urgicalVol: 12 No:9 October 2011 Sthe royaL Australasiannews College of Surgeons
College firms up support for Federal plain packaging campaign. page 16
The College of Surgeons of Australia and New Zealand President’s Perspective The Royal Australasian College of Surgeons urgicalVol: 12 No:9 October 2011 STHE ROYAL AUSTRALASIANnews COLLEGE OF SURGEONS Member Advantage Benefit Program
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College firms up support for Federal plain packaging campaign.PAGE 16
The College of Surgeons of Australia and New Zealand
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Car Buying Service Private Fleet Receive up to 20% off the dealer price on new cars and a range of related finance services contents through Private Fleet. Some of our members have saved over $3,000! Call Member Advantage 8> Weary Dunlop today for a quote on a particular make and model. Value for Money www.memberadvantage.com.au/racs/privatefleet or call 1300 853 352 Boonpong Fellows Important changes over recent years Exchange program
Packaged Tours Intrepid Travel continues success Fancy an overseas trip? Enjoy a 10% discount on all land tours through Intrepid Travel. 12> Translation pathways issues that I have pushed very hard to try and improve the visibility of Choose from a range of tours from around the world that are designed to appeal to all tastes Fellow Damien Bates on and budgets. Browse your options today via the Member Advantage website. the “value for money” proposition. www.memberadvantage.com.au/racs/intrepid or call 1300 853 352 developing research Many Fellows have commented on the new FRACS corporate brand. 16> College Advocacy Ian Civil Inspired by a colleague in New Car Rental AVIS College support for Federal President Zealand, I encouraged the College Enjoy specially negotiated rates and reduced excess liability for passenger vehicle rental campaign t is a fascinating concept and one Council and Executive to explore across Australia and New Zealand. Quote RACS AWD number P203701 when making a that I have pursued in numerous new branding that could be used 18> Law commentary booking to receive a reduced quote. Idiscussions as I have met with by College Fellows on their own www.memberadvantage.com.au/racs/avis or call 1300 853 352 Michael Gorton on Complaints Fellows across both Australia and stationery and now this has also 20> Younger Fellows New Zealand. The College subscrip- been expanded to include decals tions are an event that we all share on that can be used on glass surfaces. Seema Bagia on what to an annual basis. The amount is sig- In a health care environment where NEW BENEFIT for NZ Fellows & Trainees expect at the 2012 Forum nificant enough to make one pause the importance of our qualifications and question the return. Do we get and standards are becoming more 27> Library report value for money is the question Fel- significant it is vital that we can New online tools for users * lows not unreasonably ask. differentiate ourselves and confirm Enjoy savings of up to $186 28> Article of Interest As with your income tax that being a Fellow of the College is the standard. This will be the first Bullying a key College payments, there is much that is done on Koru club membership fees with your fees that does not seem of a number of initiatives to ensure concern to benefit you directly. Advocacy, “Surgeon of excellence” and FRACS 32> Retired Fellows compliance and appeals are all areas are synonymous. Take advantage of the Koru club airline lounge corporate membership rates: where the College responds on your The second initiative has been Gerard Sormann is light behalf, but you will not necessarily the presence of the College at the • $155 joining fee1 (save $100) on retirement see or appreciate the output unless Specialty Society meetings. This has • $455 for 1 year membership (save $51) the matter is very specific to you dramatically increased over the past • $803 for 2 year membership (save $86) personally. On the other hand there 12 months. It is important that the are some areas where I hope Fellows interface between the College and • Access to Air New Zealand and Virgin Australia airport lounges2. regular pages will see and appreciate value. While all the Specialty Societies is actively I have been President there are three nurtured. u 5> Relationships & Advocacy Apply today! 7> Poison’d Chalice Visit www.memberadvantage.com.au/racs/koruclub 14>Regional News or call NZ Member Advantage on +61 3 9695 8997 21> PD Workshops 40>Lettersto the Editor 44>Surgeons’ Bookclub * Savings include $100 off the joinng fee, and an $86 discount on a two year membership. All Fees and savings are quoted in NZD. 1. A joining fee is applicable for both new Memberships and existing memberships who are renewing Membership after 1 month of expiry of an existing Surgical News Page 3 October 2011 membership. 2. Virgin Australia lounges accessible for Koru Club members are located in Sydney, Brisbane, Melbourne, Adelaide, Canberra and Perth. President’s Perspective Relationships & Advocacy
On the other hand there are some “areas where I hope Fellows will see and appreciate value ”
Both the Vice President and I have been honoured by being asked to address the meetings with key presentations and also have the chance to catch up with many colleagues and inform them about the Training our surgeons issues of the day. We live in contested days where external review and The College faces important challenges for training regulation are increasing. The College strongly believes in the unity of surgery and presenting a coherent front in the health sector debates. Significant effort “behind the scenes” continues and may not be evident on a daily basis. It is a poignant moment when you understand that even when we are acting collectively, surgery is still a small percentage of the overall health budget and political focus. Splintered we will be number of surgeons who will retire over the from fundamental surgical skills courses to ineffective. next 15 years, any small decrease in average cadaveric workshops attracting participants The presence of a College stand at these meetings with the ability Keith Mutimer working hours, and to allow for HWA’s stated from all around Australia and many from Vice President to network, gather feedback as well as distribute information about objective of reducing Australia’s reliance on overseas. The ongoing educational activities on our activities is adding much value. Purchasing exhibition floor space s part of the Australian government’s IMGs by as much as 95 per cent. the Melbourne site continue a tradition dating and having a profile does not come without expense, but of course health reform process, Health The average cost of training one surgical back to 1851, when the future state education that directly benefits the Society in question and is very worthwhile. AWorkforce Australia (HWA) is trainee, if he or she is expected to do 200 operative system was founded with the Model School. The third component I am now impatient to see is the Information developing a National Training Plan (NTP) cases per year, is $903,000. Further expenditure With the establishment phase of the Skills Technology transformation within the College. We live within a world aimed at achieving self-sufficiency in the is required for educational infrastructure and and Education Centre well-consolidated and that is “mobile” connected and IT facilitated. The College must have supply of medical personnel by 2025 within a costs incurred by the supervisor. It follows a strong customer base in place, the time is a meaningful and streamlined presence that adds significant value global labour market. therefore that if Australians are to continue right to build on that success, ensuring the in this world. As part of this process the College’s to receive the standard of surgical care they facility remains relevant and provides the best I have undertaken my CPD documentation on line for some Workforce Assessment department has currently receive, additional expenditure of possible service to Fellows, Trainees and other years, but am looking forward to the new web presence with developed surgical workforce models based on at least $72 million per annum is needed on stakeholders in line with the College’s values significantly increased capacity for CPD, professional development the NTP’s assumptions and available data. surgical training alone. and vision. e-learning and better access to our library and other educational The key finding of this modelling is that Given the logistics and expense of such A significant issue is that while use of the resources. unless there is a substantial increase in the an increase in training, this represents an skills laboratory by external organisations Having worked in hospitals where IT ‘roll-outs’ have not number of graduating surgeons, Australia faces unprecedented challenge to Australian continues to increase annually, use by the been smooth, I appreciate that attention to detail, adherence a surgical workforce crisis within the next 15 governments, hospitals and Fellows of the surgical specialties has plateaued. Some to time lines and detailed project management are all years. Royal Australasian College of Surgeons. specialties do not use the skills laboratory required to ensure that IT projects happen. However, I am To avoid this crisis, and assuming that for training at all. While external customers optimistic that this, the third key development over the past the current surgeon per population ratio is New Vision for the Skills & provide a source of ongoing revenue which 18 months will hopefully deliver benefit to us all. adequately and safely servicing the Australian Education Centre can then be invested in improving the facilities Council does spend significant time and effort identifying areas population, it is conservatively estimated that Since the establishment of the Victorian Skills for Trainees and Fellows, the centre is keen to where value can be delivered for the benefit of all Fellows. These are in addition to the 184 new surgeons currently and Education Centre in 2004, thousands of explore how it can be of more service to the some examples of how we are attempting to make your subscriptions graduating each year, a further 80 will have to Trainees, Fellows, other medical practitioners College and its surgical specialties, especially deliver value to you in your practice on a day by day basis. graduate alongside them – a total of 264 new and medical students have benefited from those not currently utilising the facilities at all. surgeons per annum. world-class teaching across a wide array of With that goal in mind, the Skills and This is to compensate for the increasing skills. During that time, workshops have ranged Education Centre’s oversight committee has u Younger Fellows Forum
3 – 5 MAY 2012, KUALA LUMPUR Correspondence to Surgical News should be sent to: Surgical News Editor: David Hillis [email protected] © 2010 Royal Australasian College of Surgeons All Younger Fellows are invited to nominate for 2012 Younger Fellows Forum. Letters to the Editor should be sent to: All copyright is reserved. The Forum provides a unique opportunity to debate ‘hot surgical topics’ and a chance to relax [email protected] The editor reserves the rights to change material submitted The College privacy policy and disclaimer apply – www.surgeons.org and network with your colleagues and Council representatives. Next year’s theme is ‘The Public Or The Editor, Surgical News Royal Australasian College of Surgeons The College and the publisher are not responsible for errors or consequences -Private Balance in a Surgeon’s Working Life’. The Forum is a unique chance to share ideas and from reliance on information in this publication. Statements represent the College of Surgeons Gardens views of the author and not necessarily the College. Information is not experiences that affect your professional and personal life. 250-290 Spring Street intended to be advice or relied on in any particular circumstance. Attendance at the Forum and airport transfers to the venue is covered by the College. East Melbourne, Victoria 3002 T: +61 3 9249 1200 F: +61 9249 1219 Advertisements and products advertised are not endorsed by the College. Applications are open from 1 September to 1 December 2011. W: www.surgeons.org The advertiser takes all responsibility for representations and claims. Published for the Royal Australasian College of Surgeons by RL Media Pty Ltd. Contact Professional Development Department. Ph: +61 3 9249 1106 Fax: +61 3 9276 7432 Email: [email protected] ISSN1443-9603 (Print) ISSN 1443-9565 (Online) ACN 081 735 891, ABN 44081 735 891of 129 Bouverie St, Carlton. Vic 3053.
Surgical News Page 4 Vol: 12 No:9, 2011 Surgical News Page 5 October 2011 Relationships & Advocacy Surgical Services
“ A significant issue is that while use of the skills laboratory by external organisations continues to increase annually, use by the surgical specialties has plateaued been re-established after an interval of several ” years. Chaired by College Councillor Associate Professor Helen O’Connell, this passionate and committed group comprises the Dean of Education, the Medical Director of the centre and representatives from several specialties. The committee has a role in providing guidance and Poison’d assistance in the development of courses and workshops for the nine specialties, in alignment with their curricula. A strategic planning workshop was recently Chalice instigated by the committee to explore options “Of all base passions, to maximise use of the centre’s skills laboratory. fear is the most accursed.” Eighteen participants representing many of the specialties along with some external stakeholders brainstormed ideas aimed at a refreshed vision for the skills laboratory, and considered strategies for re-energising skills training programs in a sustainable way. Strategies discussed included: focusing activity Professor U. R. Kidding had lost proximal control – catastrophic questions began flooding the auditorium, a around a balanced portfolio of training programs haemorrhage, cardiac arrest, death. storm was approaching and I wish I had the with an appropriate mix of master classes, basic The main message to come out of the tossed and turned, sleep eluded me – or And then I stumbled, much to my future opportunity to call a ‘rain delay’! Perhaps I skills, and non-procedural training; identifying indi- evening was the importance of partnerships maybe it hadn’t and I was merely dreaming. regret, I probed further – “why had they lost could wake up and my dreams and nightmare vidual surgeons to act as champions of skills train- to realise the strategies discussed. My mind drifted … Awake or dreaming, I proximal control?” would just pass. ing; re-engaging the surgical specialties; exploring I Simply put, if the skills laboratory is to be jolted, my heart racing and the words of the I lapsed back into a deeper sleep. Was I the But with each question or comment, the the case for employed part-time surgical trainers; used more for surgical training then demand Bard were in my mind … “Of all base passions, enthusiastic Clinical Director? Was I the “battle issue grew. Is the primary role of surgeons in capitalising on partnerships with trade; and scaling for training courses across the specialties Your feedback would be fear is the most accursed” (King Henry VI, Part hardened” surgeon that had now paused and our institution patient care or training? If it is up the use of the centre’s multimedia capabilities. needs to increase. It is therefore essential that welcome and if you would 1. Act V). I seemed to be awake, but asleep and looked at me? The look that still haunted me the former, why isn’t the most qualified person With the time demands experienced by the training board of each specialty is engaged like to discuss how you think the scenes were in front of me … of “what are you really asking?” doing the procedure? Why should a trainee be surgeons, availability of faculty was identified as an by the oversight committee to work together to the centre could benefit your On face value, the morbidity and mortality It turned out that my surgical colleague allowed to undertake a dangerous procedure, important issue for surgical training. This suggests design training programs. This shared task will specialty or just have a tour, meeting was going to be mundane. The death was overseeing the registrar – a good registrar even if closely supervised? What happens in the need for renewed effort to nurture pro bono ensure the centre’s equipment is appropriate, please contact Skills and of an 85-year-old male on the table during an nearing the end of his training. He entrusted a the private sector? Views polarised. I was not surgeons for highly specialised training, while also guide the centre’s engagement with the trade Education Centre Medical elective abdominal aneurysm repair needed to vital step in the procedure to the registrar. Alas quick enough off the mark. raising the question of the use of non-surgeons as and provide advice to the specialties on Director, Donald Murphy or be discussed, but would not be contentious. he hadn’t got it quite right. Try as he might, my Had I been out of my depth as the trainee, instructors for selected basic skills training. managing the portfolio of training. Manager, David Lawrence. Although not perhaps expected, it did not surgical colleague was unable to remedy the slow off the mark as the surgeon-supervisor or seem unreasonable. situation in time – the patient died. just losing control of the meeting? Which one A meeting this young (in reality ageing The question remained almost unanswered was I? Or was I all three? The debate raged in at ever increasing rate), enthusiastic Clinical of would the patient had died if my surgical my mind. Director could chair with aplomb. I do pride colleague and not the trainee had done the I woke with a start. The meeting had ended. Operating a Private myself on my anticipation, my control of events, proximal end. He felt responsible. If he had I had trudged back to my office uneasy in Practice is not easy... but even I did not see this one coming. I always performed the vital step in question, the patient mind – just how do we train the surgeons of follow the dictum – “never ask a question would have most likely survived. tomorrow? It is tough to do everything, be everywhere, unless you already know the answer”. In fact I tossed and turned again. I semi woke My esteemed colleague and I had spent manage staff and be a great surgeon. I have used that dictum in reverse – not my feeling sweaty and almost claustrophobic. so much of our training observing and Rooms with Style can help. nicest hour – when an exploitable advantage Mumbling I went to sleep again, was I the then went to UK to ‘practice on the Poms’. could appear. Clinical Director, was I the trainee, or was I the However, that capacity to flex our developing We renovate, refurbish, deal with council, recruit battle hardened surgeon? surgical muscles was now closed with a and manage motivated staff, provide marketing services, The patient had bled to death – the surgeon build you a website, provide streamlined accountancy blamed himself, took full responsibility. The I had not planned for this to happen. I hate unified Europe. So how will training change, services and much, much more..... We work details don’t matter or perhaps they do. The it when things happen that I hadn’t planned for how will we get those skills; will simulation Call or email us today 1300 073 239 surgeon, an experienced colleague, who I had – whether it be during an operation or during a or some other approach ensure that there are We have been helping surgeons achieve and exclusively [email protected] meeting that I was supposed to be controlling. no ‘sacrifices’ to training? Something that we maintain successful practices for years. for in fact ear-marked to repair my own aneurysm Specialists. www.roomswithstyle.com.au should I develop one, explained that they Suddenly the room became animated and all do fear.
Surgical News Page 6 Vol: 12 No:9, 2011 Surgical News Page 7 October 2011 International Development
Weary Dunlop Boonpong Exchange Fellowship
techniques and to understand how Australian International scholarships surgeons work. continue to serve our neighbouring countries as When did you arrive and where have you well as building ties been working? I am training at the Royal Prince Alfred Hospital in Sydney for six between communities months.
What new skills or knowledge have you gained? I have learnt a lot of techniques in Far left: Dr Sitichok Wachirasrisirikul with colleagues at the Royal Prince Alfred Hospital. CABG (conventional and off pump), aortic Left: Dr Jarun Sayasathid out the front of root surgery, thoracic surgery and some parts Westmead hospital; above, with Dr Sylvio of TAVI. I also appreciate the chance to observe Provenzano and Dr Graham Nunn. surgeons and to ask and discuss matters with Professors and Fellows.
How will this impact upon your work at home and the care of your patients? It will absolutely impact on my ideas and Dr Jarun Sayasathid: When did you arrive and where have you welcome, advice and the good care taken of me techniques when I go back to my workplace. Cardiothoracic Surgeon. been working? I had been an observer at Mater throughout the time I have been working here. Why did you wish to come to Children’s Hospital in Brisbane for two months Have particular surgeons in Australia Australia to work and study? I in October and November last year then I have What has been the highlight of your stay so acted as mentors or provided support? wished to come to Australia because been a Cardiothoracic Fellow at the Children’s far? They would be the very nice experiences I Yes, I wish to thank Professor Paul G. Bannon it has many famous cardiac surgeons Hospital at Westmead since April. have had with both the people and the complete who has been very helpful. There are many and advanced technology and medical facilities in the excellent hospitals I’ve worked others, but I also think it is up to the scholar care. I hope to learn and obtain good What new skills or knowledge have you at and the health system. I also have enjoyed to take responsibility for what they wish to experiences to improve my knowledge gained? I have gained a lot of knowledge and the experience of living in this modern and learn. scholarship funded by the College The exchange Fellowship is named after and skills when I return to the hospital skills including operative techniques, how to beautiful country. that commemorates the bond forged Sir Edward “Weary” Dunlop, one of Australia’s in my home country. Thailand does not approach and treat many complex congenital What has been the highlight of your stay A between Australia and Thailand greatest wartime heroes and life-long have many cardiac surgeons, especially heart diseases, what it is like to work in such How important do you think the Weary so far? I could not understand very much in the horrendous construction of the Thai- humanitarian and Mr Boonpong Sirivejbhan, paediatric cardiac surgeons. I finished a health care system and also improving my Dunlop Boonbong Scholarships are for the in the first couple of weeks with the English Burma railway during World War Two has a local man who helped the prisoners of war my cardiothoracic training in 2004 and English language. advancement of surgery in Thailand and language when I started to train, but it has now sponsored the visits of more than 70 Thai forced to build the railway by the Japanese. after that I worked as a Cardiothoracic the development of strong bonds between improved by working with nurses, residents surgeons to Australia to advance their training. Designed to not only boost the skills of Surgeon at Naresuan University Hospital How will this impact upon your work at Australia and Thailand? It’s very difficult for and Fellows. Known as the Weary Dunlop Boonpong the surgeons chosen, but to help them drive in Phitsanulok province. The hospital, home and the care of your patients? When many young surgeons in Thailand to apply to be Exchange Fellowship, the program brings improvements in the Thai health system located in the North of Thailand, served I go back to my country later this year I will use a Fellow and get good experiences in a developed How important do you think the Weary young Fellows of the Royal College of Surgeons upon their return, the Scholarship consists a population of around seven million this learning experience to improve myself, my country like Australia. One of the major problems Dunlop Boonbong Scholarships are for the in Thailand (RCST) to Australia to assist and of a $10,000 stipend with travel costs usually people. Nevertheless, there is no one who team and the health care system. I hope I can for us is the language, because we cannot pass the advancement of surgery in Thailand and observe under the supervision of a local mentor. provided by the RCST. can do paediatric cardiac surgery, but me. better assist many children with congenital examination. Hence, the Weary Dunlop Boonpong the development of strong bonds between While the recipients are not registered for Two recent recipients talk to Surgical News I have many children with heart disease heart diseases in my country. Exchange Scholarships are very important to us Australia and Thailand? I think it is very, the provision of primary care mainly because of the value of the Exchange program. and many of them must be referred for as you give Thai surgeons the opportunity to live very important for young Thai Surgeons to of language requirements, they observe and surgery to a hospital in Bangkok. I can do Have particular surgeons in Australia acted and be Fellows in Australia. We will take these have such experiences and to come to Australia assist elective operations during the day and Dr Sitichok Wachirasrisirikul: adult cardiac operations and only simple as mentors or provided support? Yes, I am wonderful experiences and knowledge to develop for further training and this programme is emergency procedures at night and weekends. Cardiothoracic Surgeon congenital cardiac operations for children. greatly appreciative of Dr Graham Nunn at our careers and health care systems in Thailand. I important because it is very difficult to find All have access to hospital libraries and Why did you wish to come to Australia to Hence, I wished to come to Australia to Mater Children’s Hospital and Dr David Winlaw think the programme definitely helps develop a a scholarship like this because of the English participate in surgical meetings and audits work and study? I wanted the opportunity work and improve my skills in paediatric at Westmead Children’s Hospital. Also I wish to strong bond between our countries. and are encouraged to attend appropriate language proficiency tests imposed on surgeons for training in adult cardiac surgery outside my cardiac surgery. thank everyone at both hospitals for their warm With Karen Murphy lectures relevant to their interests. country in new knowledge, new and different working outside medical universities.
Surgical News Page 8 Vol: 12 No:9, 2011 Surgical News Page 9 October 2011 Audits of Surgical Mortality section EARLY REGISTRATION DEADLINE: Monday 24 October 2011
ANZ Society for Vascular Surgery 2011 SYDNEY COLORECTAL Improving patient care with audits SURGICAL MEETING 2 011 19 November 2011 Now operating nationally, the audits are producing important information for improving practise Hilton Sydney Hotel 488 George Street, Sydney, NSW
Brisbane, 12 - 15 November 2011 ongoing, the dissemination of information to surgeons on fluid management via reports and the symposium has raised awareness across the “Vision and Reality” Professor Guy Maddern Western Australian surgical community. Chair, ANZASM www.vascularconference.com The deteriorating patient (2011) ince the inception of the Audit of Surgical A common issue highlighted in the audit data Mortality in Western Australia more For more information please contact: across many regions has been the detrimental than 10 years ago, there has been interest CONFERENCE ORGANISER Abbey Williams S impact of delay. The critical importance of to develop this program nationally. The audit Katie Fagan Conferences and Events Department early recognition and immediate intervention is now underway in every state and territory in RACS Conferences & Events Management Royal Australasian College of Surgeons is well recognised internationally. Royal Australasian College of Surgeons Australia, and we hope that New Zealand will P: +61 3 9249 1248 T: +61 3 9249 1260 For more information on the above, please C Incorporating follow in the near future. F: +61 3 9276 7431 visit the WAASM website at
This workshop was based on the clinical problems with fluid balance management. National Trauma Research Institute - A department of Alfred Health E: [email protected] trends discovered early in the WAASM dataset While the analysis of this information is Thank you for your ongoing support.
Surgical News Page 10 Vol: 12 No:9, 2011 Surgical News Page 11 October 2011 Fellows abroad
I think Australia does awesome research“ and clinical work which has the potential to benefit … but there Translating Australian research still seems to be an attitude which Fellow Damien Bates moved to the US to pursue his sees great research laid aside when research goals, but believes more can be done here the thesis is written ”
hile Australia is at the “While I greatly enjoyed the within industry and at what point to do this forefront of global work I was doing at the University of during product development. Wscientific and medical Colorado, it was extremely esoteric “These are the issues that I believe could research, we still lag in translating research and I felt that I would never be addressed and answered by bringing that knowledge into practical see translation of any of the science surgeons and scientists together with industry and marketable products and in my lifetime and that’s when representatives, with people who work with the technologies, according to surgeon- lightning struck,” he said. Therapeutic Goods Administration and with turned-industry-leader Mr Damien “Research is my passion, but people in venture capital companies explaining Bates. then it occurred that it didn’t just how they value an idea,” Mr Bates said. Mr Bates, a Fellow of the RACS have to be conducted in the halls “This could be done through forums in Plastic and Reconstructive of academia and what I really enjoy at conferences, through webinars, through Surgery, left a full-time career in about industry is that it forces you specific lectures offered to trainees or interested surgery six years ago to concentrate to be focused. surgeons or by forming networks linking on translational medicine and for the “You can’t just go down any people with specific knowledge to those past three years has worked as the path of interest because you have seeking it.” Chief Medical Officer for research to constantly think whether this Mr Bates also told those attending the group Organogenesis. will help generate a product. It is presentation that another approach could also The biotech company, based the ability to produce a product be to present trainees with information on just south of Boston, US, is growing that generates value – both for our the broad spectrum of employment options rapidly and now employs more patients and for the shareholders of offered by industry, in the belief that having than 500 staff and has successfully the company. more surgeons with clinical, research and developed an FDA-approved bio- “This focus forces you to commercial experience could shrink the gap engineered tissue called Apligraf® be productive and practical in between scholarship and industry. which speeds the healing of diabetic everything you do and I like that.” “Surgeons have a skill-set that is very useful Damien Bates at the College in August. foot and venous leg ulcers. Mr Bates said surgeons and to industry and there are a variety of career During a visit to Melbourne in scholars wishing to commercialise paths within the commercial sector that do not August to meet with representatives PhD would keenly love to see their work have their research needed to understand necessarily involve leaving surgery full-time,” of research and venture capital companies, practical application, but they don’t know how both the pathways of getting a product to he said. Mr Bates was invited to the College to give a to progress it, a problem that could be solved market and the market forces which would “Within the pharmaceutical, biotech presentation on translational medicine and by holding forums on translational medicine determine the likelihood of commercial and device industry, relevant full-time career his experience working in industry to develop at conferences, having industry representatives success. options for surgeons can be found in research Top: Working in products and technologies to improve patient address trainees and surgeons and establishing He said in the US, getting a new medical and development, clinical operations, medical Northern Uganda with a network of mentors and advisers.” MSF in 1995 after care. product or technology onto the market can affairs, pharmacovigilance and marketing. completing the Part 1 “I think Australia does awesome research In his presentation to the RACS meeting, take up to 12 years of research, studies and “Other industry options include Surgical Exam; Working in and clinical work which has the potential to Mr Bates said he first became interested in a clinical trials to receive regulatory approval, a consultancy work, employment within Haiti after the earthquake in early 2010 (on the left). benefit both Australia and the world, but there career pursuing translational medicine after process which can cost up to $US1 billion. regulatory bodies such as the TGA in Australia, still seems to be an attitude in Australia which doing a PhD in developmental biology at the Surgeons and scientists interested in FDA in the US or the EMA in the EU while sees great research laid aside when the thesis is University of Melbourne and the Murdoch translation medicine would benefit from insurance companies and venture capital firms that culture of commercialisation in Australia marketable products for the good of patients written,” he said. Institute which was part-funded through three knowing about the market potential of their also have great need for clinical expertise.” as there has always been in the US. Indeed I everywhere.” “That means Australia does great proof-of- RACS Scholarships. idea, whether it addresses an unmet medical Mr Bates said that in an era of globalisation, think it was at times frowned upon, perhaps Mr Bates said he would be happy to concept work, but that’s where it stops whereas In 2006 he continued his post-doctoral need, whether it could be cost-effectively great ideas and research generated in Australia as part of a tall poppy syndrome or through participate in web-based seminars or lectures in the US it is more commonly seen as just the research at the University of Colorado scaled-up in production, how consistently which had broad practical applications and the belief that only academic science was pure. if the RACS chose to hold a forum, saying that beginning and I believe that if we can get our working with a world leading scientist in they can produce their product, knowing if which could be cost-effectively produced “But given the quality of clinical and despite his life in America, he remained keenly great researchers and scholars and surgeons limb development before leaving for industry the clinical outcome was replicable upon a no longer needed to be sold to off-shore research work now being conducted in interested in the Australian surgical profession closer to industry it would benefit patients, the and working with Baxter Health Care in Bio- variety of patients in a variety of settings, how companies. Australia, it is clear that thinking has passed particularly given the training, academic and innovators and the Australian economy. Surgery first as a Medical Science Liaison and to navigate the intellectual property landscape “We can do it here,” he said. its used-by date and we should now be putting financial support given him throughout his “I think most researchers who undertake a later as a Global Medical Director. and whether to out-license the idea or work “I think in the past that there hasn’t been in great effort to turn that great work into early career.
Surgical News Page 12 Vol: 12 No:9, 2011 Surgical News Page 13 October 2011 Regional news The SURGICAL RESEARCH SOCIETY Change is inevitable, change is constant 48th Is it time for a name change to prevent confusion? ANNUAL MEETING will be held in Adelaide on Friday 11th November 2011 at the Basil Hetzel Institute, Woodville
This meeting is open to those involved in or interested in research, including surgeons, surgical or medical trainees, researchers, scientists and medical students.
JEPSON LECTURER: Professor Wayne Morrison Director of the Bernard O’Brien Institute of Microsurgery and Professor of Surgery and Head of Department of Plastic and Reconstructive Surgery, St Vincent’s Hospital, Melbourne. “Tissue engineering – Regenerative surgery”
ASSOCIATION FOR ACADEMIC SURGERY The recent New Zealand ASM GUEST SPEAKER: was held in Queenstown. Dr Justin Dimick Director of Policy Research at the Center for Healthcare Outcomes & change, a postal ballot took place in 2007. While more than two Australasian in our name has created confusion for many Policy and Assistant Professor of thirds of Fellows supported a change, this majority did not reach years. The mis-spelling and mis-understanding of our name Surgery, University of Michigan the 75 per cent support required under the constitution in place at is widespread both inside and outside the College. Fellows “Measuring surgical outcomes: that time. The new constitution requires a two thirds majority for and government organisations (and even, occasionally, the Rethinking the calculus of quality” votes on changes in the Articles of Association. College itself) write and speak of our organisation as the Like all organisations, the body that represents surgeons in Royal Australian College. Scott Stevenson Australia and New Zealand has undergone many changes. Until As the unifying professional body for surgeons in Chair, New Zealand National Board the 1920s, surgeons were comfortable gathering in the Surgical Australia and New Zealand, I believe our title should list our CALL FOR ABSTRACTS: We are now calling for abstracts; Section of the Australasian Medical Congress of the British Medical two nations explicitly, rather than using a collective noun these must be submitted no later s the seasons come and go, we are reminded our world is Association. I don’t think this body had an acronym. that has a variety of definitions, most extending well beyond than Friday 30th September 2011. constantly changing. In New Zealand, early winter brings As support grew for an independent body to represent surgeons, our collective borders and into large areas of the Pacific. Abstract forms will be available Acelebrations of Matariki – the Maori New Year. In late May, a series of meetings in 1926-1928 debated the issues, including an A name change would align the College with the from the email address below. a small group of stars becomes visible in the north-eastern pre-dawn appropriate title. It seems opinion alternated between “Australasian majority of the bi-national bodies, including many of our Several awards are on offer for sky. Matariki is celebrated at the first new moon after the appearance College of Surgeons” and “College of Surgeons of Australasia”. “CSA” specialist surgical societies. When our anaesthetic colleagues outstanding presentations. of the Pleiades (The Seven Sisters). Like all New Year celebrations, it was settled on initially, perhaps because the alternative would have (supported as a faculty of the RACS from 1952) became a is a time to reflect on the past and prepare for the future. This mid- led to Fellowship being abbreviated to FACS (which was already separate bi-national college in 1992, they settled on Australia CONVENOR: Professor Guy Maddern year celebration is one of the many ways New Zealand differs from used by the American College, since its inception in 1913). Even at and New Zealand in their title. Australia and as we move into spring, I suggest we should revisit that time, it seems the College founders recognised the name may Benjamin Disraeli was correct when he stated “change is PRESIDENT:Professor John McCall changing our College’s name to more accurately describe its bi- cause confusion, as the journal first published in 1928 had the title inevitable, change is constant”. I suggest is it time to initiate national character. “Journal of the College of Surgeons of Australasia which includes New another vote on this matter, I believe it will be a step forward FOR FURTHER INFORMATION In June 2005, Murray Pfeifer, then Chair of the NZ National Zealand”. for the College. We can manage the issues around a name CONTACT: Mrs Sue Pleass Board, wrote an article in Surgical News, presenting the case for Adding Royal to the title in the 1930s required another name change, just as the College has coped with many changes T: +61 8 219 0900 E: [email protected] replacing the term “Australasian” with “Australia and New Zealand”. change and allowed Fellowship to become FRACS (avoiding during its 84-year history of unifying and representing the After Fellowship surveys and a Council vote in support of a name conflict with the American award). However, continuing to use surgeons of our two nations.
Surgical News Page 14 Vol: 12 No:9, 2011 Surgical News Page 15 October 2011 November 2010 College advocacy 17 The Hon. Nicola Roxon, MP Minister for Health and Ageing PO Box 6022 House of Representatives Parliament House Canberra ACT 2600
Via email: [email protected] Smoking kills half its long-term “users, reducing life expectancy Dear Minister ia Plain Tobacco Packaging – Recommendations on legislative criter College by an average of 10 years n all The Royal Australasian College of Physicians (RACP) and the Royal Australasian policy as College of Surgeons (RACS) are united in our support for plain packaging o supports moves for plain packaging ” tobacco products. We applaud the Australian Government plain packaging a demonstrated commitment to health promotion and disease prevention. and
The Australian Government would become a world leader in tobacco controlure mortality cancerROYAL prevention AUSTRALASIAN by mandating plainOLLEGE packaging OF of tobacco products. Smoking C SURGEONS remains one of the leading causes of preventable disease and premat SUBMISSION TO THE The College continues its long tradition of health and safety advocacy among Australians. It is responsibleDEPARTMENT for over OF 7 perHEALTH cent of theAND total A GEINGburden of disease in Australia, and it is expected that the Australian death toll caused by smoking will pass the million mark J UNEwithin20 the1 next1 decade. ment, ng The move towards a generic package would remove another form of advertise eradicating brand identity through the removal of logos, colours and eye-catchi PUBLIC CONSULTATION ON College of Physicians, Professor John Kolbe, In its submission to the consultation detail. PLAIN PACKAGING OF TOBACCO PRODUCTS tobacco By removing the marketing tools that can be used on cigarette and other wrote to the Federal Health Minister late last process, the College rejected the argument The Royal Australasian College of Surgeons welcomes the opportunity to comment on product packaging, and reinforcing the idea that tobacco is notthe an exposureordinary consumer year to applaud the Government on its plain advanced by the tobacco industry that there draft of the Tobacco Plain Packagingitem, the Bill lure 2011 of tobacco. to new users will be reduced, helping to discourage a new generation from taking up this deadly habit. Health packaging proposals. was no evidence plain packaging would reduce Formed in 1927, the College is a not-for-profit organisation training surgeons and maintaining surgicalg and standards in Australia and NewWe Zealand. note estimates A Fellowship from Professor based organisation, Rob Moodie ofthe the College National is Preventativecommitted to In the letter to the Honourable Nicola the incidence of smoking as an absurdity. ensuring the highest standard ofTaskforce safe and that comprehensive plain packaging surgical might resultcare forin 100,000 the community fewer adults we servesmokin through excellence in surgical education,25,000 fewer training, children profe takingssional up this development appallingly harmful and support. habit. Roxon, Mr Civil and Professor Kolbe wrote: It said no evidence existed because such an this commitment the College strives to take informed and principled positions on issues of publicAs part health. of initiative had never been tried before. Fax: +61 2 9252 3310 “By removing the marketing tools that can be alia Tel: +61 2 9256 5444 The College is on the record as supporting the plain packaging of all tobacco Web: www.racp.edu.au products sold in Australia 45 Macquarie Street, Sydney NSW 2000, Austr The RACS lobbied for road safety measures and has also called for a review of the Tobacco Advertising Email: [email protected] Prohibition Act used on cigarette and other tobacco product ACN 000 039 047 ABN 90 to270 343take 237 place every three years. packaging and reinforcing the idea that tobacco that are now commonplace around the world is not an ordinary consumer item, the lure of and has urged the Federal Government, the Smoking kills more than 15,000 Australians each year i. Smoking kills half its long tobacco to new users will be reduced, helping Opposition, Greens and Independents to -term users, reducing life expectancy by an average of 10 years.ii to discourage a new generation from taking up support the legislation and allow Australia to It is the known or probable cause of more than 25 diseases, including coronary heart disease, stroke and a range of cancers. this deadly habit. lead the world on this issue, one of the most Accordingly, the College supports any initiative which might reduce the incidence of smoking, “In light of the now-widespread restrictions important public health challenges of the age. with its profoundly harmful effects on public health. on advertising in the mass media and outdoors, With Karen Murphy The College rejects the self-interested and often self-contradictory arguments advanced against plain packaging has become the key promotional packaging by the tobacco lobby. Moreover, the tone of these arguments suggests that the tobacco vehicle for the tobacco industry to encourage industry fears plain packaging may indeed reduce the uptake of smoking by young Australians. smokers and potential smokers in purchasing Product packaging is an integral part of the marketing strategy for tobacco companies and is a vehicle for creating significant point iii -of-sale presence. British American Tobacco and Philip M orris have tobacco products. 2011 Victorian Annual Generalpredicted that in the future, pack designs alone will drive brand imagery. iv “(As such) we note estimates from Professor The College notes estimates made by Professor Rob Moodie of the National Preventative Health Taskforce that plain packaging might result in 100,000 fewer adults smoking and 25,000 fewer children Rob Moodie of the National Preventative Scientific & Fellowship Meetingtaking up this appallingly harmful habit.
Health Taskforce that plain packaging might Professor Moodie is supported by Friday 21 – Sunday 23 October 2011 Australia’s leading healthcare experts , who have called on all political result in 100,000 fewer adults smoking and Quality Inn Gateway, Wangaratta, Victoria.parties to support plain packaging for all tobacco products. 25,000 fewer children taking up this appallingly The tobacco companies’ insistence that there is no evidence plain packaging will reduce the incidence of smoking is of course an absurdity – no evidence exists because this initiative has never been tried harmful habit. before. “The Australian Government would Under the theme “Outreach Surgery, The ThirdAustralia pioneered road safety measures that are now commonplace around the developed world; we become a world leader in tobacco control should now lead the world on this issue, one of the most important public health challenges of our World: At Home” an exciting program has been age. and cancer prevention by mandating plain i Established since 1977 developed that will cover the broad depth ofBegg S, Vos T, Barker B, Stevenson C, Stanley L and Lopez A, The burden of disease and injury in Australia 2003. PHE 82. packaging of tobacco products and we applaud Canberra: Australian Institute of Health and Welfare, 2007 ii Doll R, Peto R, Boreham J, and Sutherland I (2004) BMJ 328(7455):1519 … the policy as a demonstrated commitment surgical specialties whilst bringing Fellowsiii Wakefield and M, Morley C, Horan JK, Cummings KM (2002). The cigarette pack as image: new evidence from tobacco industry documents. Tobacco Control, 11(1):Suppl 1:I73-80 to health promotion and disease prevention.” Trainees together on a variety of issues thativ Cummings KM, Morley CP, Horan JK, Steger C, Leavell NR (2002). Marketing to America’s youth: evidence from corporate n line with its long and successful history may significantly reduce the uptake of smoking documents. Tobacco Control 11 Suppl 1:I5-17 as an advocate for public health reform, by young people. Specifically, the College called on the involve the surgical community today. Ithe College has strongly endorsed the If the legislation is passed, Australia will Government to remove all colours, brand Federal Government’s plans to introduce plain be the first country in the world to implement imagery, corporate logos and trademarks, Co-Convening the AGSFM are Francis Miller and packaging of tobacco products. such measures to reduce brand recognition permitting manufacturers to only print Peter Thomas. In its submission to the public consultation and point-of-sales presence on all tobacco the brand name in a mandated size, font process earlier this year, the RACS urged products. and place in addition to required health Additional perspective to the presentations and Specialist Consultants in permanent the Federal Government to proceed with its Smoking kills more than 15,000 Australians warnings and other legally mandated panel discussions will be provided by a number of and temporary medical staff placements. legislative plans to enforce plain packaging each year and is the known or probable cause product information. invited speakers including Leslie Bolitho, Andrew It believes that the standardised appearance Contact Carol Sheehan and also called for a review of the Tobacco of more than 25 diseases including coronary Cochrane, Michael Dobson, Glenn Guest, Ollapallil of all tobacco products would greatly reduce Advertising Prohibition Act to take place every heart disease, stroke and a range of cancers. Jacob and Edmund Poliness. Telephone 03 9429 6363 three years. Smoking kills half its long-term users, reducing the status and appeal of tobacco and said Facsimile 03 9596 4336 It also rejected the self-interested and life expectancy by an average of 10 years. that forcing all tobacco products to be sold in Email [email protected] often self-contradictory arguments advanced At the start of the College’s public one colour would remove the chance for the to register please phone 03 9276 7406 or against plain packaging by the tobacco lobby campaign in support of the legislation, the tobacco industry to suggest some tobacco was Website www.csmedical.com.au stating that the tone of the arguments clearly President of the RACS, Mr Ian Civil, along “light” which created a false sense of reduced email [email protected] Address 22 Erin St Richmond 3121 suggested industry fears that such measures with the President of the Royal Australasian risk.
Surgical News Page 16 Vol: 12 No:9, 2011 Surgical News Page 17 October 2011 Law commentary
Open Disclosure As part of the response by governments, both Federal and State, to the medical indemnity Complaints – and how to avoid them crises, legislation has been introduced into most states to permit “Open Disclosure”. That is, the legislation now permits doctors to have How you manage a a frank discussion with their patients, without patient can make all there being adverse legal implications. the difference The legislation fosters the concept of openness and a frank discussion with patients after an adverse outcome (whether or not there has been negligence). There can be an open acknowledgment of an adverse outcome, and even an apology (to express regret for the fact that the patient has not had an optimal outcome). It may not be ‘trendy’ in Australia to give an apology. However, in the case of adverse Annual Scientific Congress events, an apology may well be a critical factor as to whether a patient sues a doctor or not. Coordinator Legislation in most states now allows doctors to deal with adverse outcomes, without there being any admission of liability, by: The current Annual Scientific Congress Coordinator will – expressing regret or apologising for an retire from the position following adverse outcome; the 2012 ASC in Kuala Lumpur (May 2012). – expressing sorrow or sympathy; – reducing fees; or waiving fees entirely. The College wishes to appoint a Fellow to the role Such events will also not constitute before the current Coordinator an admission of professional misconduct, retires to ensure an adequate hand-over period. or otherwise expose the doctors to civil liability for carelessness, incompetence, or The Coordinator is based in the Conferences and unsatisfactory performance. Events department at the College in Melbourne. The role is remunerated at three sessions per week It’s important to be aware of the following issues: (plus superannuation) and is supported by a full time The concentration of complaints to communicate with their patients after an – It is critical to ensure that appropriate staff member of staff. The Coordinator works closely with the particular doctors mirrored the finding that 1 per adverse event will substantially influence are involved in communication with the members of the Conferences and Events department, cent of the medical workforce in private practice whether the patient considers making a patient. the Executive and Scientific committees convening against whom complaints were made accounted formal claim or even suing their doctor for – Those involved in providing information to each Annual Scientific Congress and the Chair of the for nearly 20 per cent of the complaints. negligence. patients should have adequate training and ASC Planning and Review committee; the Coordinator Michael Gorton To some extent these conclusions will The doctor who is attentive, responsive be fully informed about the issues involved College Solicitor is an ex officio member of each of these bodies. reassure doctors that sound practice should and sympathetic after an adverse outcome in open disclosure. recent study in the Medical Journal ensure that complaints against them will (whether or not negligent) is less likely to be – Open disclosure, of necessity, involves of Australia (MJA, Bismark et al, July be avoided. There is no suggestion of any sued than the doctor who is dismissive, distant medico-legal issues. It is about providing A2011) identified that in the decade to high levels of frivolous complaints and that, or less empathetic. appropriate information to consumers, The Position Description and Person Specification 2010, complaints occurred at the rate of one in to some extent, patients do not complain It is common knowledge that there without necessarily an admission of are available on the College website, under College five doctors in Victoria in private practice, for lightly. are doctors who achieve less than optimal liability. Resources, Positions Vacant/College Positions. complaints made by a patient to the Health Nonetheless, other studies have confirmed outcomes, but whose patients would never This approach should give confidence to Alternatively, an email may be sent to careers@ Services Commissioner in Victoria. that complaints can be avoided if doctors adopt think of taking action against them. That is doctors and medical administrators to deal surgeons.org. Potential applicants may contact the More reassuringly, the study also identified an appropriate strategy to complaints when they because their patients “love them” as a result of with adverse outcomes (whether negligence or current Coordinator ([email protected]) that there was a significant concentration are made, or potential claims when they arise. the attention, empathy and friendly treatment not) in a caring and humane way. It is, after all, or the Director of External Affairs, Daliah Moss (daliah. of complaints to a small group of doctors, Studies, both in Australia and overseas, they receive. human nature to be able to express regret and [email protected]) for information regarding the role. who obviously had a significant number of have confirmed that one of the prime reasons There are certainly occasions when sympathy where a patient has had an adverse multiple complaints. The study identified that for patients seeking to make claims against doctors, despite their best efforts, and with no outcome to treatment or procedure, without The closing date for applications (reference 372) is surgery and psychiatry were significantly over- their doctor after an adverse outcome is the suggestion of legal negligence, nonetheless face such concern being considered an admission 28 October 2011. The start date is negotiable but it is represented in the ‘frequent flyer’ group and, manner in which the doctor dealt with them claims from patients because of the perception of legal liability. envisaged that the new Coordinator would begin the role overseas trained doctors were significantly and communicated with them. of less than optimal outcomes or the perception To do so may also reduce the risk of two months before the 2012 Annual Scientific Congress. under-represented in that group. In other words, the way doctors of poor care. complaints, claims and litigation.
Surgical News Page 18 Vol: 12 No:9, 2011 Surgical News Page 19 October 2011 Younger fellows Professional Development workshops Professional development is important as it supports your life- long learning. The activities offered by the College are tailored to the needs of surgeons. They enable you to acquire new skills and knowledge while providing an opportunity for reflection about how you can apply them in today’s dynamic world.
Younger Fellows Forum – >Writing Medico Legal Reports NEW-redesigned evening program* 19 October, Brisbane This workshop can help improve skills in preparing medico legal reports that comply with court rules. It is an opportunity to gain an understanding of the legalities of expert reports and the lawyer/expert relationship. Learn about report writing from the advocate Kuala Lumpur and surgical perspectives.
>Polishing Presentation Skills November date to be confirmed, Melbourne 2011 DATES: You can only expect the best from the Younger Fellows Forum2012 in 2012 This whole day workshop helps to advance your presentation skills and provide you OCT - NOV 2011 with a step-by-step presentation planning process and practical tips for delivering your message. It is equally applicable to presentation sessions in hospitals, conferences and international meetings. NSW 20-22 October resources to indigenous Australians and Over the two and a half days, I hope Forum Seema Bagia >Sustaining Your Business Surgical Teachers Course, Younger Fellows Forum Convenor 2012 developing countries. I am sure we will learn a delegates can explore the issues that relate to Sydney 18-20 November, Brisbane lot from Sam’s experiences. keeping a surgeon interested and engaged in 25-27 November This two-and-a-half day workshop provides the foundation for developing business ’d like to take this opportunity to invite all The other area we hope to explore is the the public sector. There will also be a lively AOA/RACS combined Medico plans and explores the various approaches to sustaining business growth and Legal Section meeting Younger Fellows to submit an application balance between private and public practice. debate about what should be done to facilitate performance. Participants can learn the principles of sound financial management Ito attend the Younger Fellows Forum for Many surgeons enter the workforce with an aim the public/private balance by administration in order to understand effective budgetary management and be able to produce a QLD 2012. We are still exploring venues, but are to have a practice which straddles the public in both the public and private systems as well budgetary plan. It addresses both perspectives of health practice management and the 19 October currently looking at a lovely waterside location, and private sectors. Often this practice becomes as the training issues within the public and broader health service delivery environment. Writing Medico Legal about an hour outside of Kuala Lumpur. polarised over time, due to the difficulties in private sector. Furthermore, we will explore Reports NEW – redesigned >Non-Technical Skills for Surgeons (NOTSS) NEW evening program We hope to explore a number of themes maintaining commitments in both sectors. whether or not this is in fact an effective model, 11 November, Perth; 18 November, Melbourne 18-20 November at this forum. The first is “Professionalism: This is partly a function of increasing work i.e. to have surgeons who work in both the This new workshop focuses on the non- technical skills which underpin safer operative Sustaining Your Business What this means for a surgeon”. The health load, but is also the result of organisational public and private system. surgery. It explores a behaviour rating system developed by the Royal College of Surgeons service environment is changing from difficulties which could perhaps be improved The Forum is a unique opportunity to of Edinburgh which can help you improve your performance in the operating theatre VIC single practitioner practices to a more within the public and private sector. provide recommendations to RACS Council in relation to situational awareness, communication, decision making and leadership/ 21 October corporate environment so it is timely to We know that the UK has a predominantly about strategic issues and challenges faced by teamwork. Each of these categories is broken down into elements or behavioural markers SAT SET, Wangaratta (Victorian AGS Meeting) explore the external and internal challenges public-based system and the US a more both private and public hospital systems in the that can be used to identify a superior or substandard performance. Through a series 21 October to professionalism from commercialism, privatised system. The Australian system has in next 10 years. The meeting is really what you, of interactive exercises you will better understand how these markers can be used to reflect on your own performance and that of the surgeons you work with. Target group Keeping Trainees on Track consumerism and the increasing involvement some ways been a balance between these two the Fellows, bring to it. I hope that these topics - Fellows, International Medical Graduates and senior SET trainees. (KToT), Wangaratta of technology industrialisation. John Quinn, systems. Having worked in both health systems, catch your interest and can’t wait to see you all (Vic AGS Meeting) NEW 17 November the College’s External Director Surgical Affairs I have come to appreciate our system and hope in Malaysia in 2012. >Acute Neurotrauma Management (Rural) (Aust) will offer an interactive session so that that we can preserve, and perhaps improve, Acute Neurotrauma 17 November, Melbourne Management (Rural), we can explore issues around professionalism it. We ideally want a public system that also This new workshop focuses on gaining the skills to deal with cases of neurotrauma in Melbourne and younger surgeons. allows and supports surgeons working in the the rural setting, where the urgency of a case or difficulties in transporting a patient 18 November Sam Prince, a doctor who has completed private sector as it is important to keep talented demand rapid surgically-applied relief of pressure on the brain. Participants will Non-Technical Skills for some interesting work in aid projects, will and experienced surgeons contributing to the develop a capacity to accurately evaluate whether on-the-spot treatment is required. Surgeons (NOTSS), Melbourne NEW discuss the second theme: ‘Young Leadership public sector. There are some health systems The workshop teaches procedures (craniectomy, craniotomy, tap-shunt and a burr-hole Tbc, November and Challenges’. Sam is not your typical doctor in which young surgeons start in the public procedure with Hudson Brace) through demonstration and practice on human cadaveric material. Target group – Surgeons as well as advanced Trainees and International Polishing Presentation Skills, or businessman. His Zambrero Mexican food system and, by their early forties, ‘graduate’ Applications are open from Medical Graduates (IMG) working in rural hospitals. Melbourne chain helps to fund a “plate for plate” project to the private sector, never to look back at the 1 September to 1 December 2011. and he has entrepreneurial mining interests. public sector. This is a loss of experience and For more information and a Forum WA He uses business ventures to fund projects talent for the public sector and leads to a two- registration form please email Please contact the Professional Development Department on +61 3 9249 1106, 11 November through the E-magine Foundation, his not-for- tiered system of healthcare, which is not what I [email protected] by email [email protected] or visit the website at www.surgeons.org Non-Technical Skills for Surgeons profit group that delivers health and education would hope for in Australia. or call +61 3 9249 1122. - select Fellows then click on Professional Development. (NOTSS), Perth NEW
Surgical News Page 20 Vol: 12 No:9, 2011 Surgical News Page 21 October 2011 ANZGOSA Scientific Conveners College & Industry Sponsored Visitors
Bariatric Surgery Dr John Jorgensen Dr Raul J Rosenthal USA Mr Ken Loi Dr Randy Seeley USA Call for Abstracts Professor Wei-Jei Lee Taiwan AustBreastr aSurgerylian and New ZealDrand Kylie Snook Dr Eisuke Fukuma Japan Dr Patsy Soon Dr Armando Giuliano USA Mr Douglas Macmillan UK GBurnastric Surgery and OProfessoresophageal Peter Maitz Professor S Paulurgical van Zuijlen Netherlands Cardiothoracic Surgery Mr Paul Bannon Professor Scott LeMaire USA Associate Professor Brian McCaughan Professor Alec Patterson USA A ssociation ADr uditTristan Yan Dr Valerie Rusch USA Colorectal Surgery Mr Chris Byrne Professor Anders Mellgren USA A tool for members of the ANZGOSA Mr Ian Lindsey UK Professor Arun Rojanasakul Thailand Dr Parvez Sheik India RACS ASC 2012 Professor Samuel Tay India THE MAKING OF A SURGEON Craniomaxillofacial Surgery Mr Mark Moore Associate Professor Oleh Antonyshyn USA Dr Eduardo Rodriguez USA Endocrine Surgery Dr Mark Sywak Professor Jonathan Serpell Australia Professor Gerard Doherty USA Royal Australasian College of Surgeons General Surgery Professor Michael Cox Mr Simon Paterson-Brown UK Dr Ernest (Gene) Moore USA Associate Professor Phillip Carson Australia st Associate Professor Mark Smithers, 81 Annual Scientific Congress PresidentHead of ANZGOSA& Neck Surgery and Interim Chair of Mr Jonathan Clark Dr Douglas Chepeha USA the Audit Committee Professor Jeffrey Myers USA Dr Kee Chee Soo Singapore Kuala Lumpur Convention Centre, Malaysia he Australian and New Zealand Professor Dr Abdullah Sani Singapore Gastric and Oesophageal Surgical Dr N G Iyer Singapore Association (ANZGOSA) Audit 6 – 10 May 2012 THPB & Upper GI Surgery Mr Arthur Richardson Professor Diane Simeone USA was officially launched in August 2010. The auditInternational is a self-assessment Forum tool for ANZGOSADr Michael Hollands Dr Charles Mock USA members,Medicolegal collecting data on patients withDr Neil Berry Dr Mark Sidhom Australia oesophago-gastric cancer or gastrointestinal Mr Peter Semmler Australia Web: asc.surgeons.org stromalMilitary tumour Surgery (GIST). Collated bi-nationalMr Brett Courtenay Associate Professor Philip Iau Singapore data will also form an accurate picture of upperMr Anthony Chambers gastrointestinalNeurosurgery cancer treatment in AustraliaMr Andrew Chin Kam Professor Katsumo Tomita Japan and New Zealand for research and assessment Dr Larry Khoo USA purposes. The precise details of any research are Dr Kornelis Poelstra USA yet toPaediatric be determined, Surgery but will concentrate onDr Wee Chia Dr Anne John Malaysia the surgical treatment of patients in this area. Dato’ Dr Zakaria Zahari Malaysia ThePain ANZGOSA Medicine Audit is managed by theMr Marksurgeons Dexter while restricting access toAssociate only those Professor RajFurther Sundaraj plans for theAustralia audit include the Morbidity Audits department of the College hospitals where they have permissionProfessor (e.g. Christophera ability Winfree to export personalUSA data to analyse in and isPlastic open & to Reconstructive all members of Surgery the ANZGOSA. Dr Anandpublic Ramakrishnan hospital data manager willMr onlyDavid see Elliot external software such asUK Microsoft Excel, In 2011, the ANZGOSA Audit was declared patients from that hospital). Data managersProfessor are Susan Mackinnonas well as the addition ofUSA a reporting suite to a Quality Assurance Activity under the issued with their own username andDr Mariaaccount Siemionow the online portal. The USAreporting suite will CommonwealthRural Surgery Health Insurance (QualityMr Grahamwhich Stewart can be disabled if an employee leaves allow for comparison of individual surgical AssuranceSenior SurgeonsConfidentiality) AmendmentMr Robert an organisation.Rae This prevents theMr needAnthony for Jackson performance against the bi-nationalAustralia aggregate Act (1992) in Australia and a protected password sharing and the inherent security according to pre-determined areas of interest Surgical Education Dr Mary Langcake Professor Rhona Flin UK quality assurance activity under the Health risk this involves. for ANZGOSA. PractitionersSurgical HistoryCompetence Assurance ActMr Philip SharpData collected includes Professorpatient Irvin ModlinActive participationUSA in the audit 2003Surgical in New Oncology Zealand. The purpose of thisMr Warrendemographics, Hargreaves pre-treatment Mrdiagnosis Andrew Hayes demonstrates both an appreciationUK of the legislation is to ensure that information that and staging, surgical details, complicationsProfessor Khee Cheimportance Soo of quality surgicalSingapore care in this area becomesTrainees available Association as a result of the activityDr Sally(intra-operative Ng and post-operative) and and a commitment to achieving such quality. can notTransplantation be disclosed, Surgery other than for generalMr Davidhistopathology. Joseph Dr Kim Olthoff USA reporting purposes (i.e. aggregated results in The latest feature being developed for the Trauma Surgery Professor Zsolt Balogh Professor Hans-Christoph>For further Pape informationGermany on the data annual reports or research papers). audit is an institutional upload program. An collected or on how to become part of ANZGOSAVascular Surgery surgeons submit data to theMr Raviupload Huilgol program allows institutionsDr Jon with Matsumura a USA Professor Nicholasthis Cheshire initiative, see the ANZGOSAUK Audit audit through an online portal via secure large case volume and sufficient commonality webpage: www.surgeons.org/anzgosa; or Women in Surgery Dr Cindy Mak log-in. Surgeons can request that a separate of fields to have their data directly uploaded contact the audit helpdesk at data manager account be linked to theirs into the system each year, rather than having [email protected] list correct as at August 2011 so that their data can be entered by a third to re-enter data manually. This program is still or +61 8 8219 0918. party (e.g. hospital data manager, receptionist, under development and will be available to >For further information on the registrar). Data managerRoyal access Australasian allows data Collegeusers once of Surgeons a technology Gardens solution has T:been +61 fully 3 9276 7406ANZGOSA generally, see the ANZGOSA managers to log-in andCollege enter data of Surgeons for multiple 250-290developed Spring and tested.Street F: +61 3 9276 7431website: www.anzgosa.org Convocation and Workshops: Sunday 6 May ABN 29 004 167 766 East Melbourne, Victoria, 3002 E: [email protected] Australia W: asc.surgeons.org Scientific Sessions: Monday 7 – Thursday 10 May Royal Australasian College of Surgeons Surgical News Page 22 Vol: 12 No:9, 2011 Keep abreast of program developments on the conference website: asc.surgeons.org RACS ASC 2012 THE MAKING OF A SURGEON 6 – 10 May 2012 Kuala Lumpur Convention Centre, Malaysia
13. Please ensure that you indicate on the Abstract Kuala Lumpur ASC 2012 Program Overview (indicative only) Submission of Abstracts for Submission site whether you wish to be considered for: Research and Invited Papers Section Prize Sunday 6 May Monday 7 May Tuesday 8 May Wednesday 9 May Thursday 10 May Abstract submission will be entirely by electronic means. Bariatric Surgery (Trainee) $500 Breakfast session Masterclasses Masterclasses Masterclasses Masterclasses This is accessed from the Annual Scientific Congress 7.00am – 8.20am Breast Surgery (Trainee) $500 website ‘ asc.surgeons.org ’ and clicking on Abstract Session 1 Submission. Burns Surgery (Trainee) $500 Plenary Scientific Sessions Scientific Sessions Scientific Sessions 8.30am – 10.00am Cardiothoracic Surgery (Trainee) $500 Several points require emphasis: 10.00am – 10.30am Morning Tea Morning Tea Morning Tea Morning Tea Craniomaxillofacial Surgery (Trainee) $500 1. Authors of research papers who wish to have their Session 2 abstracts considered for inclusion in the scientific Colorectal Surgery Scientific Sessions Plenary Plenary Plenary $500 10.30am – 12 noon programs at the Annual Scientific Congress must (Mark Killingback Prize for Young Fellows & Trainees) Pre-Congress submit their abstract electronically via the Congress Endocrine Surgery (Tom Reeve Prize - Trainee) $500 12 noon – 12.30pm Keynote Lectures Keynote Lectures President’s Lecture Keynote Lectures Workshop website having regard to the closing dates in the General Surgery (Trainee) $500 Program Call for Abstracts, the Provisional Program and on 12.30pm – 1.30pm Lunch Lunch Lunch Lunch Head & Neck Surgery (Trainee) $500 the Abstract submission site. Abstracts submitted Named Lectures Named Lectures Named Lectures after the closing date will not be considered. Hepatobiliary Surgery (Trainee) $500 1.30pm – 2.00pm Keynote Lectures and and and 2. The title should be brief and explicit. Neurosurgery (Trainee) $500 Keynote Lectures Keynote Lectures Keynote Lectures Paediatric Surgery (Trainee) $500 Session 3 3. Research papers should follow the format: Scientific Sessions Scientific Sessions Scientific Sessions Scientific Sessions 2.00pm – 3.30pm Purpose, Methodology, Results, Conclusion. Plastic & Reconstructive Surgery (Trainee) $500 4. Non-scientific papers, eg. Education, History, Military, Surgical Education (Not exclusively for Trainees) $500 3.30pm – 4.00pm Afternoon Tea Afternoon Tea Afternoon Tea Afternoon Tea Medicolegal, may understandably depart from the Surgical History (Trainee) $500 Session 4 4.30pm above. Scientific Sessions Scientific Sessions Scientific Sessions Scientific Sessions Surgical Oncology (Trainee) $500 4.00pm – 5.30pm Convocation Ceremony 5. Excluding title, authors (full given first name and family Trauma Surgery (Trainee) $500 Sectional Dinners name) and institution, the abstract must not exceed and Younger Upper GI Surgery (Trainee) $500 6.00pm 1750 characters and spaces (approximately 250 words). 7.00pm – 11.00pm Sectional Dinners Congress Dinner Welcome Cocktail Fellows & Trainees In MS Word, this count can be determined from the Vascular Surgery (Trainee) $500 Reception Dinner ‘Review’ menu. Any references must be included in this allowance. If you exceed this limit, the excess text will The submitting author of an abstract will ALWAYS receive NOT appear in the abstract book. email confirmation of receipt of the abstract into the submission site. If you do not receive a confirmation email Research Paper Specialties ASC Executive 6. Abbreviations should be used only for common terms. within 24 hours it may mean the abstract has not been Convener Mr Philip Truskett For uncommon terms, the abbreviation should be given Authors of research papers and posters are invited to submit abstracts for received. In this circumstance, please email Binh Nguyen in brackets after the first full use of the word. consideration and inclusion in the Scientific Program in the following areas: Scientific Convener Mr Raffi Qasabian at the Royal Australasian College of Surgeons to determine Member of Executive Mr David Storey 7. Presentations (slide and video) will only have electronic why a confirmatory email has not been received Bariatric Surgery Paediatric Surgery Member of Executive Mr John Cartmill PowerPoint support. Audio visual instructions will be ( [email protected] ). Breast Surgery Pain Medicine available in the Congress Provisional Program and in Burns Surgery Plastic & Reconstructive Surgery Member of Executive Mr Joseph Lizzio correspondence sent to all successful authors. Important Information Cardiothoracic Surgery Rural Surgery ASC Scientific Coordinator Mr Campbell Miles TO SUBMIT AN ABSTRACT GO TO ‘ asc.surgeons.org ’ ASC Manager Ms Lindy Moffat 8. Authors submitting research papers have a choice Colorectal Surgery Senior Surgeons Group AND CLICK ON ‘ABSTRACT SUBMISSION’. of two specialties under which their abstract can be Craniomaxillofacial Surgery Surgical Education ASC Executive Officer Ms Katie Fagan considered. Submissions are invited to any of the THE CLOSING DATE FOR ALL SCIENTIFIC PAPER Endocrine Surgery Surgical History NSW Regional Manager Ms Beverley Lindley specialties or special interest groups participating ABSTRACT SUBMISSION IS 23 JANUARY 2012. General Surgery Surgical Oncology in the program except cross-discipline. PLEASE NOTE THAT PAPER OR FACSIMILE COPIES Head & Neck Surgery Transplantation Surgery 9. A 50 word CV is required from each presenter to WILL NOT BE ACCEPTED, NOR WILL ABSTRACTS Hepatobiliary Surgery Trauma Surgery facilitate their introduction by the Chair. BE SUBMITTED BY COLLEGE STAFF ON BEHALF International Forum Upper GI Surgery For further information contact: OF AUTHORS. 10. The timing (presentation and discussion) of all papers Medico-Legal Vascular Surgery [email protected] is at the discretion of the Convener of each Section. If there are any difficulties regarding this process, please Military Surgery Women in Surgery Notification of the timing of presentations will appear contact Binh Nguyen, for assistance on +61 3 9249 1279 Neurosurgery in correspondence sent to all successful authors. or email ( [email protected] ). 11. Tables, diagrams, graphs, etc CANNOT be accepted Scientific Posters in the abstract submission. This is due to the limitations All posters will be presented electronically during the of the computer software program. Congress and will be available for viewing on computer 12. Authors must be registrants at the meeting for their screens at the venue. Posters will be placed on the abstract to appear in the publications, on the website Virtual Congress in addition to the abstract. or the Virtual Congress. Important Dates Abstract Submission opens October 2011 Closure of Abstracts 23 January 2012 Closure of Early Registration 13 March 2012 Library report Scientific Conveners College & Industry Sponsored Visitors
Bariatric Surgery Dr John Jorgensen Dr Raul J Rosenthal USA Mr Ken Loi Dr Randy Seeley USA Call for Abstracts Professor Wei-Jei Lee Taiwan Breast Surgery Dr Kylie Snook Dr Eisuke Fukuma Japan Dr Patsy Soon Dr Armando Giuliano USA Mr Douglas Macmillan UK Burn Surgery Professor Peter Maitz Professor Paul van Zuijlen Netherlands Accessing a growing Library Cardiothoracic Surgery Mr Paul Bannon Professor Scott LeMaire USA Associate Professor Brian McCaughan Professor Alec Patterson USA New products make the online library easier to use Dr Tristan Yan Dr Valerie Rusch USA Colorectal Surgery Mr Chris Byrne Professor Anders Mellgren USA Mr Ian Lindsey UK Professor Arun Rojanasakul Thailand Dr Parvez Sheik India RACS ASC 2012 Professor Samuel Tay India THE MAKING OF A SURGEON Craniomaxillofacial Surgery Mr Mark Moore Associate Professor Oleh Antonyshyn USA Dr Eduardo Rodriguez USA manually. This provides a selective easy to use listing, limited to journals and e-books likely to The challenge for Endocrine Surgery Dr Mark Sywak Professor Jonathan Serpell Australia be highly relevant to that specialty. the“ College continues Professor Gerard Doherty USA CathyRoyal Ferguson AustralasianThis approach College provides both ofto be Surgeons to provide a user General Surgery Professor Michael Cox Mr Simon Paterson-Brown UK comprehensive and very specific access for Dr Ernest (Gene) Moore USA Chair, Fellowship Services st Fellows and Trainees. friendly interface along Associate Professor Phillip Carson Australia 81 Annual Scientific Congress Head & Neck Surgery Mr Jonathan Clark Dr Douglas Chepeha USA n the past few years, the College Online with the opportunity Professor Jeffrey Myers USA Library has grown exponentially in both ANZ Journal of Surgery to discover everything Dr Kee Chee Soo Singapore Isubscription packages and usage. Like The KualaANZ Journal Lumpur of Surgery can Conventionbe accessed Centre, Malaysia Professor Dr Abdullah Sani Singapore other similar large scale libraries, the challenge from the Online Library main page via several the Library holds Dr N G Iyer Singapore for the College continues to be to provide a user pathways. There are two specific links, one at 6 – 10 May 2012” HPB & Upper GI Surgery Mr Arthur Richardson Professor Diane Simeone USA friendly interface along with the opportunity the top of the table of contents, at the top of International Forum Dr Michael Hollands Dr Charles Mock USA to discover everything the Library holds that the page, and a second in the area of the page Until recently, external users of the Library is relevant to the individual user. The following called Online resources listed alphabetically. would sometimes come up against the Medicolegal Dr Neil Berry Dr Mark Sidhom Australia requirement for an EZ Proxy password which Mr Peter Semmler Australia paragraphs explain some of the recent changes The journal is also in the comprehensive Web: asc.surgeons.org and improvements. A-Z list. was provided via two step message/action. The Military Surgery Mr Brett Courtenay Associate Professor Philip Iau Singapore extra password was needed only once in each Mr Anthony Chambers A-Z listing of E-Journals Summon search facility session, in the first full text access attempt, and Neurosurgery Mr Andrew Chin Kam Professor Katsumo Tomita Japan Summon is a powerful search tool that is linked not with any consequent clicks. In the past, Dr Larry Khoo USA and E-Books most users who encountered this have not Dr Kornelis Poelstra USA The Library is using a new commercial to the A-Z product (i.e. it is a comprehensive product for the Journals A-Z listing. This database of this library’s full text content). found it too difficult. Paediatric Surgery Dr Wee Chia Dr Anne John Malaysia The request for extra login became much Dato’ Dr Zakaria Zahari Malaysia replaces the manually maintained listing, Summon is designed to retrieve the full text of which had become impractical because of all articles and/or book references relevant to more common, for some users, with the Pain Medicine Mr Mark Dexter Associate Professor Raj Sundaraj Australia the search keywords. In an optimal response introduction of the added layer of Summon, Professor Christopher Winfree USA the expansion in the Library’s subscriptions. There are now thousands of journal titles the full text links will go directly to the full to the point where the user experience was Plastic & Reconstructive Surgery Dr Anand Ramakrishnan Mr David Elliot UK available to library users. The new A-Z text article. That happens about one time in overly complex and frustrating. Consideration Professor Susan Mackinnon USA of this problem has led to the recognition that Dr Maria Siemionow USA listing allows the publishers’ packages to be five, and there are two further steps for most added and displayed fully, without needing searches. This is the result of the complexity additional security requirements for access to Rural Surgery Mr Graham Stewart to identify and list all the titles within the of having numerous different publisher the Library resources are not warranted. Senior Surgeons Mr Robert Rae Mr Anthony Jackson Australia package. It helps users to see the breadth of platforms. The EZ proxy password requirement Surgical Education Dr Mary Langcake Professor Rhona Flin UK the collection. Summon makes a complicated library has now been completely removed. This will Surgical History Mr Philip Sharp Professor Irvin Modlin USA There are hundreds more journal titles now accessible and remains a convenient alternative certainly reduce the number of clicks for many displayed in the A-Z list; for example, there are to Medline which links to the Library’s full text Fellows and Trainees. Surgical Oncology Mr Warren Hargreaves Mr Andrew Hayes UK Professor Khee Che Soo Singapore now 291 titles beginning with the letter A. A about 10 per cent of the time, depending on the comprehensive list means that more user clicks search. Future improvements to Trainees Association Dr Sally Ng are now required to get through the title lists. It is possible to put a complete journal the Online Library Transplantation Surgery Mr David Joseph Dr Kim Olthoff USA The assumption is that the benefits to library article title into Summon and have it reliably Over the past few years, the Online Library has Trauma Surgery Professor Zsolt Balogh Professor Hans-Christoph Pape Germany users of a comprehensive listing outweigh the appear at the top of the list that is returned, grown considerably in complexity. Vascular Surgery Mr Ravi Huilgol Dr Jon Matsumura USA requirement for additional clicks. In this, the making it quicker than finding a journal title Expansion of the Library will continue Professor Nicholas Cheshire UK College is using the model of University and and then the specific article. in 2012. We hope that the new A-Z list and Summon search feature continue to help make Women in Surgery Dr Cindy Mak similar large scale libraries. Web site single log in and a growing library accessible. Our goal is to Visitor list correct as at August 2011 Specialty pages in the EZ Proxy make the Online Library as rewarding and Online Library The Online Library, like many libraries, uses a useful as we can. If you would like to make any As a counterpoint to the comprehensive A-Z product called EZ Proxy which makes it possi- comments or suggestions about the Library Royal Australasian College of Surgeons Gardens T: +61 3 9276 7406 listing on the main Online Library page, each ble to overcome the requirement for numerous service, please email library staff on college. College of Surgeons 250-290 Spring Street F: +61 3 9276 7431 Convocation and Workshops: Sunday 6 May [email protected] ABN 29 004 167 766 East Melbourne, Victoria, 3002 E: [email protected] of the specialty page listings is maintained different user logins for different publishers. Australia W: asc.surgeons.org Scientific Sessions: Monday 7 – Thursday 10 May Royal Australasian College of Surgeons Surgical News Page 26 Vol: 12 No:9, 2011 Surgical News Page 27 October 2011 Keep abreast of program developments on the conference website: asc.surgeons.org Article of Interest
Learn how to A recent Productivity Commission report puts the number of Australian workers who are likely to be bullied or harassed in the workplace at 1.5 million, while the Beyond Bullying Association estimates up to 5 million Australians will experience bullying at some point in their working lives. That makes it a threat to employers as well: the Productivity Commission estimates the annual cost of bullies at work workplace bullying to employers and the economy in &Bullying Australia can be up to $36 billion in lost productivity, knock out Harassment stress leave, higher staff turnover and other costs. Bullying is an important issue to the College, and we Recognition, avoidance & management And for every reported case, there are many more continue to promote professionalism of Fellows through toxic office relationships in which a person might be our Code of Conduct and our Bullying and Harassment aggressive, sarcastic, intimidating, rude or insensitive, booklet, both available from the College yet not reach the threshold of “bully”. Graham Castledine is a solicitor and accredited mediator, as well as chairman of the WA chapter of LEADR, the Association of Dispute Resolvers. Ruth Callaghan Where previous generations might have The association trains mediators and can clocked off and gone out for the evening connect businesses or community groups – or even with friends, it is increasingly common for here are laws and procedures to protect families – with a professional who can help resolve our work to represent our most significant Are you at fault? everyone from workplace harassment, problems when they arise, before they get into more connections with other people. Dealing with other people’s prickly or unpleasant habits is finds Ruth Callaghan. complicated legal waters. T So when those connections get crossed, one thing – but what if you are the difficult person? The young doctor looked after patients in He says mediation is not new in bigger workplaces, things can get bad — fast. Author Gretchen Rubin, who wrote The Happiness Project his hospital unit on weekends and provided but more organisations are seeing the value in having Michael Sheehan, from Relationships the details to a senior specialist each Monday – a third party untangle damaging conflicts. and runs a blog of the same name, says there are signs to and that’s where the trouble started. Australia, says misunderstanding other look for – including that other people might not appear to Royal Australasian College of Surgeons “More and more employers are understanding people or believing they should be seeing The College of Surgeons of Australia and New Zealand In a complaint letter to his hospital director, the benefits of mediation because it is an informal appreciate your willingness to help them out. things a particular way are common RACS_Bullying_A5.indd 1 the young doctor said he dreaded the handover process that can enable people to discuss the issue Maybe you offer to host Christmas lunch, for example, problems where even reasonable people 3/12/2009 9:54:32 AM meetings. in a confidential way,” Mr Castledine says. “It can only to have people turn you down. can be misled by their own perceptions. If he summarised the patients’ situations, maybe help them resolve what is going on without Or you might feel you are generous with your wisdom and Mr Sheehan, who helps train organisations might be an issue where you are asked to do he was attacked for not providing enough needing more formal processes that can be costly and insight, but find people are less than enthusiastic about tak- in the skills needed to deal with angry clients, something additional. Then you might need to detail, he said. If he provided detail, he would damaging to relationships.” ing your advice. Another sign might be that you are accused says differences of opinion are normal and clarify things or point out you have other work be told to be more succinct. Sometimes he of being “over” truthful, or you find yourself often defending to do,” Mr Sheehan says. The role of the mediator is to help all parties have would be ignored, then accused of not keeping accepting this is a first step to finding some “You need to be assertive, but that means a chance to discuss the issue in a controlled way – and statements with: “It was just a joke.” his superior informed. compromise. being able to tell someone how you feel about even if one side is more articulate than the other, the Michael Sheehan, from Relationships Australia, says the “Every day, I enter the hospital with “The whole aim of living with other people the situation, then listen to their response, then mediator can help drill down to the core problems. best way to find out if you are the difficult person in a situa- apprehension and tension, fear of being trivialised is to negotiate,” he says. “People need to expect come up with a compromise.” “I think when a working relationship has reached tion is to learn more about what is called “emotional intelli- and humiliated in front of my colleagues, other that no one will agree with us all the time and If that fails, he recommends appealing to a a point where it is becoming destructive to the people gence”, a way of measuring how well you assess and control staff and my patients,” he wrote. that people have different points of view and higher authority. involved and their workmates, then that’s the time for your own emotions and how well you read the emotions of As the Australian Industrial Relations it is about coming to some sort of consensus.” “I always encourage everyone to know mediation to begin,” Mr Castledine says. Obviously others. Commission tried to untangle the conflict When you mix those different opinions what the grievance procedure is and ask about there is a certain amount managers can do and you The second step is to ask other people how they find you. — one of several incidents that led to the into a work situation, though, conflict can it so you know what you can do if someone is would encourage them to get involved and see if it is “You can seek feedback – if you are always asking ‘How senior specialist’s dismissal — it wasn’t result, particularly when there is friction bullying you or your immediate line manager just a matter of working through the issues. clear if bullying was taking place. More between layers in the office hierarchy. did I go, was I too hard on that person’; that is one way to is being difficult,” he says. “But when you have a problem that has gone from experienced doctors saw the senior specialist “With a hierarchy, the person is in charge know whether or not you are OK,” Mr Sheehan says. Many organisations do work to reduce the being a basic personality clash to something being as excellent, professional and able to make and they have the right to direct what you do,” But he warns that the more difficult a person is, the less chance of office relationships falling apart – for very negative and destructive to the workplace then it swift decisions. Mr Sheehan says. “You can still be assertive and likely they are to believe what they are told. good economic reasons. is probably a good idea to get those people off site into Junior staff found the same behaviour rude say how you feel and offer your suggestions, “Difficult people don’t have that sensitivity or don’t think The number of complaints about bullying a different location and try to get to the bottom of what and patronising. The commission eventually while understanding it is their decision.” they are doing the wrong thing so they never ask those in the workplace in WA has risen to above is going on. Part of mediation is to work out where you found the senior specialist had been unfairly Relationships Australia encourages people questions,” he says. 600 a year. Nationally, there are about 1,500 do have common ground and building on that. dismissed and ordered his reinstatement. to be assertive in their workplaces, but warns “For some people it is difficult to get that insight, but for successful workplace claims each year for “Even the smallest consensus can lead towards The dispute is one of thousands heard there is a difference between that and being those who want to know if they are doing the right thing, it is bullying and work-related harassment, each resolution.” every year in formal settings like the AIRC or aggressive. helpful to get that feedback.” taking an average three months of lost work This article originally appeared in the informally in the staff canteen, showing the “Someone might have an opinion or the time to resolve. West Australian newspaper on 13 July, 2011. complexity of relationships formed at work. boss might ask you to do something, or there Surgical News Page 28 Vol: 12 No:9, 2011 Surgical News Page 29 October 2011 Younger fellows
[My supervisor’s] unrelenting work Arthroscopic Rotator Cuff repair using “ethic, professionalism and hospitality Covidien Synthetic ligaments for turned the entire journey into a Massive Cuff Repairs Travelling pleasure with him becoming not only my mentor, but a close friend Fellowship ” Educational Grant in Europe. Norway was our next stop at the American Hand Society Meeting in Las Vegas. International Arthroscopy Meeting. Here we The time spent with Marc Garcia-Elias and presented on instability of the shoulder and Albert lluch was invaluable and fascinating chaired the conference regarding synthetic with regular meetings and teaching sessions. ligaments in the shoulder and plasma rich Their philosophy and approach to hand and 2012 platelets in Rotator Cuff Surgery. wrist pathology was not only ground breaking, I was invited to test the new Arthroscopic but was the culmination of treating the entire Younger Fellows face LaserJet equipment in Arezzo, Tuscany which spectrum of hand and wrist pathology from many challenges was a beautiful location and because of Prof newborns to adults over a combined 75 year Castagna we attended the Closed International experience. when undertaking post Meeting of Acromioclavicular Joint in Even carpal tunnel release was different Fellowship studies or Copenhagen where I was able to question an performing plastys and reconstruction of training. The Younger International Faculty such as Mr Itio from the ligament rather than just incision. We Japan and Mr Mazzoca from the US, leaders in learnt new nerve sparing capsulotomies and Fellows Committee their field on AC joint pathology. the new ligament reconstruction for Scapho- in partnership with We shared a luxury liner from Copenhagen lunate tears, capitate resurfacing and wrist Covidien offers two to Norway and had an interesting question and arthroplasty using pyrocarbon inserts. In travelling scholarships Covidien Travelling Fellows answer time with Brazilian and Columbian the end I was left with more questions than Grant Arthroscopy enthusiasts. The Shoulder Unit answers, but with a great vigour to delve annually which can was trialling the reverse shoulder replacements more deeply in finding an answer to common help to offset the cost of Ash Chehata recently visited various European countries as a Covidien Travelling Fellow with various new bearing surfaces and problems. performed more than 150 per year so the My overseas experience has confirmed the studying overseas. experience in joint replacement as well as the diversity of surgical techniques and approaches Ash Chehata becoming not only my mentor, but a close Ski Team and also to begin a rehabilitation management of revision arthroplasty surgery for similar problems yet all share a common You are eligible to apply Covidien Travelling Fellow friend. protocol that was instigated by Prof Castagna was second to none. goal in trying to achieve the best possible if you are planning to The days were exciting although exhausting and his Sports Physician, Marco Conti. It was a terribly sad day when leaving outcomes for the patients. My whole family train overseas within y Upper Limb Fellowship was with two theatres running simultaneously The clinic in Rome was a tertiary referral although the promise of returning with my has returned brimming with unforgettable always planned as an overseas with six to seven cases in each. Many cases centre for young adults with osteoarthritis of own original research for the Milan Shoulder memories and with a huge number of new- the next 12 months but Meducational adventure not only for were tertiary referrals from around Europe the shoulder and various unique arthroplastys meeting in a few years softened the farewell. found friends. Most importantly it was the returning to Australasia myself, but the entire family. With my newly and there was a steady stream of International were being devised and trialled. Again the Even my kids were unhappy leaving their inevitable cross-pollination of ideas for both to practice. Applications pregnant wife and two children we bundled all Visitors. I was paired with a Russian Surgeon week of operating was extremely challenging playgroups. Although, we thought we were research and management strategies that I will be accepted until 30 10 suitcases on board, destined for Europe. Half and then an American from Providence, which with revision shoulder surgery for both rotator prepared for a third child when my wife began hope will allow for better care for my patients. way through the flight I was sure I had made allowed for a truly varied exchange of ideas on cuff and instability. having labour pains on the overnight train The Younger Fellows Committee in September 2011. the biggest mistake of my life. My children had the best course of management in a Northern The following week was taken up between Milan and Barcelona, a 16 hour ride. partnership with Covidien offers two Travelling spilt everything possible on the surrounding Italian Hospital. preparing for the Italian National Shoulder I was almost inconsolable. Thankfully it was a Scholarships annually which can help to offset passengers and the entire scene was beginning There was a busy schedule of courses and and the Italian National Elbow Meeting in false alarm. She delivered three days later! the cost of studying overseas. Barcelona was more child friendly than For more to exhaust both myself and my wife. presentations along with peripheral hospital Brescia. The invited speakers were from the It was only once we landed and were visits. The first weekend we travelled to Rome Mayo clinic and we were together on the we could ever have imagined and this alone information, met by the Professor in Milan that the tide to perform an operating list and clinic at the podium with simultaneous translation for the was so soothing, let alone the vibrancy of the please contact suddenly turned. We were whisked away to International Villa Stuart Sports Institute. We entire congress. A week later we performed city and cultural entertainment. My week Professional a ‘très chic’ apartment in the city and within then spent the next day touring the Italian Live Arthroscopic Surgery using a synthetic was split up between operating and cadaveric Development 24 hours of reaching the city I had consumed Olympic Village and the new shoulder ligament to bridge massive cuff tears in a Local wrist research in the Barcelona University and Department multiple espressos and was on the on-call institute where we were involved in assessing Italian Meeting in Venice. I was paired with an American fellow from If you require more information P: +61 3 9249 1106 roster in the Elbow and Shoulder Unit of Prof athletes’ techniques in various throwing sports. The travelling continued with a Cadaver New York. We worked together to investigate please contact the Younger Alessandro Castagna. His unrelenting work The next day was spent via an invitation by the course in Utrecht, The Netherlands, where the effect of distal scaphoid resection and the Fellows Secretariat at F: + 61 3 9276 7432 ethic, professionalism and hospitality turned Olympic Committee to review the Shoulder we again performed live surgery alongside effect on the dorsal ligaments of the wrist. The [email protected] E: [email protected] the entire journey into a pleasure with him and Elbow protocols for the Italian National the current president of Shoulder Surgery research paper has been accepted at this year’s or on +61 3 9249 1122.
Surgical News Page 30 Vol: 12 No:9, 2011 Surgical News Page 31 October 2011 Retired fellows
“Quadriplegic patients suffer such great loss that I believed if I could at least restore some hand function and extend arm movement such patients could at least feed themselves and even paint … Helping those who have little The ups and downs of a career in hand surgery has led to some great achievements ”
“I crushed one of my fingers in a door and “After the bionic devices were taken off training surgeons and setting up units first lost the tip of it, which was quite traumatic, the market, we went back to tendon transfer in the UK and then in Israel and in 2010 was but then the surgeon sewed it back on and surgery to restore elbow extension, wrist invited to be keynote speaker at the South I remember feeling absolutely thrilled that extension and finger and thumb flexion and African Spinal Injury Congress during which could be done,” he said. grasp and very successfully treated hundreds he ran workshops. “Later during my general surgery training of patients. A unit has since been established in I assisted a plastic surgeon to rebuild a thumb “We also invented “Grip Aid”, a substance Pretoria to conduct such surgery while Mr and that impassioned me to such an extent applied to the hands of patients with weak Sormann has also trained three surgeons at the that I realised hand surgery was my calling. or absent grip, which facilitates a tenodesis Austin Hospital. “Hands are an extension of the brain and grip using friction resistance principles such With an estimated 5-6000 people in are not only vital for basic survival, of course, as that of tyre treads, which is now provided Australia now quadriplegic, Mr Sormann also but also as a means of expressing ourselves, of to patients at spinal rehabilitation units at no established an out-reach service based at the reaching out to touch others, to shake hands, to charge here and around the world. Austin Hospital to conduct hand function show love and affection. “A young lad in Switzerland has used this restoration surgery for patients in South “Quadriplegic patients suffer such great to provide the grip to hold a pen and is now Australia, Tasmania and the Northern Territory. loss that I believed that if I could at least finishing a university degree, while a portrait Now in semi-retirement, Mr Sormann restore some hand function and extend arm painter has been able to continue working; so is concentrating on teaching at various movement such patients could at least feed while it does not have the excitement of other international centres, with offers of training themselves and even paint, write and possibly advances, it is satisfying to have developed positions coming in from the US and drive a car.” something of such practical use.” meanwhile indulging his passions for sailing Dr Sormann became involved Throughout these years and travel. in the treatment of quadriplegic of thrilling advances and Looking back, Mr Sormann listed the patients in his role as Head of the disappointing set-backs, Mr highlights of his career as hosting the Congress Gerard Sormann at work; QHF fundraiser at Brighton Rotary with two tendon transfer patients and one bionic implant to restore hand function. Right inset: Grip Aid, applied to fingertips improves friction resistance. Unit of Plastic and Reconstructive Sormann also became an in Melbourne, establishing hand function Surgery at the Austin Hospital active board member of the restoration units around the world and treating treating the problems of pressure International Quadriplegic Hand the backlog of patients in need of such surgery sores in spinal patients. Surgery Congress and hosted the through the outreach service. uring the thirty-plus years of his University, the bionic device for restoration of “This was very disappointing, but I Having trained at Columbia congress in Melbourne in 1997. “Just recently I was informed of the first career, now-retired Plastic and upper limb movement, known as the “Freehand continued my interest in this field as Adjunct University Medical Centre in the He travelled the world such surgeries in South Africa and that was a Reconstructive Surgeon, Mr Gerard System”, was introduced into Australia by Dr Professor in Bionic Engineering at the D US and at the renowned McIndoe very rewarding moment,” he said. Sormann has seen the best and the worst Sormann in the 1990s. Royal Melbourne Institute of Technology. Burns Unit in the UK, he not “It was Australia, and Melbourne of times in the development of genetic and Believing the units to offer great potential, We patented a unique method of remotely- only introduced microsurgery in particular through the efforts of the technological advances believed capable of Mr Sormann lobbied for the funds to pay powering implanted bionic devices. and fascio-maxillary surgery to RACS, where the push to enforce the returning movement to the paralysed. for the devices, known as functional nerve “This means that bionic implants would the services offered at the Austin use of seat belts, helmets and airbags As the head of restoration of hand stimulation implants, and to participate in the not need a battery nor wires and could be Hospital, but designed a number originated, all of which have significantly function surgery for quadriplegic patients in US-based FDA trials, but with little success. powered through irradiating the body at a very of procedures that are now reduced the number of people suffering the Austin Hospital’s Spinal Unit, some such So frustrated was he by this, that in 1991 he safe and specific frequency to stimulate nerves commonly undertaken around complete quadriplegia and that has been breakthroughs seemed to hold enormous established the Quadriplegic Hand Foundation and muscles. the world. enormously gratifying to witness. promise only to turn to dust and ashes (QHF) to help fund the purchase of the “This technology is still some years away “Over the years I invented “I have always thought quadriplegic while more practical ideas resulted in actual $50,000-units. The foundation received such from practical use, but with the rapid advances the use of a silicon device for people the most deprived of all patients improvements. strong support that it was also able to fund the this does have potential for practical application stabilising the thumb instead and felt compelled to offer all the help There was, of course, the time when stem building of a new ward at the Austin Hospital and may be picked up again by scientists and of fusing the bones, as well as I could. cells seemed to be the holy grail of spinal cord for spinal patients needing elective surgery. engineers in the future.” developing the Brachioradialis “I spent my career hoping that if I regeneration, yet little advance has been made Twelve patients had the bionic units Mr Sormann, who was born in Paris and Flip operation in which a forearm could give them a little more upper-limb in this field of research in more than 15 years. successfully implanted in Australia. Then came to Australia as a young boy, said he chose muscle is used to extend the function, a little more movement, that Then, in Mr Sormann’s particular field of disaster struck in the US where “A trial to to become a surgeon and particularly a hand elbow which is very successfully would be a most rewarding endeavour.” interest, there came bionics. use the same device to restore lower-limb surgeon after having suffered a significant used around the world,” he said. With Karen Murphy Developed in the US at the Case-Western movement failed,” Mr Sormann said. hand injury as a toddler.
Surgical News Page 32 Vol: 12 No:9, 2011 Surgical News Page 33 October 2011 Education section Teamwork behind the Fellowship Examination A great deal of teamwork and organisation goes on behind the scenes of examinations
Spencer Beasley Chair, Court of Examiners
xaminations don’t just happen. They require the commitment, dedication Eand goodwill of Fellows, Examiners and patients with support from the College examinations department if they are to run smoothly. Our College is unique in that it conducts nine different exams concurrently – while maintaining the genuine sense of collegiality for which our Court of Examiners is renowned. Detailed planning for the examinations commences approximately 18 months beforehand. The Executive of the Court consists of the Chair and two Deputy Chairs, and the Senior Examiners from each of the nine The support team for the Otolaryngology Head and Neck Surgery Specialty Courts. The Senior Examiners Fellowship Examination led by Mr Sam Arena, FRACS (centre) represent their specialty at the Executive meeting and share ideas and best practice Court Registrar - Mr Tim Bright, FRACS regarding the conduct of the exam. They Cardiothoracic Surgery – Dr Michael Worthington General Surgery - Dr Cea-Cea Moller, FRACS (Royal Adelaide Hospital) also lead their specialty in ensuring the General Surgery - Dr Sarah Thompson, FRACS (Royal Adelaide Hospital) Fellowship Examination remains at the General Surgery – Dr Marina Yeow, FRACS (Flinders Medical Centre) high standard at which it has always been General Surgery - Dr Harsh Kanhere, FRACS (Queen Elizabeth Hospital) conducted, and that it is continuously Orthopaedic Surgery - Dr Rob Wallace, FRACS reviewed and improved to ensure maximum Plastic & Reconstructive Surgery - Mr Anthony Porter, FRACS reliability and validity, and to fit in with the Vascular Surgery - Mr Mark Hamilton, FRACS requirements of each specialty’s curriculum. This development and review process is conducted annually at the Specialty exam. As a ‘non-court’ member, he or she is Fellows, especially in the week leading up to Workshops held in February and March. responsible for ensuring the vivas run without the examination. The Senior Examiners are supported by the problems. The Court Registrar organises The College Examinations Department Deputy Senior Examiner in their specialty, the Surgical Anatomy component of the with the assistance of the respective Regional a newly created role to help with the ever examination and is a point of contact for the Office team are integral in their support to increasing responsibilities of the Senior local coordinators in all nine specialties should all involved in the examinations. It is widely Examiner. The Examiners are involved in the any issues arise. recognised that they go well beyond the call creation of questions, provision of images and, The Local Coordinators are the cogs of duty as they ensure the candidates and if the examination is being held in their home who make the exam run. Without their Examiners have everything they need, and city, are often called upon to coordinate the assistance on the ground in securing venues, their help is valued and appreciated by the sourcing of patients for the clinical component organising patients, collating histories, as well Court. of the examination. Often they rely on as arranging catering, parking, transportation, It would be fair to say that the success colleagues to assist in finding suitable patients. marshalls (and even hospital computer “log of the Fellowship examination is in large The Court Registrar is a Fellow nominated ins”) the Fellowship Examination would not part attributable to the commitment and by the relevant College Regional Committee be successful. This role represents a significant teamwork of the Fellows and staff involved to undertake the supernumerary role for the and time-consuming commitment by our behind the scenes.
Surgical News Page 34 Vol: 12 No:9, 2011 Surgical News Page 35 October 2011 Heritage Report
It is not surprising that Newton, “who impressed Sir Henry Newland with his clear thinking and ability to grasp essential concepts, was involved with the fledgling College ”
Late one morning when Sir Alan had been of Departments of dealing with two difficult goitre operations, I Medicine and Surgery, received an urgent message from the hospital – with a unit at each Clinical ‘please tell Sir Alan that one patient is bleeding School’. slightly’. I took up my stand near the front Newton’s literary output doorstep and on arrival of Sir Alan and his was prolific – between 1927 and theatre sister, the Daimler headed them quickly 1948 he produced 35 published back to the hospital. On his return Sir Alan and many unpublished, papers. queried anxiously ‘You wouldn’t have told Hugh His interests were broad, ranging about that would you?’ ‘Oh no’, I said, but I from his ‘pet’ subject of goitre to smiled, even the great are human. They were medical education and other more great friends and though, perhaps not always obscure topics. In a letter of 1939 to in complete agreement, this was of benefit to the Secretary of the British Medical the College; for all matters were discussed fully Association, he refutes AJ Trinca’s between them. ‘official’ stance regarding congenital Both knighted in 1936, each sharing an hernia and worker’s compensation. interest in thyroid surgery and serving a term Acceptance of his [Mr Trinca’s] views Top: Examiners on the steps of the College, as president of the College during World War would be, in my opinion, unjust to the worker, who 1937 – Sir Alan Newton, Professor Frederic II, Newton and Devine were complementary should receive compensation if he could prove that Wood Jones, Dr Charles Kellaway, Professor A Huggett, Mr Cecil Wakeley, Sir Hugh Devine and characters who meshed the various threads a hernia developed, directly or indirectly, after an Mr HG Wheeler, Secretary of the RACS ‘No Time to Stand and Stare’ of the College into a cohesive body. One of excessive effort of strain sustained while at work, Above: Sir Alan Newton, Sir John Ramsay and Sir Alan Newton’s influence at the College ended too soon Newton’s ‘threads’ especially after he became irrespective of marked immediate symptoms. Sir Hugh Devine, 1939 Censor-in-Chief in 1933, was his work on In demand as an orator, Sir Alan Newton’s Opposite page: Victor Hurley, Alan Newton, William Upjohn, 1912 Courtesy of the RMH an examination system for admission to speeches from the 1940s in the College Archive Archive Fellowship. He also delineated the role of the include one given at a Royal Empire Society College in post-graduate education. In an lunch for Sir Gordon Gordon-Taylor, at the The best way of exercising control of article published in the Medical Journal of conferral of Sir Howard Florey’s Honorary anything is to get so much of it that control Australia in1936 he says: Fellowship at the College of Physicians, at the is unnecessary. The best way to get medical The College is not content to merely bestow opening of the Rupert Bunny Exhibition at equipment in a world at war is to make it. The a diploma on those deemed worthy of its the National Gallery of Victoria and a speech fact that we have helped ourselves in this way Fellowship. The education of a surgeon must to honour the return of Sir Robert Menzies to has led the United Kingdom and the United the Royal Melbourne) Hospital where they Surgical circles in Melbourne in the late continue throughout his lifetime. the office of Prime Minister. Newton’s speech States to give favourable consideration to our obtained posts as Residents and as Honorary 1920s were quite insular in both geographical Marjorie Butler considered that apart at Scotch College’s prize giving in 1946 was so requests for those things we cannot make. Surgeons. Newton described his mentor at the and political terms. Therefore it is not from the College, Sir Alan Newton’s major impressive that a master at the College was heard Newton’s work with the Medical hospital, Frederick Bird as a ‘dextrous surgeon surprising that Newton, who impressed Sir achievements were his contribution to medical to say: ‘We had Menzies last year and he’s no fool, Equipment Control Committee coincided and a sound teacher’ – qualities that could Henry Newland with his clear thinking education and his work with the Medical but this year’s effort knocked him cock-eyed’. Mike Hollands with his Presidency of the College (1943-5) and Treasurer describe Newton himself, for like Bird, he was and ability to grasp essential concepts, was Equipment Control Committee during World The Medical Equipment Control this heavy workload may have contributed to to become ‘one of the great figures associated involved with the fledgling College. When War II. Committee was established at the beginning his early death in 1949. Clarity of vision and A Foundation Fellow, but not a founder, with the Melbourne Hospital’. Newton joined the Council in 1929, his rooms Although intimidating to some, Newton of World War II to supervise ‘the importing, foresight were his forte and his words in a Sir Alan Newton’s contribution to the College After service with the Royal Army Medical at 85 Spring Street, which he shared with Sir was an imposing and influential teacher. In the manufacture and distribution of medical and speech to the Royal Asian College of Surgeons began with his appointment as Honorary Corps during World War I – in 1917 he worked Robert Hamilton Russell, were just around 1940s, he became the George Steward Lecturer veterinary equipment and drugs’. Chairman Secretary/Treasurer in 1929 and only ended in 1944, still ring true today. with the American surgeon, Harvey Cushing the corner from the College’s premises at 6 in Surgery at the University of Melbourne from 1940, Newton was reputedly ‘masterly at with his death in 1949. Science knows no national boundaries and at Ypres – Newton returned to Australia and Collins Street. Hugh Devine and AL Kenny and in this role, initiated improvements to circumventing or cutting red tape’. In 1940, on scientific ability is not the prerequisite of any ewton’s medical career began at the the Melbourne Hospital. During the 1920s he also had rooms in Collins Street and according the curriculum and promoted the idea of the eve of Japanese occupation and without one race although any country can suppress University of Melbourne (MBBS 1909, quickly acquired an extensive surgical practice to Newton’s secretary Marjorie Butler, Devine Chairs of Medicine and Surgery. In one of official sanction, he managed to purchase the it by abolishing independence of thought, MS 1912) where he held the Beany and like his near contemporary Sir Thomas was a frequent caller at number 85. She recalls his last speeches (read by his brother Dr WS Java quinine crop – an important coup in a N regimenting its people and denying adequate surgical scholarship. He completed his training Dunhill, became a leading exponent of the following incident from the 1930s which Newton), given at the Alfred Hospital in 1948 time of material shortages. His philosophy facilities for research work. with Victor Hurley and William Upjohn and thyroid surgery, specialising in difficult goitre she saw as ‘indicative of his [Devine’s] frequent, and entitled: ‘No Time to Stand and Stare’, he outlined in the Syme Triennial Lecture of 1944, the trio then moved to the Melbourne (later operations. familiar and unexpected presence’. advocates the establishment ‘as soon as possible was simple: Written by Elizabeth Milford, College Archivist Surgical News Page 36 Vol: 12 No:9, 2011 Surgical News Page 37 October 2011 Professional Development
The outcome of this meeting is a Hot Tubbing with the best! document“ that identifies the matters upon Being a part of legal proceedings has its complexities which (the experts) agree, and those matters upon which they disagree.xx” In Memoriam Our condolences to the family, friends With a decade of experience with the joint There are a variety of concerns about joint and colleagues of the conference approach, the courts have reported conference arrangements. These concerns following Fellows whose on the effect of the changes. The Federal include: death has been notified Court’s experience is that the ‘hot tub’ narrows (i) [Hot tubbing] may change expert over the past month: David Hardman the issues in dispute; it is beneficial for all of performances, but to the extent that Medico Legal Executive the expert evidence to be presented while fresh experts conform to judicial expectations in the mind of the decision maker (the judge); and engage in a more collegial discussion, >Duncan Simon, hen your friendly lawyer invites reduces the level of partisanship of experts; this does not make the evidence or any NZ Plastic & you to come hot-tubbing, it may and results in a saving in hearing time. consensus reliable or even more reliable. Reconstructive surgeon not be the experience you had in W Another concern about the legal process (ii) The Joint conference or expert conference >Neil Miles, mind. The courts have developed a process, that fostered the development of the joint is part of the trial that is conducted away used in cases where the expert evidence is conference is the view that the adversarial from the view of the plaintiff, defendant NSW General surgeon central to the issues in dispute, whereby experts trial may discourage the leading experts from and their legal representatives. This >Douglas Cohen, from both sides of a dispute gather to discuss advising the courts. denies the process of justice. NSW General surgeon their expert evidence, in an attempt to develop There is a view that the expert is often paid (iii) If there is a difference in the professional >Aird Hill Eti Enosa, a consensus view to help the courts. to promote a position that supports one side or positions of the experts (e.g. young Samoan General A new experience for the medical expert the other. The experts did not see the process surgeon and the professor who taught involved in medico-legal proceedings is the as fair; they didn’t see it as aimed at identifying him), the junior may be intimidated surgeon invitation, or more accurately, the direction, to in any genuine way, what it was that the expert by the imbalance in position. The We would like to notify readers that participate in a, lawyer free, joint conference had to contribute to the case. Rather it was a more articulate expert may have more it is not the practice of Surgical News with the other experts involved in the same contest with winners and losers. influence than his professional opinion to publish obituaries. When provided matter. deserves. Experts may assume the role they are published along with the Such a joint conference, otherwise termed of advocate and influence the outcome. Should you get involved? names of deceased Fellows under In concurrent evidence or expert conference is Consequently, some experts are reluctant to (iv) A clinician with a particular atypical Memoriam on the College website sometimes identified by the legal slang term get involved as court witnesses, but this view or bizarre theory can dominate the www.surgeons.org go to the Fellows ‘hot tubbing’. The purpose of the hot tub is to any issue of clinical concern. The outcome that might be to the disadvantage of their is to the detriment of the legal system. “The discussions and contribute little to the page and click on resolve the issues in contention between the of this meeting is a document that identifies clients.” justice system must ensure that the leading appropriate resolution of the issue in In Memoriam. medical experts. the matters upon which they agree, and those In response to these types of concerns, the experts on relevant issues accept a role in the question. The actual ‘hot tub’ process is that the matters upon which they disagree. court rules changed. These rules evolve in an dispute resolution process. Second rate experts (v) The lawyer spends a lot of money on experts, that is, those medical experts who Any matters upon which they disagree attempt to balance concepts of justice against will result in inferior justice and an erosion of the reports, and should have the right Informing the College have submitted reports for the plaintiff and then become the agenda for a discussion in the real constraints of administrative efficiency confidence in the entire system.” to present those reports, at a time and If you wish to notify the College the defendant, are required to meet, as a the court room. The judge is responsible and fiscal accountability. In 1998, the Federal Although the joint conference process has in a manner, to the court that allows the of the death of a Fellow, please sworn panel, without lawyers, and discuss the for chairing that courtroom discussion, and Court Rules were amended to facilitate the use many supporters and judicial proponents, the lawyers to best put their clients’ case. contact the Manager in your medical issues from their own viewpoint and asking questions as the judge believes to be of ‘hot tubs’. About this time, similar guidelines support is not unanimous within the legal There is no doubt that the lawyers will Regional Office. They are form a consensus understanding of the issues appropriate, in order to assist the judge to were introduced in other jurisdictions. profession. Lawyers, especially plaintiff lawyers, continue to argue about the development of in contention. understand what the witnesses are saying. The Federal Court issued guidelines for have very real concerns about the gradual the trial process, but from the view point of The experts, in good faith, should be The introduction of the joint conference expert witnesses, essentially a code of conduct. erosion of the traditional bulwarks that protect the medico-legal expert the joint conference is ACT [email protected] willing to consider alternative factual premises has occurred in response to some concerns The principal purpose of those guidelines was the interests and legal rights of the plaintiff. likely to continue. So when you are asked to NSW [email protected] and opinions. The joint conference can only about the manner in which expert evidence to outline the responsibilities of the expert There is some concern within legal circles jump into the hot tub, remember you are there NZ [email protected] work if the witnesses are genuinely prepared to is presented to the courts. There is a frequent witness to the Court: that the use of joint conferences is part of the for the court, not the lawyer. Try not to muddy QLD [email protected] shift their ground. perception of bias. Lord Woolf in the interim (i) ‘An expert witness has an overriding duty emerging role of the judicial activist. In some the water! The hot tubbing experience gives back to report, Access to Justice said: to assist the Court on matters relevant to circumstances there is a concern that judicial An extended version of this essay SA [email protected] the experts a proper role in the court room. It “Expert witnesses used to be genuinely the expert’s area of expertise’; decision making may be beyond the powers with references is available by contacting TAS [email protected] enables the experts to ask questions of each independent experts; men of outstanding (ii) ‘An expert witness is not an advocate for given by legislation or precedent. This concern [email protected] or calling VIC [email protected] other, and to respond to those questions. eminence in their field. Today they are in a party’; and was foreseen by H.V. Evatt, “The sooner we +61 3 9276 7433 WA Angela.D’[email protected] The experts can ask, and answer, each other practice hired guns. There is a new breed of (iii) ‘The expert witness’ paramount duty get back to the ideals that justice should be This article originally ran in the March 2011 NT [email protected] questions in the same way they would interact litigation hangers-on, whose main expertise is to the Court and not to the person administrated according to the law and not issue of Surgical News, however was incorrectly in their hospital environment, discussing is to craft reports which will conceal anything retaining the expert’. according to claptrap the better it will be for all.” attributed to the wrong author.
Surgical News Page 38 Vol: 12 No:9, 2011 Surgical News Page 39 October 2011 Professional Development WORKSHOPS
of setting the research requirements at a low >STEP (Surgical Teacher requirements in Neurosurgery are for a year of level. The curve would be shifted to the right Education Program) full time research for all trainees. In contrast, the if the research requirements during SET were SAT SET Course requirements in General Surgery can be met •7 September, Adelaide; to be lifted. This would increase the average •16 September, Darwin with a poster presentation at a local meeting. research competency with most trainees at the Overall, the requirements are low, are ‘practitioner’ and ‘knowledgeable practitioner’ >Keeping Trainees on not based on defined learning objectives, levels, there would be few trainees left at the Letter to the editor Track (KToT) NEW nor are they embedded in a curriculum that ‘novice’ level, and more trainees would likely •18 August, Queenstown; defines appropriate training and assessment choose to reach the ‘expert’ level. •5 September, Brisbane; methodology. Michelangelo once said that “the In considering the need to lift the research •13 September, greater danger for most of us lies not in setting requirements during SET, so that all trainees Melbourne; our aim too high and falling short; but in gain a higher level of research competency, •16 September, Darwin; Academic Surgery setting our aim too low, and hitting the mark.” there are three options. The first is that each •23 September, Hobart; Aiming too low has been the problem and specialty continues to go their separate ways ‘Keeping Trainees on Track’ the ‘minimalistic’ research requirements smack in defining the research requirements, even is a new workshop in the of tokenism, and they belie an understanding though they are essentially trying to achieve ‘Supervisors and Trainers for SET’ (SAT SET) series. of the research competencies (knowledge, skills the same thing. Over 3 hours it explores and attitudes) that are essential in our trainees The second is to develop a common how to performance manage in the world of modern surgery. approach to the research requirements that trainees by setting clear goals, These are just two areas where I see the training in any subspecialty and I would urge A recent article in the New England draws on the best of what has already been giving effective feedback and Shifting the curveJournal of Medicine emphasised the need for developed within the different specialties. discussing expected levels of scientific literacy in all graduates of medical The third is to start afresh by defining the performance. Participants are 3 surgical student would find surgical research that it should be post FRACS and as structured promoting surgical researchschools, and itin could alsotraining be said for surgical learning objectives for training in research also given the opportunity to trainees in relation to research competencies learn methods for encouraging More emphasis on surgical research in training would during SET, focusing on essential knowledge, that “we should expect a higher standard skills and attitudes and how learning should self-directed learning by inspire another generation and advance our vocation from those who wish to pursue (surgery) in be gained and demonstrated in these domains. establishing expectations at the Has surgical research lost its way? start of term meeting. appropriate to their own surgical raison d’etre. as any other specialty. Current surgical training is an era in which genomics and informatics The Board of Surgical and Education and will revolutionise biomedical science and Training (BSET) considered these options John A Windsor health care. To fulfill expectations we need >Surgical Teachers Course at its recent June meeting. It was decided to •1-3 September, Chair, Section of Academic Surgery Researchto foster scholastic rigor, analytical thinking, Regarding administrative aspects of surgical constrained enough with mandated work hours establish a working party to work towards the Waitakere Estate Requirementsquantitative assessment and analysis of third option, with the support of the Section urgery is a scientific discipline. The Figure 1: The Auckland complex systems in human biology. Our goal Memorandum of Association (1924) theoreticalof Academic Surgery and the Academy of •20-22 October, Bondi should be to help them acquire a different, distributionSurgical Educators. marking the birth of the Royal of research Beach, Sydney y August reading of surgical journals surgeons. Surgeons who have clinical expertise and surrounding hip joint implantation suggest S more molecularly orientated and scientifically research: Should every University Department of to say nothing about quality of life issues to add Australasian College of Surgeons stated that competencyThere will need to be recognition of the This two-and-a-half day “the two most important duties of the College, sophisticated knowledge base.” 2and theresource levels implications of the recommendations intensive course enhances the The American Surgical Association report} of research educational skills of surgeons are the training of surgeons and the promotion competency4and a willingness to draw on external resources. of research in surgery”.1 These are the two adds another dimension by saying that “itfor a lowIt and is a important that all surgical specialties who are responsible for the included (1) “Dr Berci receives the manual dexterity continue to inspire students and that basic surgical research tenets were violated higher research Surgery have a Department of Research and what further mandated time in the run up to the big pillars on which surgery stands. The delivery is inherent in the education of a surgeon are represented on the working party. Any teaching and assessment of requirement during Trainees. Participants learn of high quality surgery in an increasingly that he or she be exposed to a thoroughsurgical training.comments, criticisms or contributions from the foundation of improved complex environment and the progressive understanding of basic scientific methods. Fellows are welcomed. educational skills through development of surgery in pursuit of better It is especially important that the surgeon in College’s Jacobson Innovation Award residents to emulate them in spite of less than ideal or not used with respect to tissue response to should be the compass of surgical research? The hurdle FRACS. The research Fellow should have Trainees Number of four main modules: adult patient outcomes requires the continuing training understands the appropriate methods acquisition of new knowledge and skills learning; teaching technical of evaluating published material, clinical skills; feedback and assessment M (research) and the dissemination of these References research and decision analysis.” Other research (education and training). and change and leadership. for 2011” in the August Bulletin of the American interpersonal skills. materials and end points of physical usefulness NOVICE ExperiencedcompetenciesPRACTITIONER could beKnowledgeable added. EXPERT 1. Newland H. President’s Address. The head of research should be involved with private grounding in diagnostic, technical and post op. 4 The modules are integrated to Since the foundation of the College, the BEGINNER PRACTITIONER have defined five Australian and New Zealand Journal of Dreyfus and Dreyfus achieve progressive acquisition domains of training and research have not Surgery 1931; 1(1): 3-5. Levellevels of Research of competency Competency related to skill acquisition of knowledge and skills. received equal attention. Surgical training has 2. Debas et al. American Surgical and this is helpful because it promotes a College of Surgeons. Melbourne surgeons will Our College does sterling work and is a leader of the implants over years, to name just a couple been its primary focus and training has thrived Association Blue Ribbon Committee industry and law makers if we are to prevent such management of surgical cases as a starting point continuum of research competency, rather with the attention. Fellows of the RACS are stated that “the future of surgery as an academic The quality of surgical care will suffer for Report on Surgical Education: 2004. Please contact the Professional than a dichotomy, and there is a decision to be known throughout the world for their excellent and professional discipline that will continue want of the appropriate and timely integration Annals of Surgery 2005; 241 (1): 1-8. Development Department on surgical training. And the College continues to contribute to the discovery and madeclinical about of the evidence level that based we advances expect allinto of surgicalour care 3. Dienstag JL. Relevance and rigor in +61 3 9249 1106, to set high standards for our trainees and translation of new knowledge, technology and guidelines. And probably of most importance remember his start in endoscopic research in 1957 in surgical teaching and care in a number of third of essential details that should emerge from such events as the present orthopedic problems from for surgical research. He/she should know how trainees to reach. premedical education. New England by email PDactivities@surgeons. surgical therapeutic innovation will depend on will be blunted progress in surgical science be- continues to innovate in surgical education If a theoretical distribution of research Journal of Medicine 2008; 359: 221-224. org or visit the website at and training. how high research is on the priority scale of cause of a diminished surgical research work- competency were plotted for our trainees it 4. Dreyfus HL, Dreyfus SE. (1986) Mind www.surgeons.org The same cannot be said for surgical surgical education and practice.” force less able to compete for research funding. would likely be skewed to the left (Figure 1), over Machine: the power of human intuition - select Fellows then click on at the Alfred and Royal Melbourne Hospitals; world countries where hundreds of thousands research. Has surgical research been wrested from research, which has struggled over the years, With a sharp tongue the report goes on to The Section of Academic Surgery has taken lack of continuing surgical research involvement to dissect surgical journals to understand what with most trainees at the ‘novice’ level and and expertise in the era of the computer. for there has not been the same investment or say that “research training in surgery is regarded on two challenges under the heading of “pro- Professional Development. some at the ‘experienced beginner’ level. It Oxford; Basil Blackwell. attention. The reasons are several, not the least almost as an afterthought, and the surgical pro- moting surgical research”. There is the need to PAGE 25 August 2011 is suggested that this is a direct consequence Surgical News being the pressing and more immediate need fession has not placed a premium on its devel- both ‘raise the bar’ and ‘raise the floor’. The first and (2) “Shifting the curve promoting surgical of people are without surgeons and where the the academic community by the implant industry and longtime oversight. has gone before, regarding the project proposed. to produce a competent surgical workforce. opment and support. Further research training challenge is the need to identify what is required The College’s mandate to promote in surgery lacks the structure, organisation and for those who choose to commit to a career in research was partly devalued when University oversight that are so well developed in clinical academic surgery. They need more intentional, Departments of Surgery and the Surgical training.” And not just in America. recognised and supported training pathways. research in training” by Professor John A Windsor practical wielding surgeon’s skills will be needed or has it lost its way? Research Society of Australasia were strong. There are some far reaching consequences if This topic will be the subject of the meeting } ASERSNIP-S is an important and unique He/she should also be trained and aware of what But that did not last, winter followed spring. we do not face up to the challenge that is before in Adelaide (November 10-11) sponsored by the Surgical research has also suffered through a us. If surgery does not promote surgical research, Section of Academic Surgery and the Surgical lack of funding, the increasing sophistication there will be less interest in a surgical career as Research Society of Australasia. The second in the August Surgical News (Page 24, Vol 12, No for many years to come. Delivery of these surgical Surgeons as hands on professionals are ideally organisation that looks into global research and is policy, legal and private industry considerations of science, the struggle to identify, train and students view surgeons more as technicians. challenge is the need to revisit the research appoint academic surgeons, the rise of private The surgeons sphere of influence will be requirements during SET, which relates to the practice and the failure of governments to further reduced as significant aspects of peri- research competencies considered important adequately fund public hospitals. operative care are assumed by more expert for all surgeons, across all specialties. 7) of the Royal Australasian College of Surgeons. skills should be part of surgical research. Scientific placed to translate knowledge and technology particularly useful to practicing surgeons and their could be related to their research project. This The American Surgical Association others. There will be fewer trainees choosing A brief review of the current research commissioned a report on surgical education academic surgery because they missed out on requirements during SET for each of the that contains a clear statement of concern.1 It a compelling research experience. specialties is striking for their variation. The My immediate thought was, has surgical literacy is an essential facility in the explosion of into clinical practice and I see that there is an patients with respect to emerging technologies. depth of study cannot be seriously accomplished Surgical News PAGE 24 Vol: 12 No:7, 2011 research lost its way and thus lost its appeal to medical publications and Professor J.C. Hall’s area of surgical research taking telemedicine, Sadly a number of studies leave the reader with in the run up to the FRACS. another generation of surgeons? In answer to articles “How to dissect surgical journals” should surgery and consultation to third world countries the comment that further studies will be needed Dr Berci was a practical surgeon who what does not work and why not, to appeal to the Professor Windsor’s remark that contributions be mandatory reading in Medical Schools and where the RACS has such an impressive history before concrete useable (my remarks) statements saw that emerging technologies in lenses and next generation of aspiring surgeons. We should would be welcome from Fellows, I would like to SET training and examinations. Basic surgical of involvement. Practical surgeons could survey can be made. This indicates a need for more well illumination had a place in surgery and thus in leave enzyme systems and molecular biology to add some musings of a retired surgeon. knowledge is necessary to the understanding of specific areas of need for frequency of surgical thought-out research with at least a reason and goal surgical research. He has continued to expand professionals who know how to manipulate these One of the reasons that I became a surgeon biological systems, but surgical research has I feel, pathology and population density and determine for the research and a useable end point. This can this essentially practical work of surgery and systems. If we seriously wish to inspire young was that I had manual dexterity and enjoyed doing lost its way in moving into molecularly orientated surgical instrument need, educational need and only come from seriously well trained researchers technology. We have developing technologies surgeons to consider surgical research as a career, things for my fellow human beings. My experience scientific research where basic scientists and consultation services appropriate to the residents if we are to get beyond the anecdotal, personal in visual communications, implantable devices we should stick with our strengths because that is as teacher of medical students and residents in physicians are more appropriately found. of the area. Parenthetically obstetric facility and series of case reports which have been the bedrock and neuroelectronic prosthetic applications as where serious research is needed. Philadelphia confirms that the essentially practical There is a vast potential for surgical research expertise may loom large as a requirement in of surgical advance in the peer reviewed literature. well as the less glamorous, but equally important John R. Dalton MD, FRACS, FACS. aspect is still part of what makes students become in implantable devices. The present problems such research. Training for research is as important as surgical research into what works and why, and Wye Mills MD, USA.
Are you a general orthopaedic surgeon who would like to make a real difference? Yes, I would like to donate If so, this is your opportunity to our Foundation for Surgery
An exciting opportunity awaits you in Dili, Timor Leste (East Timor) All donations are tax deductible
FULL TIME POSITION TO COMMENCE IN JULY 2011 Name: An orthopaedic surgeon is required to assist with the development and delivery of acute orthopaedic surgical Address: Telephone: services in Timor Leste. Based at the National Referral Hospital in Dili, Hospital Nacional Guido Valadares (HNGV) this unique and rewarding role is best suited to an orthopaedic surgeon with excellent people skills, a Email: Speciality: good level of cross cultural sensitivity, and who is keen to use his/her technical skills to improve the acute orthopaedic services in this young nation. In addition to clinical work, the position offers the opportunity to mentor surgical trainees and doctors from the district hospitals, teach surgical/orthopaedic techniques, provide Enclosed is my cheque or bank draft (payable to Foundation for Surgery) for $ . equipment advice and conduct district outreach visits. The position is open to qualified orthopaedic surgeons with an Australian, New Zealand or equivalent Please debit my credit card account for $ . qualification. Mastercard Visa AMEX Diners Club NZ Bankcard Managed by the Royal Australasian College of Surgeons (RACS), the Australia Timor Leste Program of Assistance for Specialist Services (ATLASS) aims to improve the availability and quality of surgical services to the people of Timor Leste through mentoring and training of Timorese doctors and nurses and assisting with the Credit Card No: Expiry / delivery of health care services.
HNGV is responsible for the provision of a wide range of surgical and non-surgical specialist services and is the Your passion. Card Holder’s Name - block letters Card Holder’s Signature Date only referral hospital in the country. The RACS program currently employs 4 full-time clinicians (general surgeon, anaesthetist, orthopaedic surgeon and ophthalmologist) at HNGV and co-ordinates 16 specialist surgical team Your skill. I would like my donation to help support: visits across Timor Leste per year. Your legacy. General Foundation Programs International Development Programs For the successful candidate, this is an exciting opportunity to experience life in Timor Leste. The capital Dili Scholarship and Fellowship Programs Indigenous Health Programs offers a good selection of restaurants, secure and child-friendly accommodation and a variety of outdoor sport facilities, making it an ideal and safe location for both individuals and families. I have a potential contribution to the Cultural Gifts Program I do not give permission for acknowledgement of my gift in any College publication The appointment carries an attractive remuneration package including accommodation and shared access to Your vehicles. Preference will be given to applicants who can stay for 12 weeks or longer. Please send your donation to: Please send expressions of interest or queries for more information to: Foundation. AUSTRALIA & OTHER COUNTRIES NEW ZEALAND Foundation for Surgery Foundation for Surgery Ms Karen Moss Dr Eric Vreede Dr Anthony Jeffries 250 - 290 Spring Street PO Box 7451 Program Officer ATLASS Team Leader Orthopaedics Coordinator East Melbourne , VIC 3002 Newtown, 6242 Wellington [email protected] [email protected] [email protected] Australia New Zealand Ph: +61 3 9276 7436 Ph: +670 725 7125 Ph: +61 8 9366 1818 Surgical News Page 40 Vol: 12 No:9, 2011 Surgical News Page 41 October 2011 College awards
The John Mitchell Crouch Royal Australasian College of Surgeons Fellowship is the premier research award of the Fax Mentis Royal Australasian College The torch of the mind
of Surgeons. It is separate Friday 15 April, 2011 from Foundation Grants and In thisAre issue yourDear Dr Smith, details independently funded. The • The 2011 Adelaide The 2011 Adelaide ASC awaits you ASC awaits you It's not too late to register for the College's 80th Annual Scientific Congress (ASC), • International Forum Fellowship commemorates an to be held at the Adelaide Convention Centre between 2 and 6 May. at the ASC correct? • Attention New Attracting up to 2,000 delegates from across Australia and New Zealand and Congratulations featuring distinguished visiting lecturers from around the world, this is a perfect outstanding younger Fellow of Zealand Fellows opportunity to catch up with friends and colleagues while learning the latest • AfterEnd of Grandfathering recommendations developments in the science fromof your surgical the specialty College. Read more … the College who died in 1977 applications on your achievements Communications• Attention Victorian Working Party, the College now on the threshold of a highly Fellows International Forum at the ASC • Library news distributes a weeklyThose attending e-newsletter, the ASC might be interested in Faxattending Mentis the International, Forum promising career. John Mitchell • College media and on Monday 2 May. advocacy Convened by Dr Mark Moore, the forum will include discussions on global surgical Crouch was a young surgeon as• Request a way for feedback of streamliningissues, the interface between communications surgery and government and the developing to world as a training ground. • Career support for who showed astute clinical, Trainees considering Read more … rural surgery Fellows and Trainees. organisational and research • Professional Ifdevelopment you are notAttention receiving New Zealand theFellows e-newsletter, abilities and this award is made • Upcoming events Shorter Stays in Emergency Departments National Research Project • New admissions to The Shorter Stays in Emergency Departments National Research Project has to an individual who, in the Fellowship your detailsstarted the year may with a collabora be tiveincorrect. opportunity for all Health Professionals. • Surgical positions The research aims to critically examine the whole health system to understand the opinion of Council, is making an vacant impact of interventions on patient flow. Read more … Please• In memoriam fill out the change of details form that outstanding contribution to the • College staff End of Grandfathering applications comes with theConjoint Surgical Committee for Newsthe Recognition and of Training return in Peripheral by advancement of surgery. Contact Us Endovascular Therapy www.surgeons.org Please note that applications for recognition by the Conjoint Committee under the instruction,Grandfathering or contact Clause will cease the after College29 April 2011. Grandfathering on applications [email protected] +61will not be3 considered 9249 after this1200. date. Read more … If you do not wish to receive this email Attention Victorian Fellows Brandon Adams please inform the Also rememberThe Victorian Regional to Committeeadd Faxis currently Mentis undertaking their election process College by email for new Committee members. 2011 John Corby Medal All Victorian Fellows should receive a hard copy letter by surface mail of: ballot to yourpaper and safe profiles of senders the nominated Fellows list. standing for election. Read more… he John Corboy Medal is the collegiality, and his exemplary Calling all Victorian Fellows and Trainees David Little The Victorian Regional Committee participates each year in the Medical Careers only College medal awarded service has improved junior doctor Expo, and a roster is prepared of Fellows and Trainees willing to represent the T 2011 John Mitchell Crouch College and surgery at this important event. to Trainees, and is a significant training and welfare. Brandon Fellowship You are encouraged to join the roster. Read more… honour. The four criteria for is recognised by RMOs, senior the John Corboy Medal are doctors, and administrators alike rofessor David Little graduated MBBS outstanding leadership, selfless as a spokesman for New Zealand Pin 1986 from the University of Sydney. Currently the Head of the Orthopaedic Inventors stories service, tenacity, and service to junior doctors. After completing his specialist training in the Research and Biotechnology Unit at the the Trainees of the College. The Brandon has served as a Australian Orthopaedic Association training Children’s Hospital at Westmead (CHW) Awardee for 2011 has fulfilled all of committed representative on the scheme (in 1994), he became a Fellow of the NSW, and Senior Staff Specialist in Paediatric these criteria with excellence, and RACS Trainees Association for four Orthopaedics, David is also a Conjoint wanted! College and went on to complete his PhD on is Dr Brandon Adams. years and in several capacities. His bisphosphonates in distraction osteogenesis (in Professor at the University of Sydney. In 2003, If you or someone In addition to his workload as leadership skills were formative 2005). He undertook fellowships in Paediatric he published the first paper suggesting that you know has a plastics trainee, Brandon Adams in providing direction and Orthopaedics in America at the Shriners Hospital bisphosphonates may be a useful therapy in invented the self has excelled in a busy portfolio of momentum to the early committee, for Children in Portland, Oregon, and Texas osteonecrosis. Since then he has pioneered the retaining abdominal professional service activities over and he was a key voice during the Scottish Rite Hospital for Children in Dallas. investigation of bisphosphonates modulation retractor or several years. transition to SET. Trainees have In his career to date, he has received several of bone repair. The receipt of the John Mitchell something like appreciated Brandon’s intelligence, Brandon is renowned for prestigious awards, including the Basic Science Crouch Fellowship will assist Associate that we would tenacious leadership. In 2003, as wisdom and diplomacy skills, and Paper Award for the outstanding paper at the Professor Little in his current research into the like to hear from a student leader, Brandon was he has contributed to the College cellular contribution to bone repair and bone 2005 and the 2010 Paediatric Orthopaedic Society you. It can be a instrumental in devising the becoming more responsive to the of North America meetings. He was an ABC tissue engineering, research which has high successful or not Advanced Choice of Employment needs of its trainee members. Travelling Fellow in North America, and received translational value to many areas of clinical Scheme and then lobbying for Aside from these outstanding the Australian Orthopaedic Associate’s Award need in orthopaedics. The current focus of so successful its introduction. This successful contributions to the medical for Orthopaedic Research for his contribution to his department’s research includes improving invention in surgery. scheme has now efficiently community, Brandon has achieved international orthopaedic research. bone healing outcomes in neurofibromatosis, matched over 2500 graduating academically, being regarded as Professor Little has been invited to lecture at and using muscle for in vivo bone tissue doctors to employment in New an excellent trainee and having a number of national and international meetings engineering. Zealand over eight years. achieved 10 research publications in Australia, South Korea, USA and Spain, and Associate Professor David Little is a highly We are interested We Brandon has served the New in his early career. has been published in several high impact respected clinical leader with a busy clinical need Zealand Medical Association for Brandon is a selfless leader, publications, with 21 of his papers being cited at load, who has a highly productive research in the ideas. seven productive years, including an effector of positive change, least 21 times. He has expanded his teaching role track record and whose laboratory has a stories as Chair of the Doctors in Training and above all, a role model of with research students in the last five years, being considerable international reputation. He is T: +61 3 9276 7430 Council from 2008 to 2010. In trainee professionalism. He is the involved in the supervision of three students to a commendable recipient of the 2011 John this role, Brandon has been a deserving awardee of the 2011 John completion of a PhD as well as five current PhD Mitchell Crouch Fellowship. E: [email protected] passionate advocate of medical Corboy Medal. students. Citation kindly provided by Julian Smith FRACS
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Surgical News Page 44 Vol: 12 No:9, 2011 Surgical News Page 45 October 2011 RACS order form Sep 11_Layout 1 20/09/11 2:32 PM Page 1
RACS PATIENT EDUCATION – THE GOLD STANDARD Successful scholar LAPAROSCOPIC GALLBLADDER SURGERY PRICE LIST PER TITLE (FOUR-PAGE PAMPHLETS) Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 100 copies @ $1.12 each: $112 200 copies @ $1.08 each: $216 WEIGHT LOSS SURGERY 500 copies @ $1.04 each: $520 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 1,000 copies @ 98 cents each: $980 COLECTOMY –SURGERY OF THE COLON (ASOHNS) Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 DIRECT LARYNGOSCOPY, MICROLARYNGOSCOPY, ENDOSCOPY OF THE COLON OR MICROLARYNGEAL SURGERY, BRONCHOSCOPY UPPER GASTROINTESTINAL TRACT AND OESOPHAGOSCOPY Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Research a passion of the heart SURGICAL REMOVAL OF THE APPENDIX TREATMENT WITH GROMMETS Dr Yi Chen looks forward to more collaborative research Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000
HAEMORRHOIDS AND THEIR MANAGEMENT SURGICAL TREATMENT OF EXOSTOSES Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 TREATMENT OF VARICOSE VEINS SURGICAL TREATMENT OF PILONIDAL DISEASE SURGERY OF THE NOSE (RHINOPLASTY) AND OTHER PROBLEMS WITH VEINS Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 SURGERY TO REPAIR HERNIA SEPTOPLASTY AND SURGERY TO SURGICAL TREATMENT OF LEG ULCERS ” REDUCE ENLARGED TURBINATES orking in collaboration with Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 scientists in Melbourne and VASECTOMY INGUINAL HERNIA, HYDROCELE OR MYRINGOPLASTY – REPAIR OF THE EARDRUM Seattle, cardiothoracic trainee Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 MALDESCENDED TESTES IN SMALL CHILDREN W Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Dr Yi Chen has not only described the role MELANOMA SURGERY Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 CHOLESTEATOMA AND CHRONIC SURGICAL TREATMENT OF GASTRO- played by the protein activin A in myocardial MIDDLE-EAR INFECTION OESOPHAGEAL REFLUX DISEASE (6 PAGES) ischaemia reperfusion injury (IRI), but has also BREAST LUMP SURGERY Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 100 copies @ $1.65 each: $165 ❑ Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 shown that the naturally-occurring compound FUNCTIONAL ENDOSCOPIC SINUS SURGERY 200 copies @ $1.58 each: $316 ❑ PERIPHERAL NERVE SURGERY follistatin can reduce IRI by neutralising the ❑ ❑ ❑ ❑ ORONARY RTERY YPASS RAFT PAGES Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: 100 200 500 1,000 C A B G (6 ) effect of activin A. ❑ OTOSCLEROSIS AND STAPEDECTOMY 100 copies @ $1.65 each: $165 CRANIOTOMY As part of his PhD thesis, which he is now ❑ ❑ ❑ ❑ 200 copies @ $1.58 each: $316 ❑ Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: 100 200 500 1,000 in the process of finalising, Dr Chen used HEART VALVE SURGERY (6 PAGES) SURGICAL REMOVAL OF THE TONSILS mouse models to investigate the effects of using SURGERY OF THE CERVICAL SPINE 100 copies @ $1.65 each: $165 ❑ AND ADENOIDS Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 ❑ follistatin, an anti-fibrotic agent, as a way to Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 200 copies @ $1.58 each: $316 reduce the inflammatory response caused by the LUMBAR SPINE SURGERY CARE OF YOUR INCISION AT HOME (2 PAGES) SURGERY TO REMOVE A NECK LUMP Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 100 copies @ 80 cents each: $80 ❑ effects of activin A during myocardial reperfusion. Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 HAND AND WRIST SURGERY 200 copies @ 77 cents each: $154 ❑ Having proved the hypothesis in animal HYPERHIDROSIS PAMPHLET HOLDERS (clear acrylic) models, Dr Chen said that in the future, if Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 ❖ Wall Mounted VASCULAR ACCESS SURGERY follistatin could be commercially produced, SURGICAL TREATMENT OF AN A4 single pocket, $16 per unit ❑ ❑ ❑ ❑ it could be used either before or during heart Copies: 100 200 500 1,000 ABDOMINAL AORTIC ANEURYSM Number of units required: ...... surgery to reduce IRI. SURGERY OF THE THYROID Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 ❖ Free Standing GLAND AND PARATHYROID GLANDS CAROTID ENDARTERECTOMY A4 single pocket, $19 per unit “Every time the heart stops and then blood Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Copies: ❑ 100 ❑ 200 ❑ 500 ❑ 1,000 Number of units required: ...... is restored, the patient suffers some degree of I have not seen these publications before. Please send me a sample pack. ischaemic reperfusion injury, which means He said work was now underway to Society of Cardiothoracic Surgeons in 2009 Please return this form by facsimile to: 03 9888 6465 OR post to: RACS Patient Education that even patients who have had successful determine exactly how and when activin A was and now has a number of articles awaiting OR email: [email protected] Mi-tec Medical Publishing heart surgery often do not get the full benefits released as well as the mechanisms controlling publication. OR order online: www.mitec.com.au P.O. Box 24, Camberwell, VIC 3124 of it,” Dr Chen said. the production of follistatin. He said he was honoured to have received SEPT 2011 TELEPHONE ORDERS: 03 9888 6262 PRICES DO NOT INCLUDE 10% GST. GST APPLIES TO ORDERS WITHIN AUSTRALIA ONLY. PRICES WILL CHANGE OVER TIME.POSTAGE AND HANDLING ARE “Having looked at the role of activin A in Dr Chen has received three RACS such strong support from the College and said CHARGED AS AN AT-COST DISBURSEMENT.MI-TEC MEDIA PTY LTD A.C.N. 053 106 497 A.B.N. 65 053 106 497 If you have a practice stamp, please make an imprint below scholarship to support his research, the latest that even though he is now back in full-time PLEASE PRINT CLEARLY cardiopulmonary bypass at the start of my research, I then wanted to see if it plays any role being the Surgeon Scientist Scholarship for 2010. training at the Monash Medical Centre he Name: DR in myocardial IRI because the problem of IRI He has undertaken his PhD under the hoped to continue his research in the field. is so common and in severe cases can lead to supervision of Professor Julian Smith from the “This is an interesting area of cardiac Post Office Box or Street Address: a significantly prolonged stay in intensive care. Department of Surgery at Monash University research because IRI can have potentially “It was most rewarding to investigate and Associate Professor Mark Hedger and devastating effects on patients even when follistatin and to see how it binds with activin Dr David Phillips at the Monash Institute of cardiac surgeons are doing everything they can A to neutralise its action in setting off IRI and Medical Research. to treat it,” he said. City/Town: State: Postcode: in future, after a great many other questions His work has also been undertaken as a “It happens to every patient who has a heart have been answered, it may be possible to put collaborative project with scientists at the Baker attack and even if the original problem can be Phone: Fax: it into the cardioplegia solution as a part of a Institute in Melbourne and the Department remedied through surgery, IRI can still weaken Please 1. myocardial protection strategy.” of Surgery, University of Washington, Seattle, the heart and increase morbidity and mortality. add your Dr Chen said, however, that the science was which Dr Chen visited to undertake the in vivo “While I am now concentrating on 2. email addresses No still in a very preliminary stage now with much mouse studies. finishing my cardiothoracic training, I hope Card Receive the latest titles from RACS Bookshop. All email addresses and customer details are confidential. Surcharge still to be understood both about activin A and “The people I worked with in Seattle have to still find the time to work alongside other Pay now by credit card, or pay on invoice. follistatin. He said activin A had only been iso- great expertise in animal models of myocardial researchers in our attempt to answer the (If paying by cheque, please pay on receipt of invoice.) Please tick lated within the past 20 years and that while ischaemia reperfusion and it was a wonderful questions still remaining relating to both ❑ American Express it was originally understood to be primarily experience to work alongside them and learn activin A and follistatin because if the science Card number: ______from them,” he said. could be translated into a product, the benefits ❑ Mastercard a reproductive hormone, subsequent research pointed to a larger role as part of the body’s de- Dr Chen presented his early findings at the to patients could be enormous.” Name on card: Expiry date: ______❑ Visa fence mechanism. Annual Scientific Meeting of the Australasian With Karen Murphy ❑ Diners Club Signature: Surgical News Page 47 October 2011 Not oNly does it feel like a secoNd skiN it has its owN immuNe system
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