Core skills in hand surgery
Authors: Sophia Opel
Publication date: 17 Nov 2012
Who is it for?
This course attracts trainees mainly from plastic surgery but also from trauma and orthopaedics and accident and emergency—anyone with an interest in hand surgery and trauma. The college advises a level of experience from core training year 1 to specialty training year 4.
When did you do it?
I did this course in January 2012, as a core trainee year 2 with eight months’ experience in plastic surgery.
Why did you do it?
I did the course for two reasons. Firstly, because hand trauma is a large part of plastic surgery, I wanted to be taught (and then practise) techniques by hand surgeons from all over the United Kingdom. Secondly, I thought that having a hand surgery course on my CV would be beneficial before my interview for specialty training year 3.
How was it structured?
This three day course emphasised practical experience. Each day consisted of short lectures followed by practical work using fresh cadaveric specimens, microscopes, and plastic bones. The cadaver was in excellent condition and was a pleasure to “operate” on. The course’s structure meant that the faculty had time to teach us how to set up the microscope, and there was ample opportunity to practise this skill and to handle tissues under the microscope.
The first day covered anaesthetics and soft tissue—in particular, applied anatomy and local and regional blocks; common incisions; compartment syndrome; and methods for finger tip, proximal digit, and thumb local flap reconstruction.
The second day covered nerve and bone—tendon repair and fracture fixation. The third covered tendons, ligaments, and joints—nerve repair and grafting; proximal interphalangeal joint hyperextension injury; thumb abduction injury; and ulnar collateral injury. I found it particularly useful to consider techniques for repair.
My course had about 20 members of faculty in total over the three days—anaesthetic, plastic, and orthopaedic consultants—and 20 participants.
Like all courses, this one required motivation and enthusiasm. The opportunity to practise basic techniques on a fresh specimen and get feedback and tips from highly skilled faculty members was invaluable.
How were candidates assessed?
The course had no formal assessment. A certificate was issued to participants on their completion of the online evaluation. The high ratio of faculty to participants allowed plenty of one to one guidance, feedback, and assistance over the three days.
How much did it cost?
The total cost was £1350, which included refreshments and lunch each day as well as all instruments used. Members of the Royal College of Surgeons of England get a 10% discount on booking.
Was it worth it?
This course was expensive but worth the money. The high faculty:participant ratio meant that your technique could be critiqued and all burning questions answered. The course gave me confidence in assessing and operating on hands. It would be invaluable for those wanting a career in plastic surgery.
Make use of the pre-course pack: it prepares you well, with a DVD of upper limb anatomy and outlines of each day.
Book in advance, as this is a highly popular course.
The next course is on 8-10 January 2013. The Royal College of Surgeons of England website has dates, availability, and an application form (www.rcseng.ac.uk/courses/course-search/hand-surgery.html). For further information contact the college’s education department ( firstname.lastname@example.org or tel 020 7869 6300).
Thanks to Yaser Ghani for help in preparing this article.
Competing interests: None declared.
Sophia Opel core trainee year 2, plastic surgery
Royal Free Hospital, London, UK
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