required to have at least some practical experience in trauma and orthopaedics. The candidates on my course were from foundation year 1 and 2 to specialty trainee 1 level from all over the United Kingdom and overseas, and all participants had worked in trauma and orthopaedics at some point.
Why did you do it?
Having done four months as a foundation doctor in trauma and orthopaedics, I had a good understanding of the principles of orthopaedic management but wanted to gain more practical experience, build on my skills base, and increase my confidence before a rotation in accident and emergency, where I would have the opportunity to use my skills in trauma management.
What did it cover?
The course ran from 8.30 am to 5 pm over the three days, with regular breaks for refreshments. It was led by five or six consultants and senior fellows.
The course programme gave useful information, course objectives, and a brief summary of each of the topics to be covered. It was emailed to candidates before the course.
Day 1 consisted of a mix of lecture sessions, hands-on practical sessions, and discussions about the management of common orthopaedic emergencies, joint aspiration, reduction and immobilisation of fractures, and management of soft tissue injuries, including tendon repair. Lectures highlighted the initial assessment of emergency admissions and the importance of protecting the soft tissues in the management of fractures.
Day 2 followed the same format and was aimed at developing core practical skills in trauma surgery. Several lectures covered the theory of fracture healing, basic fracture principles, and options for fracture fixation. Most of the day involved practical application of skills through dry bone workshops on lag screw insertion, plating, external fixation, and tension wire banding.
Day 3 focused on core skills in elective surgery, with lectures and practical sessions on patient positioning, surgical approaches, cementing techniques, and arthroscopic skills stations.
Throughout the course all participants had an opportunity to participate in practical work in pairs using dry bones. All faculty members were friendly and answered any questions throughout the course.
The session that most interested me was that on management of common orthopaedic emergencies. In particular, recognition of pelvic injury and application of a pelvic binder were especially useful, providing valuable insight into the management of a potentially fatal condition that a junior trainee could easily miss.
Where is it held?
The course is held several times a year at the Royal College of Surgeons in Edinburgh.
Was there an assessment?
Informal, anonymous “clinical scenario” assessments in the form of multiple choice questions took place at the beginning and end of the course. Continuous assessment by the faculty occurred during the practical sessions throughout the course.
Was it enjoyable?
The course was interesting, and the mix of lectures and practical sessions helped to maintain interest and concentration throughout. The course also offered candidates the opportunity to speak to consultants about their experiences and to ask any questions.
How much did it cost?
The fee of £725 (£675 for affiliates of the Royal College of Surgeons of Edinburgh) included all course materials, refreshments during breaks, and a two course lunch each day at the college hotel.
Was it useful in clinical practice?
This course is useful for doctors working in the emergency department or in trauma and orthopaedics. It not only helped me consolidate the principles of orthopaedic management and managing trauma patients but also gave me the skills and confidence to perform practical procedures such as fracture reduction and management under senior supervision. It also familiarised with the orthopaedic equipment and tools encountered in theatre.
Would you recommend this course?
Without doubt. The course is a good opportunity for doctors who want to pursue a career either in trauma and orthopaedics or in the emergency department. It should help them gain confidence and practical skills in orthopaedics in a safe environment, with small group tuition by experienced consultants.
Gain practical experience in orthopaedics and trauma before the course.
Book early to avoid disappointment.
Read about the management of common orthopaedic problems before the course to ensure you get the most out of it.
Competing interests: None declared.
Sara Dorman foundation doctor year 2
Ninewells Hospital, NHS Tayside, UK