Surgicalthe royaL Australasian CoNewsllege of Surgeons October 2012

Inside 14 page Spring Lifestyle Post Op

2013 ASC Call for Abstracts. P45 Don’t miss out!

The College of Surgeons of Australia and A Matter of Life New Zealand Fellow Gert Tollesson lends a hand through ROMAC c ntents

10 Trauma in Indigenous Communities Medfin helps Foundation for Surgery Medfin helps initiatives to reduce the toll make finance 16 Helping a life 21 make finance Gert Tollesson lends a easy with... hand with the help of easy with... ROMAC 19 Library report Your library resources Appointments at a time and place that suit you continue to deliver Appointments at a time and place that suit you Fast response 20 Making fake real Fast response A Member of the QLD Minimum paperwork Minimum paperwork trauma committee is Financial solutions designed for healthcare professionals committed to saving regular pages Financial solutions designed for healthcare professionals young lives 13 Curmudgeon’s Corner 14 Case Note Review 22 Successful Scholar 30 15 Poison’d Chalice Darren Katz is part of 18 Dr BB Gloved Want more information? pioneering surgical 27 PD Workshops Want more information? Contact your local Medfin Relationship Manager research for men 42 Book Club onContact 1300 your361 local122. Medfin Relationship Manager on 1300 361 122. 28 Regional News A stop at the Pacific Don’t have time to phone? Don’t have time to phone? Islands Surgeon’s Visit medfin.com.au and request a quote online. Visit medfin.com.au and request a quote online. Conference 30 Farewell to Dean of Education Farewell speech for Professor Bruce Barraclough 22

SurgicalTHE ROYAL AUSTRALASIAN COLLEGENews OF SURGEONS OCTOBER 2012

INSIDE 14 page Spring Correspondence to Surgical News should be sent to: Lifestyle Post Op 2013 ASC Call for Abstracts. [email protected] P45 Don’t miss out! Letters to the Editor should be sent to: [email protected] Or The Editor, Surgical News, Royal Australasian College of Surgeons, Buy or sell a practice at medfin.com.au/classifieds/ College of Surgeons Gardens. 250-290 Spring Street, East Melbourne, Victoria 3002 Finance your:Buy or Car sell • Equipmenta practice •at Practice medfin.com.au/classifieds/ • Cashflow • Investment Property T: +61 3 9249 1200 F: +61 9249 1219 W: www.surgeons.org Finance your: Car • Equipment • Practice • Cashflow • Investment Property ISSN1443-9603 (Print) ISSN 1443-9565 (Online)

The College of Surgeons of Australia and A Matter of Life Surgical News Editor: David Hillis / © 2012 Royal Australasian College of Surgeons / All copyright is reserved. New Zealand Fellow Gert Tollesson lends a hand through ROMAC The editor reserves the rights to change material submitted / The College privacy policy and disclaimer apply – www.surgeons.org Important Information: Finance subject to credit assessment. Terms and conditions apply. Fees and charges apply. Medfin Australia Pty Ltd ABN 89 070 811 148, The College and the publisher are not responsible for errors or consequences from reliance on information in this publication. Statements represent on the cover: ImportantAustralian Information:Credit Licence Finance 391697. subject Medfin to creditis a whollyassessment. owned subsidiaryTerms and of conditions National Australiaapply. Fees Bank and Limited charges ABN apply. 12 004 Medfin 044 937,Australia AFSL Ptyand Ltd Australian ABN 89 Credit070 811 Licence 148, Australian230686 and Credit part Licenceof the NAB 391697. Health Medfin specialist is abusiness. wholly owned (SN10/1 subsidiary2) of National Australia Bank Limited ABN 12 004 044 937, AFSL and Australian Credit Licence the views of the author and not necessarily the College. Information is not intended to be advice or relied on in any particular circumstance. Fellow Gert Tollesson’s 230686 and part of the NAB Health specialist business. (SN10/12) Advertisements and products advertised are not endorsed by the College. The advertiser takes all responsibility for representations and claims. operation on Larisha Published for the Royal Australasian College of Surgeons by RL Media Pty Ltd. ACN 081 735 891, ABN 44081 735 891of 129 Bouverie St, Carlton. Vic 3053. Barikoa saved her life. Surgical News.indd 1 21/09/2012 10:10:51 AM Surgical News.indd 1 21/09/2012 10:10:51 AM Surgical News October 2012 / Page 3 President’s Perspective

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS Advocating for Surgical Services MEDIA RELEASE

The College is busy on several fronts CEO’s resignation a symptom of a health system under severe pressure – SA surgeons

Tuesday 28 August, 2012

The resignation of Central Adelaide Local Health Network (CALHN) Chief Executive Officer, Brian Often just talking through concerns from a number Rousseau, was further evidence of a health system struggling to cope during a period of significant but Budgets and Surgery poorly planned change, the Royal Australasian College of Surgeons has said.

of perspectives will identify improvements or gain an The College’s South Australian Regional Chair, Mr Peter Subramaniam, said that while there is little The College Council is becoming increasingly concerned value in in speculation as to the reason for Mr Rousseau’s resignation, the College, along with other representative organisations, was aware of the tension between the drive to cost saving within the understanding of how road-blocks can be removed. If you CALHN and the reality that the new Royal Adelaide Hospital may well fall short of delivering the capacity Fellowship in Rural Surgery about how ‘tighter’ health budgets in most hospitals are that would justify the planned and significant downgrade of the Queen Elizabeth Hospital (QEH). want to assist with this, please contact the Chair of your “Central to this is the planned closure or downgrade of the Intensive Care Unit at QEH which will have impacting upon surgical services. significant downstream impact on emergency, acute care and elective surgical services at this hospital,” Wagga Wagga Base Hospital, Regional Committee or the Regional Manager (on the Mr Subramaniam said. Senior officials of both Health Departments and “While the plan is for this capacity to be taken up by the new Royal Adelaide and an expanded Lyell McEwin Health Service, the College of Surgeons remains profoundly concerned about the feasibility of NSW, Australia Treasuries are becoming more worried about the impact of College website at www.surgeons.org) achieving this within the current economic climate. “The College has also explicitly expressed its concern to the Minister and the CEO of SA Health about the impact of the planned reconfiguration of hospital services on the viability of high quality surgical health on budget demands and budget blow-outs. As health training posts to meet the anticipated demand for specialist surgeons in South Australia. This includes Applications are sought from General Surgery concerns about the possible reduction in outpatient services within the public system, where there appears to be a clear drive towards treating and billing as many patients as possible under Medicare – a is now bankrupting the State of Tasmania, just how many Alcohol induced violence step that the College fears may be the thin edge of the wedge towards privatisation of these essential Fellows who have recently completed their Part II services,” he said. other regions will be faced with similar predicaments? If the 1960s and 1970s were the era of road trauma, then our Mr Subramaniam said that at a time when South Australian hospital services were struggling to cope examination, who wish to undertake a 12 month with change that seemed to be driven more by hope than careful planning, the College of Surgeons remained committed to engaging the SA government on issues relating to the provision of high quality To explore the issue further, the College is focusing the current decade must be the era of alcohol induced trauma. surgical care to the South Australian public. Fellowship in Rural Surgery in 2013. October Surgical Leader’s forum on the sustainability of One cannot be anything but horrified at the injuries, Media inquiries: Michael Barrett, Manager Media & Public Relations Subspecialty interests are available and include: surgical services. With health now at 10 per cent of GDP disfigurement and death that are being presented to the 0429 028 933 or (03) 9249 1263 • Breast, Oncoplastic & Endocrine Surgery (compared to 17.5 per cent in the US), what will the year hospitals where we work every weekend, if not other nights • Hepatobiliary, Oesophago-gastric & Bariatric during the week. 2025 be like? How will politicians and our senior health Surgery managers cope? Glassing injuries, knife injuries, and ‘king hits’ are • Laparoscopic & Open Colorectal Surgery More importantly when directors of surgical services increasingly a problem. A number of potential solutions • Vascular & Endovascular Surgery have their budgets effectively decreased for another year, have now been identified that address access to alcohol, • Paediatric Surgery how can they respond? With a significant panel of experts, pricing, types of drinks like ‘shots’ and the culture that goes • Skin Cancer & Melanoma hopefully we will be in a better and more informed position with it. • Academic Surgery as to how to respond. Although many groups are working in this area, it is important that we also assist. Our next Surgical Leader’s Private and public work available. Regional Advocacy Forum in February will be considering how to understand Duration of Fellowship = January 2013 what can be done and make sure we advocate more to December 2013. The College Council also is now pushing for ongoing Estimated salary = $ 200, 000 p.a. meetings in major regional and city hospitals to talk about effectively for it. issues on the ground. Some Regional Chairs are organising The College is preparing a document for the Smart meetings of Department of Surgery Chairs to address these Traveller website. We recognise medical tourism is a big Applications (with CV) should be forwarded to Dr Michael Payne: concerns. issue and will not simply go away so we are hoping to Phone: (02) 6925 1488 I also hope to encourage the Regional Chair and also a provide advice about the dangers of medical tourism and Fax: (02) 6925 1499 some advice about how to investigate potential hospitals/ Email: [email protected] Councillor to visit hospitals, especially large metropolitan Post: Suite 3/325 Edward St, Wagga Wagga, NSW, 2650 and base hospitals, to get a better understanding of how we surgeons overseas. The College is building on should be helping surgeons within the hospitals where they Mike Hollands its advocacy role Applications close Friday October 19th, 2012. work. President

Page 4 / Surgical News October 2012 Surgical News October 2012 / Page 5 Relationships & Advocacy

Illawarra Shoalhaven Local Health District outpatient nurses from the Eye and Ear Hospital and Victoria Parade Surgery Centre. This enabled our Trainees to gain valuable VMOs General/Upper experience and insights under expert tuition on a wide range of procedures in two intensive sessions. The GIT Surgery and FESS workshop focused on the basic surgical principles General/Colorectal Surgery of minimally invasive endoscopic sinus procedures including septoplasty, antrostomy, frontal sinus mini- • Wollongong Hospital. trephine, ethmoidectomy and sphenoidotomy, orbital • Central ISLHD Referral Hospital. wall decompression, canthotomy, and the ‘bath-plug’ • Teaching Hospital of the University of technique for the management of cerebrospinal fluid leaks. Wollongong Graduate School of Medicine. The temporal bone dissection workshop a week later was designed to guide the Trainees through See: Advertisement, Surgical Positions Vacant, middle-ear and inner-ear procedures including RACS website. NSW Health Jobs under Illawarra , cortical mastoidectomy, posterior tympanotomy, Shoalhaven Local Health District. labyrinthectomy, cochleostomy and insertion of cochlear implant electrode arrays.

Smooth delivery The Trainees were delighted with both of the courses The 9th Cowlishaw and gave excellent feedback, highlighting in particular Symposium is the set-up and specimens, the high instructor student ratio, and the non-stop, uninterrupted nature coming of the sessions. Clearly the organisers need to be congratulated and indeed applauded. Saturday 27 October at 9.30am Richard Kennedy, previously a Trainee of mine, has reported that he found the whole experience extremely Speakers: Mr Gordon Low / Mr Wyn Beasley positive and will be recommending that more Mr Ross Blair / Prof Mike Hollands / workshops be held in the Skills Lab. Handing over the Ms Elizabeth Milford / Prof Susan Neuhaus / Prof David Watters / Prof Alan Thurston Make use of your Skills Lab organising role to College staff can “streamline” the Skills and Education Centre staff are on hand to help you devise your course whole process and make it a lot more manageable. Royal Australasian College of Surgeons, 250-290 Spring Richard reports that Skills Lab staff did an St, East Melbourne (Level 2 Training Area) exemplary job setting up and supporting the workshop. Fee: $130.00 inc. GST per person covers morning tea, He was particularly impressed on the day with their lunch, afternoon tea and cocktail reception ust downstairs from the Hughes Recently a couple of workshops from overseas, was held over for the seamless lab management, and when he asked late in For further information contact JRoom at College headquarters held in the Skills Lab have come to my second workshop. a session whether the waste fluid collectors needed to [email protected] +61 3 9276 7447 in Melbourne, in the Skills and attention: a Functional Endoscopic Sinus The wonderful capabilities of the be emptied, discovered that this had been happening Education Centre, is one of the best Surgery (FESS) workshop and a temporal Skills Lab provided for 10 operating efficiently behind the scenes without anyone noticing.

surgical skills laboratories in the country. bone dissection workshop. This pair of stations, each with suction, irrigation, This was important, as it meant that participants were GROUP HERITAGE THE The Skills Lab has been set up to provide complementary workshops was organised operating microscopes and surgical able to work on without stopping for the usual filling Lady practical surgical and related training in by Fellows Chris Brown and Richard motors. The Lab’s impressive array of and emptying of the irrigation and suction systems. Gordon- Taylor all disciplines and at all levels. It is part of Kennedy respectively for Victorian instruments was supplemented by While some specialties like Otolaryngology Head & our commitment to the ongoing training Otolaryngology Head and Neck Surgery state of the art equipment generously Neck Surgery make excellent use of the College’s Skills and development of surgeons. Trainees. lent for the occasion by medical device Lab, others are yet to make the most of this world-class Clarebrough, Mr Donald Murphy is the Skills What made these courses particularly companies including Medtronic, Karl facility for our Trainees. John K Lab Medical Director. He and his team significant was the level of cooperation Storz Endoscopy and Cochlear Ltd. The I encourage Fellows to call Donald Murphy or Skills work closely with course providers, and forward planning by Chris and specimens accessed for the workshops & Education Centre Manager David Lawrence on not only to provide the necessary Richard, their faculties, and the staff of provided Trainees with the highest fidelity 9276 7455 to organise a visit to the lab or to discuss Presentation: Portraits infrastructure for training – including the Skills Lab. This resulted in two quite ‘simulation’ – it was a rare opportunity. possibilities for future workshops so that together we Friday 19 October at 12pm instruments, specimens, audiovisual different workshops on consecutive The College has a commitment to can work towards our goal of excellence in surgical at The Royal Australasian College of Surgeons, capability and catering – but also to help weekends being able to utilise the collaboration and teamwork, and I training. 250-290 Spring Street, East Melbourne develop training models which ensure same specimens and much of the same was most impressed to hear that Chris participants are able to practice their equipment – a perfect example of “two managed to achieve a faculty to student inc. GST per person & lunch. skills in a simulated environment with birds and one stone”. instructor ratio of one to one. The faculty $30 the appropriate level of fidelity. If you This type of forward thinking meant of 12 surgeons from the Royal Victorian For further information contact have not yet attended a workshop there, that access to the anatomical specimens Eye and Ear Hospital, the Alfred Hospital, [email protected] I recommend that you arrange with was less costly and also that loan Monash Medical Centre and Austin Michael Grigg or phone: +61 3 9276 7447 Donald to take a tour. equipment, some of which was brought Hospital were joined by four theatre and Vice President

Page 6 / Surgical News October 2012 Surgical News October 2012 / Page 7 Surgical Snips Surgical Snips

Time won’t affect outcome Northern road rules New research has revealed that surgical procedures done later in the day are no less safe Northern Territory Fellows have warned the than those undertaken earlier in the day. new government about reintroducing open Previous research has hinted that surgeries speed limits on territory roads, stating that the early in the day are more successful and that Regulating social media Laws of Physics have not changed. Fellows Surgical mementoes surgeons get tired over the day. However, this A leaked consultation paper from the Australian Health David Read and Phillip Carson pointed out Doctors are being warned of camera usage in the workplace hasn’t necessarily pointed to any worse surgical Practitioner Regulation Agency could herald a new era of rules that the Territory already endures a rate of through an article in a recent issue of the Medical Journal of outcomes. for social media use such as Twitter and Facebook. The papers road deaths two and a half times the rest of Australia. Experts say that some specialists may find themselves Researchers analysed the records from 522 include closer scrutiny of posts about private lives and warned the nation. in breach of privacy laws and criticises a culture of “click first, procedures, including kidney stone removals and that practitioners who breach rules can face deregistration. “The Northern Territory members of the Royal care second”. “As the distribution of electronic data through prostate cancer surgeries. “We really didn’t find It also says health professionals should consider their posts Australasian College of Surgeons have grave the internet, social media and mobile devices becomes easier, any significant differences one way or another,” carefully and not accept unknown friend requests. concerns … based on their experience with appropriate collection, consent and the use of medical imagery said Dr Yair Lotan. “Surgeons are trained to provide Some are disappointed with the paper, stating that it disregards the severely injured, the permanently disabled is essential,” the researchers from Menzies School of Health and the sufficient level of attention so their outcomes the benefits of the applications. “That’s where our patients are and the grieving relatives that arise as a result Research said. Many of the hospitals surveyed across Australia are no different [no matter the time of day].” and that’s where we need to go,” WA GP Edwin Kruys said. of road trauma.” did not have policies for ‘phone’ photographs. Reuters Newswires, September 3. West Australian, September 19. Northern Territory News, September 17. Gold Coast Bulletin, September 5.

SAVE THE DATE Provincial Surgeons of Australia Australian and New Zealand Head & Neck SYDNEY COLORECTAL

ROYAL AUSTRALASIAN Cancer Society, Annual Scientific Meeting SURGICAL MEETING COLLEGE OF SURGEONS 48th Annual Scientific and the Conference International Federation of Head and Neck 24 November 2012 1 - 3 November 2012 Hilton Sydney Hotel Sir Robert Helpmann Theatre

Oncologic Societies, 2012 World Tour 488 George Street, Sydney, NSW Mount Gambier 24 – 26 October 2012 INVITED SPEAKERS Brisbane Convention & Exhibition Centre Professor Najib Haboubi - Brisbane, Australia Manchester Professor Seon-Hahn Kim, MD - Seoul

MEETING HIGHLIGHTS • Colonoscopy CONJOINT MEDICAL EDUCATION SEMINAR 2013 • Laparoscopy • Robotics • Radiation bowel disease • Management issues of difficult Friday 8 March 2013 patients Sofitel Sydney Wentworth, Australia C MEETING ORGANISER RACS Conferences & Events Management “Serving the Community: 250 - 290 Spring Street Training Generalists and Extending Specialists” East Melbourne VIC 3002 Further information: P: +61 3 9276 7406 Program Themes PSA Executive Invited Speakers E: [email protected] F: +61 3 9276 7431 • Inflammatory Bowel Disease – diagnosis President: Mr Matt Oliver A/Prof Peter Bampton R E: [email protected] and treatment in Rural Australia Secretary: Mr Jack Munk Mr Glenn Guest T: +61 3 9249 1273 • Update Oncology: Gastric and Colorectal Treasurer: Mr Tom Bowles A/Prof Tim Price Cancer Convener: A/Prof Matthias Wichmann Dr Frank Voyvodic

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Page 8 / Surgical News October 2012 Surgical News October 2012 / Page 9 Foundation for Surgery

Yes, I would like to donate to our Foundation for Surgery

All donations are tax deductible

Name: Telephone: Address: Speciality: Email: $ . payable to Foundation for Surgery) for Enclosed is my chSingleeque or b vehicleank draft ( roll-over accidents are also that education at school and post-licence reduces more common in the Indigenous. population. mortality. There is, however, strong evidence that Please debit my credit card account for $ Unfortunately, poor data collectioncard and difficulty speed enforcement detection devices, street lighting, AMEX Diners Club NZ Bank Mastercardin evaluating Visa interventions in remote communities red light cameras, seat belt use, random breath / Expiry Credit Card makeNo: it difficult to understand why Indigenous tests and mass media campaigns for safe driving do populations are so over represented in transport- reduceDate mortality. Card Holder’s Signature Your passion. Card Holderrelated’s Name - blockinjury. letters There is limited evidence for the effectiveness Your skill. I wouldThere like my are donation a variety to help ofsupport: risk factors that are unique of booster seats, pedestrian safety education, International Development Programs General Foundation Programs Your legacy. to the Indigenous populationams Indigenousand are Health directly Programs pedestrian visibility enhancement, vehicle Scholarship and Fellowship Progr al Gifts Program related I have a potential to the contribution environment, to the Cultu withr 75 per cent of all inspection programs and black-spot programs. our injuries I do not gi voccurringe permission for in ackn regionalowledgement and of myremote gift in any areas. College publication Some success has been achieved via a multi-faceted Y PleaseEnvironmental send your donation to factors: unique to remote approach in the Northern Territory. NEW ZEALAND AUSTRALIA & OTHER COUNTRIES communities include limitedFoundation foraccess Surgery to public This program, which required roll frames to Foundation. Foundation for Surgery PO Box 7451 250 - 290 Spring Street Newtown, 6242 Wellington transportEast Melbourne , VandIC 3002 poorly maintained roads. Vehicles be fitted to vehicles and changed legislation that New Zealand areAustralia often un-roadworthy due to a combination deemed it illegal for people to ride in open load of reduced maintenance and difficult driving spaces, was successful in reducing the road deaths conditions. from 10 per cent to 2.1 per cent over a seven year A variety of behavioural factors also contribute to period. the increased rate of transport related accidents in Research is required to address the complex the Indigenous population, including use of alcohol cultural, social and demographic issues that face and high speed, driver fatigue, overcrowding, the Indigenous population in order to determine Trauma unlicensed drivers, drivers and passengers not how to reduce the incidence of transport-related in Indigenous Communities wearing seatbelts (50 per cent of Indigenous injuries. fatalities were not wearing a seatbelt) and lying on Practical initiatives such as improving roads, or playing on the road. lighting, signage and pedestrian footpaths and Indigenous Australians face significant challenges increasing access to public transport in remote in obtaining a driver’s licence, including financial areas, combined with raising awareness of the Prevention of road and traffic injuries among Aboriginal and Torres Strait and educational problems and, as such, many drive significance of the problem and increasing without a licence. Unfortunately, transport safety compassionate enforcement of road laws, may assist Islander people; an initiative of the Foundation for Surgery promotion messages have not been effective in in reducing the Indigenous road toll. raising awareness among Indigenous communities. Programs that are tailored to the Indigenous Interestingly, education-only based intervention communities are urgently required to reduce the This is the final in a series of four articles that derive from ransport related accidents are common in has not proven to be effective in reducing transport rate of transport related injuries. This will require the Evidence Based Actions Plans (EBAP’s) commissioned Australia. However, Indigenous Australians are –associated injuries among all Australians. Some significant collaboration from a variety of diverse by the Foundation for Surgery to help identify how Tdisproportionately over represented in fatal Indigenous communities have developed culturally groups including health, transport and education improvements in the delivery of surgical services to transport accidents, at a rate of two to three times that sensitive safety programs, but like other educational authorities, police, local government, the Australian Aboriginal and Torres Strait Islander peoples can of non-Indigenous Australians. programs used in the non-Indigenous population, government and Indigenous communities. contribute to better health outcomes in their communities. While road safety interventions have been they have not been effective at reducing mortality. Dr Chantel Thornton The EBAP research was led by Professor Russell successful in reducing the road toll, these interventions Despite popular belief there is no evidence Foundation for Surgery Board member seem not to have had an effect on the large number of Gruen at Monash University and Alfred Health and Indigenous fatalities that occur each year. Alarmingly, Associate Professor Kelvin Kong, Chair of the College in some areas the death rate is 17 times greater within Indigenous Health Committee, in collaboration with Indigenous communities than within the general relevant research, clinical and policy experts from around Australian population. Australia. Indigenous road fatalities occur more frequently For those who want to support our work in In this article, Foundation for Surgery Board member, with pedestrians or passengersYes, and occur I w equallyould at like to donate Dr Chantel Thornton, discusses the prevention of road all ages, compared with the significant to opeaku rin F theo undation for Surgery Indigenous health you can do so by donating to and traffic injuries among Aboriginal and Torres Strait 18 to 25-year-old age group in the non-Indigenous the Foundation for Surgery. A donation form is Islander people. population. All donations are tax deductible included in this issue of Surgical News.

Page 10 / Surgical News October 2012 Name: Surgical News October 2012 / Page 11 Address: Telephone: Email: Speciality: Enclosed is my cheque or bank draft (payable to Foundation for Surgery) for $ .

Please debit my credit card account for $ .

Mastercard Visa AMEX Diners Club NZ Bankcard

Credit Card No: Expiry /

Your passion. Card Holder’s Name - block letters Card Holder’s Signature Date

Your skill. I would like my donation to help support: Your legacy. General Foundation Programs International Development Programs Scholarship and Fellowship Programs Indigenous Health Programs I have a potential contribution to the Cultural Gifts Program Your I do not give permission for acknowledgement of my gift in any College publication Please send your donation to: Foundation. AUSTRALIA & OTHER COUNTRIES NEW ZEALAND Foundation for Surgery Foundation for Surgery 250 - 290 Spring Street PO Box 7451 East Melbourne , VIC 3002 Newtown, 6242 Wellington Australia New Zealand Foundation for Surgery CAPTION: Indigenous Health Curmudgeon’s Corner Figure 1. Total number of single vehicle roll over (SVRO) casualties in Central Australia from 2004 to 2010. Since 2007 there has been a step-wise reduction in the incidence of SVRO’s, which can be directly attributed to the actions of the College andCAPTION: the Northern Territory Government. Figure 1. TotalYes, number I would of single like to vehicle donat rolle over (SVRO) casualties in Central Fatal numbers to our Foundation for Surgery Australia from 2004 to 2010. Since 2007 there has been a step-wise reduction in 80 the incidence ofAll SVRO’s, donations are tax which deductible77 can be directly attributed to the actions of the Single Vehicle Rollover Accidents: Trauma in Central Australia Name: 70 College and the64 Northern Territory Government. T elephone: Address: Speciality:56 Indigenous Medical 60 53 Email: 54 $ . or bank draft (payable to Foundation for Surgery) for 50 Enclosed is my cheque 45 Male 42 . here are growing concerns about the 80 Please debit my credit card account for $ 77 NZ Bankcard 35 Visa35 AMEX Diners Club Female Specialists 34 34 incidence and consequences of single 40 70 Mastercard64 33 30 29 / 27 Expiry vehicle rollovers (SVRO) in Central 30 Credit Card No: 24 56 Total 60 53 54 21 22 Medical colleges have come together T 20 Date Australia. Between 2000 and 2010, there were 18 Card Holder’s Signature Your passion. Card Holder’s Name - block letters 20 50 11 45 Male to encourage Indigenous specialists a total of 208 deaths due to motor vehicle Your skill. I would like my donation to help support:42 International Development Programs 10 General Foundation Programs Your legac35y. 35ams Indigenous Health Programs Female accidents (MVA’s); of these, 116 were due to 40 34 Scholarship and 34Fello wship Progr 33 al Gifts Program 30 I have a potential contribution to the Cultur 29 0 wledgement of my gift27 in any College publication Total SVROs. Unfortunately at 58 per cent, Indigenous 30 I do not give permission for ackno 24 2004Your 2005 2006 200720 2008 2009 201021 22 individuals constitute the majority of the fatalities. 18 Please send your donation to: CAPTION: NEW ZEALAND n a bid to close the gap in health status between AUSTRALIA & OTHER COUNTRIES 20 Foundation for Surgery Foundation. Foundation for Surgery PO Box 7451 11 Excessive speed, unsealed and unfenced roads, 250 - 290 Spring Street Newtown, 6242 Wellington Indigenous and other Australians, the National East Melbourne , VIC 3002 New Zealand narrow shoulders, animals crossing Figureroads, vast 2. Indigenous as10 compared to nonAustralia-Indigenous casualties involved in IAboriginal and Torres Strait Islander Medical Specialist distances and the high use of alcoholSVRO’s makes fromthe 2004 to 2010.0 Indigenous casualties have remained constant since Framework Project (NATSIMSFP) has been implementing spectrum of SVRO’s in the Northernthe Territory introduction of the speed2004 limit in2005 2007. 2006 2007 2008 2009 2010 the framework recommendations endorsed by the unique. CAPTION:Figure 1. Total number of single vehicle roll over (SVRO) casualties in Central Committee of Presidents of Medical Colleges (CPMC) Australia from 2004 to 2010. Since 2007 there has been a step-wise reduction In the seven-year period (from 2004-2010) the since July 2012. 45 in the incidence of SVRO’s, which can be directly attributed to the actions of the Alice Springs hospital recorded an astounding Figure41 2. Indigenous as compared40 to non-Indigenous casualties involved in The project is housed in and facilitated by the Royal College and39 the 38Northern Territory Government. 1,872 patients involved in MVA’s, of which40 382 SVRO’s from 2004 to 2010. Indigenous casualties have remained constant since Australasian College of Surgeons. Law were due to SVRO’s. Indigenous casualties the introduction of the speed limit in 2007. The main focus of the framework recommendations unto themselves 35 32 contribute significantly to SVRO statistics, 29 29 endorsed by the CPMC in 2010 was to increase the number 30 43.7 per cent (n=167). of Aboriginal and Torres Strait Islander medical specialists 24 23 Lawyers, hmmphf Interestingly, since the introduction of 25the speed 45 22 Indigenous 41 40 in Australia to help improve speciality skills particularly 39 38 limit in 2007 by the Northern Territory Government20 40 16 16 17 16 Non-Indigenous needed to address the poor status of Indigenous health. and the instrumental work of the College in this The core aim of the project is to encourage pathways for here is one thing that really annoys me and that is 15 35 32 process, there has been a stepwise reduction in the 29 29 Indigenous doctors wishing to pursue specialist training. lawyers, well not all lawyers, but some lawyers. I will total casualties since 2007 (Figure 1). 10 30 In February 2012, the project surveyed 15 medical even admit that I have some friends who are lawyers. 24 T 23 This good news is short lived as, even5 though 25 22 Indigenous specialist Colleges in Australia to identify the scope to They were friends first and then became lawyers and I never this reduction is significant, this mainly applies implement the framework recommendations. The survey quite got round to cutting them off. We curmudgeons are 0 20 16 16 17 16 Non-Indigenous to non-Indigenous casualties while Indigenous2004 2005 2006 2007 2008 2009 2010 analysis revealed that the majority of Colleges were already very short with people who waste time by unnecessary CAPTION: 15 casualties remain constant (Figure 2). engaged in Indigenous health-related learning module questions and chat. Lawyers have no idea of the value of Another issue that has arisen is the decreased 10 time – my time. Figure 3. Indigenous Australians are much more likely to be involved in SVRO’s development, including cultural competency training. effectiveness of road transport safety awareness Some Colleges also reported the recognition of Indigenous Have you noticed that when you are asked to go to court under the influenceCAPTION: 5of alcohol compared to non-Indigenous. There has been a in Indigenous communities, which is manifestedslight reduction since 2007 due to much more strict enforcement; however the knowledge and culture in their curriculum development. to give evidence the times available are from 10.30 to noon 0 and 2.30 to 4 pm? Now that is a total of 3 hours per day. in drink driving and unrestrained passengers.rate of accidentsFigure under 3.the2004 Indigenous influence2005 remainsAustralians2006 constant. are2007 much more2008 likely2009 to be involved2010 in SVRO’s The survey also revealed opportunities for improved Indigenous Australians have been involved in under the influence of alcohol compared to non-Indigenous. There has been a data collection, and information about training programs What on earth do they do for the rest of the day? In between higher rates of SVRO’s under the influence of slight reductionFigure 2. Indigenous since 2007 as duecompared to much to non-Indigenous more strict enforcement; casualties involved however in the for prospective Trainees. these hours the legal profession go to their “chambers”. alcohol (Figure 3). rate of SVRO’saccidents from under 2004 tothe 2010. influence Indigenous remains casualties constant. have remained constant Currently, the project is conducting a second round That word in itself is suspicious – it is not their “office”, 30 28 since the introduction of the speed limit in 2007.. A total of 142 individuals were unbelted in the questionnaire survey to better inform the project which sounds like a good honest working place. It is not their “consulting rooms”, which implies some sort of value 382 SVRO’s from 2004 to 2010, and of this,25 101 implementation process. 21 persons were of Indigenous descent. 20 As an early achievement, the project has recently for money in exchange for advice. It is not an “operating 3019 28 20 17 theatre”, which suggests that something really is achieved Interestingly, that those who were intoxicated 16 developed a standard guideline for Colleges to ask about Indigenous there. were far more likely to be unrestrained. And those 13 25 Indigineity for data collection purposes. It is anticipated 15 12 21 Non-Indigenous who were belted fared much better than those 20 that this guideline will be distributed to all Colleges by And then there is the “Judge’s Associate”. Why is he or 19 9 9 8 20 8 8 Total that were not belted, with those being belted10 7 17 early September 2012. she necessary – perhaps someone with whom to play 6 16 6 Indigenous at an average injury severity score (ISS) of nine 4 13 4 The project aims to launch web pages within the CPMC backgammon or whist or whatever the legal fraternity 5 15 12 3 Non-Indigenous compared with an ISS of 21 for those who were 1 1 get up to in the hours spent in their “chambers”? And as 9 9 domain so that the general public and prospective medical 8 8 8 Total unbelted. 10 7 to giving evidence – they ask your name and address and 0 6 6 Trainees can access project resources. Single vehicle rollovers and motor vehicle 2004 2005 2006 2007 20084 20094 2010 It is hoped that the web pages will be instrumental qualifications. Can’t they read the letterhead? 5 3 accidents are still a cause for worry in Central 1 1 in providing information on medical specialist training Then the questions go on and on and at one minute to Australia and much more targeted primary 0 programs for Aboriginal and Torres Strait Islander doctors noon they decide to adjourn for lunch. It sounds like a game prevention strategies need to involve remote 2004 2005 2006 2007 2008 2009 2010 hoping to become specialists. of cricket. However, the time-sensitive statement to be most communities to address alcohol and seatbelt use. For further information about the project please contact feared from a lawyer in court is what I call the great legal Figure 3. Indigenous Australians are much more likely to be involved in lie: “I won’t be very long with you, doctor”. However, there Mathew Jacob SVRO’s under the influence of alcohol compared to non-Indigenous. There Dr Netra Khadka at [email protected]. University of Notre Dame Australia has been a slight reduction since 2007 due to much more strict enforcement; Kelvin Kong is a sting in the tail. When we get them in our care we can Alice Springs Hospital however the rate of accidents under the influence remains constant. Chair, Indigenous Health Committee retaliate with the great surgical lie: “This won’t hurt a bit”.

Page 12 / Surgical News October 2012 Surgical News October 2012 / Page 13 Audits of Surgical Mortality Surgical Services

Poison’d Chalice Case Study Though this be madness, yet there is method in’t. Hamlet Act 2, Scene t was a serious discussion. I was they are completely absorbed in their self- linked across the world, the challenges of “Unconscious patients need intubation for transfer” talking about succession planning importance, content that they have lots of maintaining that local commitment and – if someone had the skill to do it. Iwith some of the ‘young Turks’. You well paid work, but failing to realise that drive, it seems to me, is more important know the ones; obvious leaders of the society is turning away from them. than ever before. middle aged patient with a headache in the morning, collapsed future, individuals with something to say, Maybe they are right, maybe they will Osler has provided a warning from In Memoriam shortly thereafter. The patient arrived at a rural hospital at around but who couldn’t as yet understand why be able to complete their careers before the past, ‘the dangers and evils which 10am and triaged as a “2”. Motor response and pupil dilation Our condolences to A people were not listening to them. To them, the final curtain is lowered – leave it threaten harmony among the units, are was not recorded. Reacting, eye opening 1, speech 1 on GCS, temperature the solutions were clear – the ramifications, to the next generation to answer for internal, not external. And yet, in it more the family, friends and 35.1 and O2 saturation 96 per cent. The secondary hospital emergency the province of others. They lacked a their deficiencies. But something in me than in any other profession… is complete colleagues of the department advised transfer unintubated. sense of how the broader world actually says this is not right. Time and again organic unity possible?’ Doubtful would following Fellows whose During the ambulance transfer, “sats” were 92 per cent to 96 per cent. worked, and resisted seeing the bigger throughout my career I have benefited be my immediate response. And yet, it death has been notified Airway intervention was resisted despite the patient being unconscious picture, intent on only solving the problem from battles fought by my predecessors. must be said that the most internally with fixed dilated pupils. over the past month: at hand, no matter how Draconian. Their I feel that they would expect the same unifying event is an identifiable external At around midday the patient arrived at the second hospital, breathing desire, to effect change by imposition. of me – to at least try to leave a level threat. Franklyn Bell, WA spontaneously, with GCS 3. A chest x-ray demonstrated aspiration. Severe The thoughts of one of my mentors playing field for my successors. It might Alas there is a real risk that as Orthopaedic surgeon hypertension was treated with hydralazine resulting in hypotension. The came to mind. He was an earnest even benefit patients of the future, one of individuals and professional groups we CT scan demonstrated a massive subarachnoid haemorrhage from a giant Oslerian. I may be able to quote which I will inevitably be. are so internally focussed that we fail to Sinclair J Smith, SA basilar aneurysm, with hydrocephalus and evidence of posterior cerebral Shakespeare intermittently, but he could “Madness”, said my younger colleague appreciate the real threat – where our General surgeon artery infarction. ramble on for hours about William Osler. and mis-quoted Shakespeare back to me. energies and efforts should really be By mid-afternoon, mannitol started. The intracranial pressure was greater “The Father of Modern Day Medicine,” “Where is the method to that madness?” focused. I began to feel tired and quite than 50 with the insertion of an external ventricular drain. Sedation was u he always said. He often reminded me – clearly thinking that he had scored a possibly old, but suddenly I began to see ceased and the patient remained unresponsive with unreactive pupils. The the biggest weakness of surgeons was telling point. in their expressions, dawning realisation. We would like to notify readers patient was palliated and brain death certified the next day. working in organisations, hospitals and It was getting late in the evening. At So where do we go to from here … that it is not the practice failing to recognise their role in a larger least they had come, participated. The Professor U.R. Kidding of Surgical News to publish Comments “Universe”. He always quoted Osler discussion had commenced around the obituaries. When provided they In an ideal situation the patient should have been intubated, ventilated are published along with the and in particular liked the address from significance of credentialing – not the names of deceased Fellows and sedated prior to transfer. This would prevent aspiration (if it had not 1897: “Physicians as a rule have less value of it, but the significance of it. For under In Memoriam on the already occurred), help maintain pO2 close to 100 and possibly help control appreciation of the value of organisations them it was just one more episode of College website www.surgeons. intracranial pressure by preventing the pCO2 from rising. The drugs used than members of other professions.” bureaucratic inspired tedious paperwork. org go to the Fellows page and for this would need someone experienced in airway management. But these young Turks; well, you could I pushed a bit further – why has click on In Memoriam. Mannitol 20% could have been administered at the rural facility with appreciate their point of view. Organisations credentialing been introduced? Does its an initial dose of 100-200 ml IV. This helps intracranial pressure and brain have not always served them well. They are mere introduction mean anything to you? perfusion. fond of sounding off about the hospital After all it is a worldwide phenomenon. } The logistics of communications between rural and major hospitals and its management (mainly me, I have “Who mandated it? Will it be successful should be a priority of hospital managements. Advice between hospitals discovered); they then start sounding off in improving patient safety? If not, where Informing the College regarding these treatments should occur as most of these treatments can about our Association and the College. do you think it will lead?” I probed If you wish to notify the College of be implemented in the rural setting, if staff have the skills. Training staff Easy targets, I must admit. Increasing further, trying to push them to places that the death of a Fellow, please contact with appropriate skills for this type of emergency is also an issue for subscriptions and always struggling to they had not previously been. I wanted the Manager in your Regional Office. management. justify where they spend the money. All them to begin to appreciate that there They are There was no neurologic assessment chart in the rural hospital record those people off to more meetings. Where is were forces at work beyond their and hence pupil responses were not recorded and motor responses were the advantage in that, they ask? immediate fields of endeavour. ACT: [email protected] inadequately noted. These are important components of the GCS. Absence Well, I was ready for that one Was I just being an ‘ancient’ NSW: [email protected] of this chart is a reflection that hospital managements have not planned for after my recent discussions with my with out-moded views on how NZ: [email protected] these eventualities. mentor. Remember Osler I said. In surgeons should work together The death certificate was incorrectly completed. Subarachnoid Cushing’s biography of him, he states and ensure we not only QLD: [email protected] haemorrhage, not brain death was the “cause of death”. that Osler actively participated in over maintain a profile in hospitals, SA: [email protected] 110 associations and societies; he saw but also keep our standards TAS: [email protected] service in voluntary organisations as an high and demonstrable within important way to develop leadership the health sector overall? It is a VIC: [email protected] and management. So, how about being paradox. When we are so much WA: Angela.D’[email protected] Guy Maddern involved? It is one of those important steps more an international community of NT: [email protected] Chair, ANZASM to the future. My concern for them is that surgeons with standards and techniques

Page 14 / Surgical News October 2012 Surgical News October 2012 / Page 15 Fellows in the News

Left: Larisha Barikoa on the mend. Below from left: The abscess when A matter of life she arrived; Gert Tollesson; The abscess when she left. Fellow Gert Tollesson and International Medical Graduate Ashish Jonathan give back life

Mr Tollesson said Larisha spent that Australia we could leave it, but in the Now doing his supervised training, he first night in ICU following multiple Solomon Islands with limited tertiary hopes to be writing his Fellowship exam scans, then the next day underwent health care and no neurosurgical service next year. a two hour operation in which he she would be in trouble in the remote He said treating Larisha was both and neurosurgical registrar Ashish chance it reformed.” medically interesting and personally Jonathan drilled into her skull and with Mr Tollesson said that while such rewarding and in an interview with an endoscope inserted a tube to start brain abscesses were sometimes seen in Brisbane’s Courier Mail newspaper draining the abscess. Australia they were most often caused described her as having “the best hairstyle Within 24 hours of that initial by a compromised immune system, in the world”. Cover treatment, she began moving her right particular lung infections or sepsis. “She is doing well very well now and Story arm and was talking and alert. “This is a very dangerous condition,” we expect her to go home soon,” he said. This was followed by further puncture he said. “Now that the abscess has been excised and drainage surgeries on July 4 and July “We knew what was wrong with there will be an area of gliosis where the 17 with the last procedure done on July Larisha before she arrived and were abscess once was which means there wo Queensland neurosurgeons and lower limbs and severe language island home to Australia for surgery. 21 to remove the abscess capsule to make greatly concerned that she came to is definitely some damage done, but have saved the life of a Solomon dysfunction with a receptive and “The germs on the nail and the skin sure no further infection could set in. Australia in time because the cyst could functionally she is doing well. TIslands child who developed expressive dysphasia. caused the abscess to form after the direct Now bright, happy and adding every well have burst which would have caused “She does have the best hairstyle in the a severe brain abscess after a nail The tiny five-year-old was also penetrating injury,” Mr Tollesson said. day to her English vocabulary, Mr encephalitis. world. penetrated her skull from a falling ladder. severely dehydrated and malnourished “Her first symptoms were a headache Tollesson said Larisha had recovered “She was very close when we finally got “When she arrived she had her hair Larisha Barikoa was close to death upon her arrival at Brisbane’s Royal and fever, then difficulty speaking and the extremely quickly and very well. to see her, probably in a week she would in little braids all over her head tied with when she was flown to Australia Children’s Hospital in June, causing the loss of movement in her right arm and “She has a slight weakness on her right have been dead, so it is greatly rewarding little pink ribbons. by Rotary Oceania Medical Aid for neurosurgery team to delay operating for leg, yet without any scanning facilities side and there may be some cognitive to help in such cases, particularly when “Unfortunately we had to shave some Children (ROMAC), arriving in Brisbane 24-hours to boost hydration and stabilise local medical staff thought it may have deficit because she has lost a lot of brain we see such a small person whose whole of it for the surgery, but she is still a four months after the accident which her condition sufficient to undergo the been malaria. tissue in the left frontal lobe, but it is life is ahead of them and who would picture.” happened on the remote Choiseul Island. first of four surgeries. “Then even though she was taken to hard to know because of brain plasticity otherwise be well if they can get the Larissa travelled to Australia with her Despite her grandfather immediately Lead surgeon and consultant the main hospital in Honiara, neurosurgi- and its amazing ability to rewire itself to treatment they need in time.” aunt and was cared for in Brisbane by removing the nail, by then the abscess had neurosurgeon Mr Gert Tollesson said he cal procedures are not something they can counteract such deficits,” he said. Dr Ashish Jonathan, who assisted Mr Ms Denise Schellbach who said ROMAC grown to six centimetres and involved had been asked if he could help Larisha perform so she was in a very bad state by “We are very confident that the Tollesson, is an International Medical become involved in her case after the Ho- the left frontal lobe of her brain, causing weeks before her arrival, but that it had the time she arrived, virtually dying, with abscess won’t come back, but as an extra Graduate who did his MBBS and niara Rotary Club learned of her plight. significant weakness in the right upper taken time to get her from her remote only about one week to live.” precaution we removed the capsule. In Neurosurgical training in India. With Karen Murphy

Page 16 / Surgical News October 2012 Surgical News October 2012 / Page 17 Surgeon Health Library Report

Royal Australasian College of Surgeons | Evidence Based Practice

Evidence Australasia So will you benefit from flu vaccination? My Network All sites indexed are Australian, the emphasis being on perceived evidence-based Health sites. Only publicly available, non-subscription-based sites are included; similarly, only guidelines that are freely My Network Profile Not if you are a healthy adult, and there available are indexed. My Connections (0) NHMRC Clinical Guidelines Portal

The National Health & Medical Research Council guidelines facility. is at least a Cochrane review of some My Messages (0)

EBM Tools 50 studies and 70,000 adults addressing Quick Links Asking Focused Questions

Finding the Evidence Edit the subject. Flu vaccines can’t stop you What’s new in the Library Making a Decision Add Page To Quick Links Evaluating Performance dying, don’t keep you from being admitted Designing Research ntroduction to the principles EBP Tutorial to hospital, don’t reduce the risk of New Evidence-based Practice Resources (EBP) via the Library This tutorial is intended for any health care practitioner who needs a basic i of Evidence-Based Practice. Upon completion of this self-paced tutorial, you will be able to:

define Evidence-Based Practice (EBP) pneumonia or time lost from work, nor do identify the parts of a well-built clinical question identify EBP searching strategies that could improve PubMed retrieval identify key issues that help determine the validity of the results of a study Policies & Publications

they prevent you infecting your patients. Member Services Policies Royal Australasian College of Surgeons | Evidence Based Practice ANZ Journal of Surgery Scholarships, Awards, Lectures & Connections Surgical News Prizes To flu or not to flu Specialty Societies Surgical Workforce Data About RACS The review had a carefully crafted and My Page Settings Logout A Search... College Resources A A Affiliated Organisations Publications he College is continually database. The Clinical Queries Member BenefitsAdvanced Search Governance & Committees Audits & Surgical Research Regions Interest Groups & Sections Find a Surgeon Academy of Surgical Educators College Merchandise rather deeply meaningful sentence: “In the Home About RACS Media Policies & Publications CommunityFoundation & International & Donations Contact Us Foundation In Memoriam improving the Library to meet section is a question-focused interface Programs Venue Booking Surgical Vacancies

ABN 29 004 167 766 that is the question relatively unusual situation of the vaccine the information needs of Fellows with filters for identifying the more © 2011 Copyright Royal Australasian College of Surgeons Evidence Based Practice Sitemap matching the circulating strain of virus, the College Calendar T Disclaimer and privacy and Trainees in their specialty and area of appropriate studies for questions, Contact Us Home > My Page > RACS Knowledge > Library > Evidence Based Practice

Last Update: 02/08/2012 09:44 “Aaaaaa .. aa.. chooooooo!” development of flu and flu-like symptoms Welcome: practice. The positive feedback we receive prognosis, diagnosis and etiology. Kirsten Burkitt Useful Sources of Evidence was reduced from 4 per cent to 1 per cent Studies about the Library confirms that this is a My Menu PubMed Clinical Queries My Account by vaccination.” A flu vaccine manufacturer PubMed is a free internet MEDLINE database. The Clinical Queries section is a question-focused interface with filters for identifying the more appropriate studies for questions, prognosis, diagnosis and valued resource. In response to popular My CPD Program SUMSearch etiology. Click directly through to the Full Text of articles where available. he winter is as usual long, cold was that nosocomial flu infections have a might promote that as a 75 per cent request, the Library has developed a new My Audits SUMSearch SUMSearch is a “super”- PubMed: A super-PubMed: SUMSearch simultaneously searches multiple internet sites and collates the results. College Calendar and damp, bringing scores of high fatality rate especially in comorbid reduction, but that is nonsense. As most Checks for the Merck manual, guidelines, systematic reviews and PubMed Clinical Queries entries. area providing Evidence-based Practice SUMSearch simultaneously searches eCommittees Cochrane Library and Collaboration The Cochrane Library is the single best source of reliable evidence about the effects of health care. The patients to my waiting room patients. They suggested that there is flu vaccines don’t match the strain, you can (EPB) resources for Fellows and Trainees. Examinations Cochrane Trials Registry contains over 30,000 controlled trials - the best single repository. multiple internet sites and collates http://www.surgeons.org/76574.aspx[2/08/2012 9:59:22 AM] T Case Studies better rephrase it by claiming 96-98 people Appraised studies sharing their viral-loaded nasopharyngeal a vaccine effectiveness of 70-90 per Evidence-Based Practice requires the Logbooks the results. SUMSearch checks for the BestBETS droplets. I am well acquainted with cent with a good strain match though out of a hundred won’t benefit and only Resource Units Provides rapid evidence-based answers to real-life clinical questions in emergency medicine, using a integration of best research evidence with Merck manual, guidelines, systematic systematic approach to reviewing the literature. BETS take into account the shortcomings of much Application to Fellowship current evidence, allowing physicians to make the best of what there is. Developed in the Emergency one or two healthy adults in 100 would be Department of Manchester Royal Infirmary, UK. their demands and expectations – most admitted this was lowered to 59-83 per clinical expertise and patient values.1 The reviews and PubMed Clinical RACSTA spared this benign, but prevalent disease Syntheses hope for a magic bullet, but will leave cent in its absence. The final paragraph RACS Knowledge Library plays a useful role in supporting Queries entries. Cochrane Library and Collaboration Library The Cochrane Database of Systematic Reviews has over 1000 systematic reviews done by The disappointed that having found no confessed that randomised controlled (in any one year). Cochrane Collaboration. The Database of Abstracts of Reviews of Effectiveness (DARE) database lists Fellows and Trainees with the process other systematic reviews. We are witnessing an era where health Recommend a Resource evidence of pulmonary complications I trials are still needed to prove whether Annual Scientific Congress of their evidence based judgement and BestBETS Synopses care resources are being splashed out on Conferences Bandolier have not offered them antibiotics. vaccinating health workers actually decision making by providing access to A monthly newsletter of evidence distributed in the NHS, which is freely downloadable. BestBETS provides rapid evidence- Courses & Workshops TRIP Database vaccines which swell the global balance Blogs & Discussion Groups Yesterday I saw one of my favourite prevents nosocomial infections. I’m not quality sources of information. Searches several different evidence-based resources including PubMed, Bandolier, and the ATTRACT based answers to real-life clinical question-answering service. Only allows title searches, but does allow AND, OR, NOT. patients, Ms Snivels, a surgeon normally signing up as guinea pig for such a trial. sheets of CSL, Glaxo and Smith-Kline Through specialty and topic focused eLearning questions in emergency medicine, Australasian Content in the best of health, but at present The same editorial was somewhat with billions of dollars for a product of pages, the Library aims to present relevant using a systematic approach to http://www.surgeons.org/76574.aspx[2/08/2012 9:59:22 AM] suffering from a bout of the flu. She dismissive of healthcare workers concerns questionable evidence base. The claim resources in a way that helps users to reviewing the literature. BestBETS had already spent a day in bed, was still about complications, but stated “adverse that flu vaccinations should be mandatory avoid ‘information overload’ but, at the take into account the shortcomings feeling lousy, had commitments to fulfil, events are always possible after flu for healthcare workers is unfounded and same time, to find and apply the most of much current evidence, allowing NHMRC Clinical Guidelines and wanted to be full throttle again faster vaccination”. The Australian published should be strongly resisted. There remain useful information. physicians to make the best of what Portal than any normal person. an article on August 3 reporting an strong vested, financial conflicts of interests The new Evidence-Based Practice there is. Developed in the emergency The National Health & Medical Research I gave her the best advice I could. Go association between flu vaccine and 10 and massive lobbying of public health (EBP) area lists useful sources of evidence, department of Manchester Royal Council guidelines facility is another home, drink plenty of fluids, take another deaths in the stampede for vaccination bureaucrats by pharmaceutical companies and links to tools for each step of the Infirmary, UK. useful source. day off, avoid exercise for a few days, following Swine flu, that gentle and with the collusion of some infectious EBP process, including an in-depth Ovid MEDLINE® also offers Clinical don’t overtire yourself the first couple of kindly strain that many of us brushed off disease physicians. I don’t know what Ms tutorial. The new area aims to bring the Bandolier Queries limit for evidence-based content. days back, adjust your schedule, confront with just a bit of a sniffle, despite a WHO Snivels will decide personally, but at least I evidence-base direct to you and, in doing The Bandolier is monthly newsletter The new EBP Resources can be viewed reality. It’s already too late for any benefit inspired world-wide panic. pointed to the lack of evidence. There are a so, enhance patient care, evidence-based of evidence distributed in the NHS, and accessed at http://www.surgeons. from anti-virals. As Ms Snivels was about You will be interested to know that the lot more dangerous things to be protected practice and clinical governance. which is freely downloadable. org/my-page/racs-knowledge/library/ to depart, feigning thankfulness for my Australian taxpayers ended up spending against with vaccines that have really been evidence-based-practice/ (you will need to shown to work. honest if unwelcome advice she asked, $131m on CSL’s Panvax, without the Cochrane Library be logged in). “I suppose I should have a flu-shot next costs of the 1716 adverse event reports, But please excuse me; I think I’m TRIP Database If you need assistance searching these The Cochrane Library is the single best This database searches several different year?” including seven deaths. Panvax was catching something … resources, or have any other questions source of reliable evidence about the evidence-based resources including I paused … I considered… then I replaced by Fluvax in 2010 incurring Aaaaaa... aa... chooooooo! about the Library service, please contact effects of health care. The Cochrane Trials PubMed, Bandolier, and the ATTRACT decided to be honest, “Personally, I a further 2136 adverse notifications, Dr BB G-loved the Library by email at College.Library@ Registry contains over 30,000 controlled question-answering service. The TRIP wouldn’t bother. There’s no evidence to including 11 cases of Guillain Barre References: surgeons.org or use the feedback form on trials – the best single repository. database only allow title searches, support giving healthy individuals flu Syndrome (GBS). Yes, there is a small but Nair H et al. Influenza vaccination in the Library web page. healthcare professionals.BMJ 2012;344;e2217 The Cochrane Database of Systematic vaccination. Now that you’ve had the recognised increase in GBS after influenza but does allows word combinations 1. (Sackett et al. 2000. Evidence based medicine. Bita N. The Australian Friday August 3rd 2012. Reviews has over 1000 systematic flu you’ll have earned a good number of vaccination! Imagine how you’d feel being including AND, OR, NOT. How to practice and teach EBM. Second Jefferson T, Di Pietrantonj C, Rivetti A, reviews undertaken by The Cochrane years immunity and resistance to another a fit healthcare worker and then suddenly Images to accompany article edition. Churchill Bawazeer GA, Al-Ansary LA, Ferroni E. Collaboration. The Database of Abstracts serious bout.” you are on a ventilator for weeks and Evidence Australasia Livingstone. London.) Vaccines for preventing influenza in healthy of Reviews of Effectiveness (DARE) There’s a big push afloat, especially incapacitated for much of a year after All sites indexed are Australian, the adults. Cochrane Database of Systematic database lists other systematic reviews. in some health services, to promote faithfully volunteering for your flu shot. emphasis being on perceived evidence- Reviews 2010 Other features of the EBP area include: influenza vaccination for healthcare Fluvax was also withdrawn for under- Thomas RE, Jefferson T, Lasserson TJ. based Health sites. Only publicly professionals. A March 2012 BMJ editorial fives in Western Australia when found to Influenza vaccination for healthcare workers available, non-subscription-based sites Cathy Ferguson even carried the subtext that it should induce febrile fits at ten times the normal who work with the elderly. Cochrane Database PubMed Clinical Queries are included; similarly, only guidelines Chair, Fellowship be mandatory. The argument proffered rate. of Systematic Reviews 2010 PubMed is a free internet MEDLINE that are freely available are indexed. Services Committee

Page 18 / Surgical News October 2012 Surgical News October 2012 / Page 19 Trauma Committee A Mother’s Perspective: - written by Carmel Stuart wanted so much to see the Docu- “IDrama that I delayed going on my holidays! Member of the Mackenzie had just gone for P plates Queensland Trauma on the Monday beforehand and I was understandably conscious of his safety Committee Mr Barry being in his own hands for the first time. Collis is committed to In fact, in the Docu-Drama, one of making young drivers the things pointed out was that very few see sense accidents happened when the aspiring driver was on their L plates, but that the risks significantly increased when they didn’t have their parent or instructor in the seat beside them. Hmmm. Rowdy peer pressure, too many people in the car, alcohol, cavalier attitudes, distrac- tions like phones and music are not things a regular parent would allow whilst notch- ing up that 100 hours for the log book. It is when we allow them out alone in a vehicle you just hope they remember all the boring things you drummed into them. And that is where this presentation to the me but my family, the victim and the blaring of sirens and flashing lights as Grade 12 boys was so important. Not only victim’s family. The most informative a police car and an ambulance came was there a “crash scene” on the oval with part was where the victims of past car across the oval to arrive at the mock some of the Toowoomba Grammar School accidents talked to all of us as a group crash scene. drama students in various states of injury and explained their experiences in The student who played the driver and inebriation, there were representatives In their face life and how they suffered since their made a convincing drunk and was from legal and medical fields and real life accident.” handcuffed and taken away by the victims who were willing to share their And Police for causing the accident. We perspectives. “I cried – it made me realise how saw our School Captain tagged as The solicitor said he represented three or fter 16 years travelling to schools, a number of participants, including road users can readily relate to it.” precious life is. I just don’t get the point “deceased” covered with a white sheet four cases of dangerous driving every year. Docu Drama Coordinator Mr student actors (from the visited schools), “This has been done with the hard of drink driving.” and loaded into the back of a funeral He guaranteed that if there was alcohol ABarry Collis is not surprised at members of Police, Ambulance and Fire work and participation of all our Despite there being no funding to hearse. involved in the fatal car crash, no court in the positive responses he still receives Rescue services, a doctor, a paraplegic, stakeholders from emergency services to quantify the results of the program, We also saw the passenger in the Australia could get the driver out of up to from students. an accident victim, a funeral director, a funeral directors,” Mr Collis said. feedback from students has all vehicle manoeuvred into a neck brace, eight years in prison. The veteran education consultant took solicitor, counsellors and even a rescue An effective tactic to engage the student been positive. One of the regularly lifted onto a gurney and placed into A bit of drawn breath and a mumble it upon himself to teach teenagers about helicopter when it is available. is by using their fellow peers as part of the participating schools stated that to its the back of the Ambulance. went through the crowd of boys listening at the responsibilities and realities of cars Designed to change the attitudes of devastating scenes. This aims to enhance knowledge it has not lost a student My first thought on the Docu- this point – they would be as old as 25 after on the road, initially as an employee of participants and audiences, the program the reality of the situation and dispel the to a road accident since the program Drama was the overwhelming shock serving this sentence. They would have a Education Queensland and now as a hopes to inspire drivers with the desire myth that they themselves are invincible – began. at seeing mates injured in what looked permanent conviction on their record and member of the College’s Queensland and ability to stay safe on the roads. It it can happen to anybody. like a very real car crash. It opened up that it may be impossible to get travel visas Trauma Committee. confronts young drivers with the realities The students also speak to the victims A Student’s Perspective: ‒ a reality that this could really happen, to some of the countries they might want to The program is a road accident of a road accident and encourages them to of car accidents, who tell of the tragic written by Mackenzie Stuart not just to others or on the News, but visit in their futures. prevention and education initiative, accept a greater responsibility when using changes in their lives. (Year 12) to people I know. Or even me. The emergency room doctor talked strongly endorsed by the regional Trauma the road, as a driver and as a passenger in e were asked to quietly walk We were shown statistics that more about the “golden hour” where if people Committee and with the support of the a vehicle. Some comments from participants “Waround a most confronting and more people my age die every don’t get help they may die or suffer Paraplegic and Quadriplegic Association In addition to effecting change in included: site – a mock crash scene on our main year in vehicle accidents as a result of permanent injury. Swelling in the brain of Queensland, the Paraplegic Benefit audiences, the spectacles generate media “I believe it is definitely worthwhile doing sports oval, complete with a crumpled drink-driving and distractions. The would mean the victim would need to be Fund (Australia), the RACQ and attention which promotes road safety it again, even if it just saves one person’s car and bodies lying around. talks from the real life victims of car airlifted to Brisbane as they were unable to Metropolitan funerals. in the wider community. Some measure life. It pushes people to think about their It was a little eerie as we were all crashes – one man in a wheel chair be treated in Toowoomba. Presented to year 11 and 12 students of success has been demonstrated with responsibility.” asked to look in silence as we circled and the other an amputee – made it I think the message definitely hit home to across Queensland, the Docu Drama coverage in local newspapers, such as the “From the experience, I now know I do the bodies slumped over steering very powerful. the boys and as a parent I was very glad to Program is a simulated car accident South East Advertiser in Brisbane. not want to ever be involved in a serious wheels and our School Captain lying It really hit home for me the be present in order to discuss this later with showing the causes and consequences Mr Collis believes the program car accident. Having to be stuck in a car still on the ground with realistic blood consequences of drink-driving and our son. Having seen what Mackenzie saw of a road accident. It is targeted at those continues to make waves at the school for hours as the fire brigade cut me out and cuts on his face. driving stupidly. This simulation of and listened to the professionals talk about aspiring drivers who fall into the high communities he visits. is something I definitely never want to After we were seated on the side of a car crash scene was an inaugural the scene and the consequences, I had a risk group using our roads. “Over the years we have endeavoured experience.” the oval, we were taken through the event at Toowoomba Grammar handy lever. This is knowledge I hope will To create a realistic scenario, Mr to make the program as realistic and “I learned that driving recklessly on the process of what happens in real life School and hopefully will be held protect many more of our lovely children as Collis features a damaged vehicle and practical as possible so that our future roads can create problems not only for road accidents. Soon there was the annually, as I think we all learnt a lot.” they head into independence.”

Page 20 / Surgical News October 2012 Surgical News October 2012 / Page 21 Successful Scholar

profile “However, for the men who suffer Awards incontinence or erectile dysfunction or 2011 – 2012: Fellowship in andrology, prosthetics, who may never be able to be a biological sexual and reproductive urology and male infertility father because of cancer treatments at the Memorial Sloan-Kettering Cancer Center or for other reasons, the distress can and Weill-Cornell Medical Centre, New York; be considerable and so if we have the opportunity to learn the skills to help 2012: Recipient of the Sexual Medicine Society of North America – Scholars in Sexuality Research these patients, we should.” Grant; Dr Katz said he first became interested in the subspecialty of andrology and 2011: Recipient of the Ian and Ruth Gough men’s sexual health after completing Surgical Education Scholarship; a research Fellowship in 2008 at the 2011: Recipient of the Australian Urological MSKCC as an uro-oncology Fellow. Foundation Travel Grant; While in New York, he met Professor 2008: Urologic Oncology Research Fellowship at Goldstein and Professor Mulhall and after Memorial Sloan-Kettering Cancer Center, New York. collaborating on various research projects, was offered the year-long Fellowship. He was then offered the College’s Ian “Erectile function, continence, and Ruth Gough Surgical Education fertility and testosterone levels can all Scholarship to help cover the costs of be affected by certain cancer treatments. moving to New York with his wife and Working within a multidisciplinary team young daughter. framework, our goal was to optimise During his Fellowship, Dr Katz these functional outcomes. Many patients also conducted a number of research would even come to us before surgery projects, many of which have been or chemotherapy so that we could start published in peer-reviewed journals and preventative measures that often limited presented at international conferences, the side effects of their cancer treatments. and continues to collaborate with his “I was involved with one of the largest colleagues in the US. penile rehabilitation programs in the world and recently we instituted a fertility These projects include: preservation protocol which spanned both > The development of a new paediatric and adult patients. Under this technique for the insertion of an protocol, we were able to extract sperm artificial urinary sphincter; using specialised techniques such as > A global study of peri-operative microsurgery or electroejaculation-under- practices aimed at preventing anaesthetic for those patients who had penile prosthesis infection with the a zero sperm count or were too sick or goal of identifying patterns and New research too young to be able to provide a sperm creating uniformity in the field; sample for banking,” added Dr Katz. > The future of fertility preservation “The urological subspecialty fields in the male cancer patient; that I worked in while overseas are > Outcomes of fertility preservation Scholar Dr Darren Katz is part of some pioneering surgical research comparably quite underdeveloped here strategies in male teenagers with in Australia. It is good to see these areas cancer; ictorian Fellow Dr Darren Katz The Memorial Sloan-Kettering Cancer infertility, reconstructive techniques for He said that while many of the patients in men’s health are progressively getting > Intralesional verapamil for the will be one of the first urologists Centre is the world’s oldest and largest Peyronie’s disease and penile ultrasound. he treated have had cancer within the more air-time than they once did, but treatment of Peyronie’s diease; Vin Australia and New Zealand to private cancer centre and the Cornell While much of his work was related to pelvic region (most commonly prostate, unfortunately gaining experience and > The effect of nerve sparing surgery have completed a Fellowship in andrology, Center for Male Reproductive Medicine the treatment of men who had suffered bladder or rectal cancer), almost any male training in the surgical management of on erectile function following prosthetics, sexual and reproductive and Microsurgery is one of the largest sexual difficulties or fertility problems receiving chemotherapy could have their such condition as male infertility, erectile radical prostatectomy; and urology and male infertility. male infertility centres in the US. as a result of cancer or cancer treatment, testosterone levels and fertility affected. dysfunction, incontinence and complex > Laparoscopic externalisation of Dr Katz spent from July 2011 to Working under the supervision of he also learnt the skills necessary to treat “Part of the package of cancer care penile disorders is difficult in Australia the retroperitoneal vas deferens June 2012 working at two of the most two pioneers in the subspecialty of male complex male hormonal, erectile and offered at MSKCC, is a Survivorship and New Zealand. This is because our and inguinal vasovasostomy prestigious medical centres in the US – sexual and reproductive urology and continence problems. Initiative which is devoted entirely to surgical training system is based in the for iatrogenic inguinal vasal the Memorial Sloan-Kettering Cancer male infertility, Professor John Mulhall Dr Katz explained that many of these optimising the quality of life of males public health sector and, understandably, obstruction, which is a novel Center (MSKCC) and the New York and Professor Marc Goldstein, Dr Katz techniques can also be used to help men who of all ages who have had cancer or been with the limited budgets of public surgical technique to treat Presbyterian Hospital/Weill Cornell gained particular expertise in prosthetic have not been diagnosed with cancer, but affected by their cancer treatment,” Dr hospitals, such quality of life conditions infertility secondary to inguinal Medical Center (NYP/WCMC). devices, microsurgical treatments for male may still have erectile or fertility problems. Katz said. are not high on the priority list. hernia repair. u

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The Ian and Ruth Gough Surgical Education Scholarship carrying a stipend of $10,000, is open to both Fellows and Trainees and was designed to encourage surgeons to become expert post op surgical educators. Now working at the Western Hospital in Melbourne and about to travel to Western Australia to take up another Fellowship at the Fremantle Hospital, 14 Dr Katz has already been asked to travel page interstate to mentor other urologists in some of the techniques he has lifestyle learnt. He hopes to develop and lead section workshops in urological prosthetics, microsurgery, and penile reconstruction for the treatment of Peyronie’s disease. He thanked the College for its support and recognition of the importance of this area of surgical Dr Katz said he believed the treatment These clinics could also help Trainees expertise and said one of the highlights of erectile dysfunction and in particular gain experience in treating these of the Fellowship had been the reaction male infertility is currently quite conditions. Dr Katz would also like to of his patients. fragmented in Australia when compared introduce survivorship initiatives to some “Working in this field often means to the US where there is a much more co- of the major cancer centres in Australia, dealing with patients who have suffered, ordinated approach to these conditions. such as the fertility preservation and often for many years, because of “In the Australian system, male penile rehabilitation programs, that he infertility, impotence or incontinence,” infertility is mostly handled by saw work so effectively in the US. Dr Katz said. gynaecologists, low testosterone by “This is about developing treatments “Then, we provide treatment for them endocrinologists and only a small for males of all ages that would facilitate and for the first time in a long time they minority of urologists have had formal those undergoing cancer surgery or experience a significant improvement in sub-speciality training in andrology, chemotherapy to receive specialised care to their quality of life. erectile and male continence problems. help maintain fertility, sexual function and “We can help them to be fathers, But it would be great if we could their overall quality of life,” Dr Katz said. we can improve the intimacy in their harness the experience of many of “These strategies can make a tangible relationships and we can get them out these specialities and develop a multi- difference to young men with cancer of incontinence pads and restore to disciplinary approach to these conditions who could miss out on the chance to them a meaningful sense of self. where possible.” become biological fathers, older men with “Consequently they have been some He said he hoped in the future to prostate, bladder or rectal cancer who of the most happy, pleased and grateful establish specialist clinics in both the may become impotent or incontinent and patients that I have treated in my career.” public and private sector to offer world- young boys who are not psychologically best-practice care to all men in need. ready to provide a sperm sample”. With Karen Murphy Get ready for the 2013 ASC in Auckland, New Zealand. Take a look at the Call for Abstracts on page 45 CALL FOR ABSTRACTS

Jet-propelled

post op appears in Surgical Flying at 400 knots is News each relaxing for this SA Fellow season Page 24 / Surgical News October 2012 surgeon RACS ASC 2013 Royal Australasian College of Surgeons 82nd Annual Scientific Congress SkyCity/Crowne Plaza Convention Centre Auckland, New Zealand 6 – 10 May 2013

asc.surgeons.org Sustainable Surgery

Royal Australasian College of Surgeons spring Lifestyle 3 u “It is the best aircraft I’ll ever fly, so I enjoy it so I enjoy fly, aircraft best ever is the I’ll “It Mr Edwards sale, of the news When he heard training a man named from for there went “We an aircraft, man outside gentle a lovely, “He’s and although he must now retired “He’s Airstrip his jet at Goolwa keeps Mr Edwards bring of being able to it into he has hopes Yet isAuthority in the Safety Aviation “The Civil they old risk the index, with moment, the “At and feet at 500 coast up at the go I can “Still, by so captivated he was said that Mr Edwards Adelaide Royal out of the he works Now “They cost between $200,000 to $300,000 and $300,000 to $200,000 between “They cost I thought that was a terrific bargain; my version my a terrific was bargain; I thought that hobby, and while it is an expensive of a Porsche think it’s I don’t of fuel, inparticularly terms outrageous. immensely.” of an aerospace pilot and owner and fellow Geraldton to Whalley travelled Jim company and authorisation assessment flighttraining, for craft. the to keys being the handed before instructor chief be the Chew to who used Willy said. Mr Edwards Air Force,” Singapore in the in his asbut back in role as soon as he sat the and he became changed hisinstructor character barking instructions fury, this adrenalin-charged of his persona nickname on the of and took at us, godfather”. “the theyoung pilots in terrifiedthe some of have safe.” them I bet he kept Air Force, Singapore stipulate that under regulations Adelaide outside and ex-military such be kept may where planes flown. Airport. Parafield city soon to the as part of a broad of reclassifying S211 the process up-grade risk to the of all ex- index project doing militarythey’re and flyingthere out planes he said. job,” a good populated like mine jets over flying want don’t if that lost engine you stipulate they areas; over glide should down be able to you power know this also is but a they uninhabited terrain, might hopeful restrictions jet so I’m the very safe upease soon. that up love I take knots and most people at 250 if and rolls can loops they in a few and I throw it.” take as career a considered he teenager that as a flying a military deciding on medicine and pilot before surgery instead. Hospitals Ashford and Wakefield and at Hospital in minimally- expertise and has particular Having gained his pilot’s licence in 1991 when 1991 in licence gained hisHaving pilot’s and I knew jets little nice really “These are Whitney a standard Pratt and “They have a than but not faster fast a trainer so it’s “It’s Mr Edwards purchased his in when the 2009 purchased Mr Edwards Singapore Air Force decided to sell its fleet of 20 of fleet sell its to decided Air Force Singapore as part of training inWA use at its then facility in up-grade. an aviation as a General Surgery in Newcastle working fulfil both childhood and – to a dream registrar of pressures the on outside focus as something to buy. to temptation the resist training – he couldn’t maintained be very because well would they Mr perfectionists,” such are Singaporeans the said. Edwards ex- are they very reliable, engine is which very, been military have design in the physics so all the reasonably are out and they worked thoroughly a jet. quiet for aerobatic. more but it is way instance, for 737, “I can’t deny I get a rush when flying the jet, a rush I get deny the jet, when flying can’t “I of mine a mate who described by I’m “Yet runway the it down take when you “Still jet little like the doesn’t however, wife, “My is a to refers MrThe jet that Edwards little Edwards for years in more sedate aircraft, has sedate in more years for Edwards jet. climb the aboard to yet he said. buzz,” it is an absolute pilot conservative the same model as a flies and I like that. that back in a push the get you and let it go great. feels on coming and that keeps of talking into her still process in the and I’m there...” get we’ll there, get but we’ll it, in made Italy and bought S211, SIAI Marchetti Air a trainer jet for as various countries by pilots. Force

feel the need for speed,” said the said the speed,” for need the feel hit the from Maverick character that a quote Gun, Top movie Not only does he love to fly, he loves to fly he loves fly, to he love onlyNot does only flier, he insists he is a conservative Yet His be convinced, Elizabeth wife to is yet Fellow James Edwards gets his adrenalin fix in the air gets his adrenalin Edwards James Fellow resonates when talking to South Australian Australian when talking South to resonates Edwards. Mr surgeon James cardiothoracic ex-militaryhis own training jet and not only a spin every other it up for take he like to does of 400 knots speeds up to getting so, or week of learning process in the now he’s Mach.08, or possibly at perform to manoeuvres aerobatic future air shows. just so far envelope willing the push to ever and no further. flying alongside Mr and despite however, “I On a high

spring Lifestyle 2 spring Lifestyle 5 u ascular surgeon ascular surgeon and the College’s Executive for Director The thrill of beating The thrill of Dr Quinn talks to Surgical Dr Quinn talks to Surgical Dr John Quinn on his love for the world of horse racing Dr John Quinn on his love V News about his love of a day at the races. Surgical Affairs Australia Affairs Australia Surgical Dr John Quinn has had a lifelong passion for horse racing. Not only do he and wife Deborah splendid sartorial make statements each November during the Melbourne Spring Racing Carnival, also members of they are a racing syndicate. Yet, glamour despite the colour, and thrill of the racetrack, he maintains a phlegmatic, amused approach to the for equine success search noting dryly that none of the syndicate’s horses have been very good or very fast Still, or very impressive. always the next sale, there’s the next horse, the next big thing. hooves With Karen Murphy Karen With “I also think I’m a better surgeon having the jet, jet, the having surgeon a better think also I’m “I is pushing Mr his Edwards Now aerial skills move each because flyingfantastic is “Formation Air in thinking involved more of becoming “We’re to is aerobatics flyingor formation to key the “But aim flying of such the should said, once someone “As because it takes focus and skill to fly which forces me forces and skill fly which to focus it takes because while refreshing thinking and that’s stop aboutto work flying the is a buzz.” by flown up jet alongside those in going the further, his expand Gale to pilot Steve Whalley and fellow Mr flying. in aerobatic abilities up get even we out before worked be thoroughly has to he wonderful,” pull but it off when you it feels there, said. future. in the trips together more take and may Shows something see go you Whenever it safe. keep always could someone bet that can Air you at an Show wrong normally don’t do something they to urge the not resist spectators. of the do because and educated the impress thrillbe to uneducated, the nobody.” scare

James Edwards loves the view from up here. Inset: James’ favourite passenger. He is a board member of the South Australian State State Australian South member of the is a board He waned has never passion his other same time, the At similarities between there not only were said that He logic and complex planning, systems, involve “Both complex after conducting same satisfaction the feel “I think also to important it is really surgeons “I for struggle with so many colleagues seen have “I invasive mitral valve surgery, achieving such exceptional exceptional achieving such surgery, mitral valve invasive becoming is now Adelaide that outcomes patient minimally- for of excellence as a centre recognised surgery. cardiac invasive member of the and a board College of the Committee Wakefield Calvary the Advisory for Committee Medical Hospital. bi-plane, aerobatic Special a Pitts owns and he also Plane and fly a Float to learn Alaska to to has travelled Australia in a De with Elizabetharound has flown ChipmunkHavilland as part of a fund-raising benefit Service. Flying Doctors the for that doing but surgerycardiac and flying a jet fighter, other. at the him made better one, said. Mr Edwards sequences,” flight a successful surgery as I do after completing to plan when you going you’re where get you where get there. non-medical have also and to interests outside have community the because with ties friends and broader at riskotherwise I think are of losing you perspective. because of retirement prospect the even or retirement and I have up in work wrapped so utterly are their lives me. to happen let that not to determined been always

spring Lifestyle 4 spring Lifestyle spring Lifestyle

When did you first become interested in dinner and after a glass of a good red or two horse racing? we collectively put names forward until we find I grew up as a young lad in country Victoria one we can all agree on. Then we check on line around Echuca and my father was a race judge to ensure the name is available and send that at a number of country tracks in the area so it through to the racing authorities to make sure was part of my life from an early age. I would there is no other horse racing with the same go with him upon many occasions and I got to name. know quite a bit about the industry. Who do you have as trainers? What do you love about it? All our horses have been with Freedman Racing, There are a number of things that make horse but you can’t blame them for our lack of success. racing wonderful. Firstly, the horses themselves are magnificent, majestic creatures, absolutely Do you have a new hopeful now? beautiful to look at and immensely powerful. This season we have a horse called Evastar Then you combine that with the ability of racing. He is a three-year-old and this will be trainers, jockeys, strappers and handlers to not his first spring racing season. We expect him only get them into peak physical condition, but to race in country meetings such as Pakenham, to train them to want to race and want to win. Cranbourne and Bendigo and we’ll see how That to me represents an intriguing cooperative he goes, see if he makes it to a city track. relationship between humans and animals. Unfortunately, we’ve already heard that he’s only Then there is the spectacle of the event, the mediocre... But then like surgical Trainees some competition, the glamour, the crowds, all of come good in the most unexpected ways. which I find greatly enjoyable. Do you always try and make it down to Does your wife Deborah share the passion? Melbourne for the Spring Racing Carnival? Yes she does. My wife loves the races too. She We have been coming down to Melbourne in used to ride in her younger days, competing in November for a long time now. We particularly dressage and equestrian events so she comes to it like Derby Day which is the best racing day in from a different background. Deborah also has a Australia while the Melbourne Cup is a terrific strong interest in fashion and millinery and likes spectacle. We tend to spend those days in a to support and showcase the work of various mixture of being on course, in the Birdcage or a milliners whose creations she finds appealing. marquee and occasionally we have a carpark on The fact that we can share this passion adds to the rails and organise catering with a group of the pleasure of it. friends.

Do you own race horses? How do you dress? For some years now I have been a member of a In a top hat and morning suit, the traditional syndicate of 10, with me in Queensland and the dress for major meetings; appropriate for the rest in Melbourne. We only ever own one horse sport of kings. at a time and while none have been terribly successful we do it for the love and fun of it, not Do you have memories of a best or worst the success. So far we have owned about five day at the track? horses over the past 10 years or so, but none have Any day at the races is a good day. I enjoy all been very good or very fast or very impressive. of it: the thrill, the spectacle, the camaraderie, In other words we have not found that elusive doing the research to understand which wherever money is involved there is likely to be Do you have any other interests outside Black Caviar yet and while you do sometimes conditions best suit which horse. As to a bad day, crookedness. Still, Australia’s horse racing industry horseracing and surgery? think you’re pouring money into a bottomless my punting is never big enough to create any is pretty clean and suggestions of wrong-doing have Yes, Deborah and I are both opera lovers. I am pit, with so many people in the syndicate you anxiety. always been part of the tapestry of racing, an aspect particularly fond of the operas of Mozart and don’t lose too much. Then again, you don’t win of the thrill of the punt in a way. There is always Puccini though I love them all. Whenever we much either. Does it distress you to hear suggestions, as talk around racing which is part of the game of travel overseas we try to arrange tickets to the recently reported in Victoria, of corruption picking a winner. You have to figure out what and opera in whatever city we are in. We are also Do you get to name them? within the industry? who to listen to and what to ignore and sometimes lucky in that Queensland Opera has a season Yes. We buy them as yearlings and then the If it’s true it’s of concern, but I’m not sure it it works and sometimes it doesn’t, which is part of each year. 5 6 syndicate members get together for lunch or would ever be entirely surprising because the fun as long as it stays within the law. With Karen Murphy 7 spring Lifestyle 9 u With Karen Murphy Karen With Yet no matter how fraught or high-stress the fraught the how high-stress or matter no Yet Burma from arrivedsmall in as a childHaving Perth sky-diving her instructor was Andrej, husband, Her as Chairwoman tenure her since said that Yin Dr is the age with what has come that found have “I State WA as Chairwoman time my of the enjoyed “I grace saving and my been has always husband “My the having enjoyed is sports and has always mad “He his from neck Andrej broke ago years a few “However, and King Hollywood out Hospital of the works Yin Dr off a list she easily reeled family, an active such With has not that WA of life one aspect in is“There barely so plentiful mines are at the money so and the “Jobs Perth to so if come you “That higher means overheads, “Our Committee did everything Committee the get possible to “Our Government to undertake of the an independentreview to Government almost report validated Stokes the policy and consequently the in which turn before that meant all of our concerns, of the many states other outacross rolled policy was and rectified.” understood were here faced problems suggest life to Yin’s is nothing in Dr there negotiations, be to she appears for iota, one her phased they that fearless. great the to took Yin Dr and living all adult life her there, sky- an experienced becoming a passion with outdoors explorer, off-road paddleboarder, canoeist, keen diver, climber. and rock camper a union their nuptial with marked even two and the jump. demonstration prioritised as much family she now time last year, expired possible. as professionally she things,” no to and say and abilitywisdom pull back to said. be a wonderful it to learning and found Committee family. on my a toll but it did take experience, look an arrangement I’d married made that when we we he and then babies were when they children after the he is the so now older, were when they over take would primary giver. care at the our competes daughter and now involved children in swimming synchronised level and our son isnational trampolining with and soccer. obsessed neurologically fine and and although he was a sky-dive a it was months, three for a brace wear to only forced of our perhaps at this stage that us both call to wake-up the for conservatively more live to might have we lives children.” of the sake and has a special Women for Memorial Hospital Edward surgery. and reconstructive in continence interest but she also Surgical News, for west of the best of the pay. to a warning: be prepared provided she said. mining the by boom,” touched been staff attracting trouble have in Perth businesses that good, them. keep to more pay to and have have We of coffee. a cup for be surprised $10 pay to don’t it. to used get all to had the hospital network was a testament to how hard they they hard how to a testament was network hospital the were. they dedicated and how worked Jessica and her husband Andrej West “This policy was based on one that was introduced introduced was “This on one that based policy was spent millions“The UK Government NHS on the under enormous pressure were junior doctors “Our into the National Health Service in the UK, but Service UK, in the Health National the into said. Yin Dr same resources,” of the provision without of this of policy in terms introduction the before and cases emergency from out elective separating up of their surgical and make operation changing the WA. in things happened none of these whereas units, numbers fact and the same workforce the without mortality in the no increase was across rate there that

hen Western Australia became the first the became Australia Western hen introduce to country in the instate 2010 rule four-hour mandated the that

Dr Jessica Yin is not just an expert on WA’s four-hour emergency rule, rule, emergency four-hour just is not Yin an expertWA’s on Dr Jessica Perth playground surrounding to enjoy and its how she also knows How to enjoy How of the the best As Chairwoman of the WA State Committee of the Committee State WA As Chairwoman of the

the time patients could remain in the Emergency in remain could the patients time the admission, or discharge either before Department herself hot seat. in the found Yin Jessica Urologist Dr free all available her devote to forced was Yin Dr College, on behalf of hospital surgical staff negotiating to time - to bureau opposed as policy flawed the who believed implementation. its to committed and politicians crats W

spring Lifestyle 8 7 spring Lifestyle 11 According to Dr Yin, if you want to fish when in Perth youPerth fish when in if to want you Yin, Dr to According Western Wines: – in to south particular head and dine wine but if you to wish north, you head a laid- once What was Augusta. and Pemberton Dunsborough, River, Margaret famous and the most one of become has now River Margaret town, surfie back offering not only 60-plus vineyards Australia, in regions and food wine prestigious but a spectacular also and boutique breweries, restaurants visit along with to but if you Perth, from car hours by three The is just region over backdrop. scenic of town the lies Nearby regularly. Perth leave bus tours and tipple, taste to wish natural its hidden beauty and more for said she preferred, Yin Dr which Augusta, historic is the Also here be missed. is not to Blackwood Canoeing the charms. peninsula dramatic the of the where tip at the situated Lighthouse, Leeuwin Cape Australia. point of south-westerly most the meet, Southern and Indian Oceans

Dr Yin said she and her family often went up to Ningaloo Reef for camping trips far from from trips far camping for Ningaloo Reef up to family went and her often said she Yin : Dr ork:

tham/Y ingaloo Reef Ningaloo distance is no that West the something from mind-set about but the it says of people madding crowd, the glorious more reef the she said she believed Still, Perth. from drive 12-hour it is a barrierbeauty that given to most amazing tourism world’s one of the and with overcome less BarrierGreat Reef, and pristine the than is Ningaloo Reef of Exmouth, town the towards north of Perth off Coral Bay, Located natural environments. It water. the into stepping just by be reached can and unlike fringing most, world in the largest one of the reefs of manta population year-round corals while has a it also fish and hard of reef of varieties hundreds is home to During in March annual spawning the coral sharks. and reef dugong dolphins, bottlenose turtles, green rays, the ocean. fish in biggest the arrival the sharks, of whale sees also reef the April, and Flying and Flying in floating Nor For those keen on keen those For Yin Dr aerial pursuits, a visit to recommended Avon Northam in the it has that given Valley, one of become now most noted Australia’s aviation for centres a calm With activities. minimal air traffic climate, countryside, and gentle some of boasts area the ballooning flying, best the inand soaring conditions and is located, world the just one hour’s this time, Here Perth. from drive beautiful in the take you scenery hot-air by balloon tryor hands at your hang- flying, gliding, paragliding and gliding, microlighting.

ches: ect bea th’s perf rocky ledges to create a powerful surf create to ledges rocky Leighton Kite surfers prefer break. is in. “Doctor” when the beach Trigg where shifting sand banks cover shifting where cover sand banks Trigg in search of that perfect wave head to to head wave perfect of that in search Per Fremantle of the cooling breeze As the no there’s Perth, into sweeps Doctor chill of at one out to than place better paddling in beautiful beaches, Perth’s the watching and Indian Ocean the Yet while west. sun finallythe set in towering its – with Beach Cottesloe buzzing and a boulevard pines Norfolk be the – may and cafes restaurants with their own have locals the most famous, is a hit Beach Scarborough favourites. surf offering impressive young, the with is lined with while foreshore the breaks is Beach clubs and pubs while Floreat like a quiet who those for a favourite Familieswith fishing. spot of beach tranquil the waters appreciate children while who are those of Mettams Pool With its shady lawns, little sandy beaches and gentle slow-moving slow-moving and gentle sandy beaches little lawns, shady its an: With The sublime Sw as the reaches upper in Known its playground. favourite is Perth’s River Swan the waters, through Darling Scarp, of the east from 240kms down way its winds River Swan the Avon, offering most peaceful, one of the process in the at Fremantle, sea the to and down Perth waters Ferries and cruise the ply boats city and surrounds. the explore to ways picturesque thrills high-octane can more you water but for evening, the and into day throughout the boat. hire jump a surf on a jet ski climb a power or cat, aboard

spring Lifestyle 10 spring Lifestyle 13 u Accommodation is also available at the College College at the available is also Accommodation which of Barbers, Company Worshipful The There are always interesting exhibitions to visit: to exhibitions interesting always are There currently, coinciding with the Olympic Games, Games, Olympic the coinciding with currently, and Sporting Surgeons’: Connections: ‘Olympic which Athlete’, of the ‘Anatomy thisearlier year, sports surgery art. through medical explored [www.rcseng.ac.uk]. has the anniversary in 2008, 700th its celebrated the heart thein of Hall, Barber-Surgeons’ magnificent Wall. adjoining Roman ancient the City of London, College of Surgeons of England where one can of England one can of Surgeons where College refurbishedMuseum; Hunterian recently the find is the also there accessed, be may Archives the also and and Pathology, Anatomy of Museum Wellcome the Library. A summary of the process of evolution relating to to relating of evolution summaryA process of the Royal visit be the could next the Accordingly commemorated with the magnificent Hans HolbeinHans magnificent the with commemorated representatives presenting portrait monarch of the signifying a paper of with bodies Act of both this original the portrait shall see, As we Parliament. of Barbers Company Worshipful The with remains Lumley Hall at the is Edward in the and a copy Inn Fields. in Lincoln’s R.C.S. follows: bodies two these (incorporated The of Barbers Company 1300-1540, c. The Guild (not incorporated); of Surgeons 1462) The of Barber-Surgeons; Company 1540-1745, The of Surgeons; Company 1745-1800, of London; of Surgeons College The Royal 1800-1843, of England. of Surgeons College The Royal - 1843 Clockwise: The entrance hall at the Society of entrance hall at the Clockwise: The Peter Burke Henry the VIII; Fellow Apothecaries; Hospital. at St Thomas’

[www.wellcomecollection.org]. Sir Henry Wellcome, pharmacist, entrepeneur, entrepeneur, pharmacist, Sir HenryWellcome, richest world’s one of the provides Images’ ‘Wellcome permanent the remains now Museum The Science The origins and history English of the of College Collection is aptly self-described as, “a free destination for for destination free “a self-described as, is aptly Collection incurablythe curious”. Silas Burroughs with formed and collector, philanthropist one of the were they 1880: & Co in BurroughsWellcome that to priorform: medicine in tablet to introduce first liquids. or sold as powders been had medicines incorporating and most unique collections, image or science medicine and magic, as, as diverse materials satire majority vast of the of HenryWellcome’s custodian two than of no less consist to is which estimated collection million [www.sciencemuseum.org.uk]. objects! of Surgeons’ ‘Fellowship union include the of the Surgeons to 1540 HenryVIII by in of Barbers’ ‘Company and the This is event of Barber-Surgeons’. ‘Company the form A guide for the curious

London

t seems almost inevitable that, as surgeons, we will we as surgeons, almostt seems inevitable that, attend it be to visit London; whether at some stage up an exchange take visit family, a conference, Depending on the time available, the surgeon has many surgeon the available, time Depending on the as the such attractions abstract more even are There available options has many more surgeon the However, Fellowship, or even work in the National Health Service. Health National in the work even or Fellowship, visit to a most rewarding guarantee to available options attractions known well all the are city:this there great Gallery, Portrait National the Cathedral, Paul’s as St such Albert and Museum Victoria of London and the Tower the and so on. off High Vaults Silver incredible the Halls, Food Harrods’ infinitum. ad Markets, Road Portobello Holborn, startAn excellent and historical interest. of collegiate in Euston Collection Wellcome visit the be to would relating is an extraordinary collection there where Road an history world, medical in all the countries from to library this current displays: excellent and fascinating

I dissected

spring Lifestyle 12 spring College Awards Lifestyle Congratulations

The Barber Surgeons coat of arms. on your achievements As we have noted, until 1745, purchased a building which had the Barbers had controlled also constituted part of the 250-year- Presentations from the College ASC 2012 the craft of surgery: this curious old Dominican Priory: most of combination of occupations arose the building was destroyed in the from the customary employment Great Fire of 1666 and rebuilding of the barber in mediaeval commenced in 1668. Fortunately Sir Louis Barnett was responsible for the original proposals in 1920, to create a monasteries for the purpose of the hall survived the air raids New Zealand and Australian association of surgeons which would be modelled on blood-letting, as well as, for the of WW2, a German 500 pound the American College of Surgeons and bestow a “hallmark” of surgical excellence. preservation of the tonsure. bomb penetrating the basement The Sir Louis Barnett Medal is awarded for outstanding contributions to In the 18th century, as surgeons and failing to explode on impact! education, training and advancement in Surgery. were becoming more skilled and Visit, just to view the 1671 numerous they petitioned the staircase, the Great Hall panelled award House of Commons to be allowed in Irish oak from that 17th winner Western Australia. He served the Faculty He served as Editor-in-Chief of the to separate from the Barbers. Royal century rebuilding, the heraldic of Medicine and Dentistry as Chair of ANZ Journal of Surgery from 2007-2011. Assent was received on May 2, stained glass panels and the { the Assessment Committee from 1996- During Professor Hall’s five year tenure as 1745, and with this split the Barbers collection of old decorated and 1999 and was a Senior Examiner for Editor-in-Chief, the journal underwent retained the Hall and many of the glazed apothecaries’ pill tiles and the Australian Medical Council from significant change. In 2011, the acceptance treasures, which may be viewed jars [www.apothecaries.org]. 1993-2001. Professor Hall was recruited rate for original articles was about 20 per there today. Closely associated with the to participate in the evolution of the cent, compared with an acceptance rate of The Hall has had a difficult apothecaries was the Chelsea RACS from a credentialing into a training 67 per cent in 2007. history, being severely damaged Physic Garden, a three-and-a- institution. He served as Chairman of the Dedicated to the promotion of in the Great Fire of 1666 and the half acre site, provided through Pathology Bank for basic surgical training outstanding surgical practice, and remnants being destroyed in an air the intervention of Sir Hans from 1999-2001 and then became the research of contemporary and raid in December 1940; finally a Sloane, who arranged a lease Interim Dean of Education. international interest, the journal’s new hall was opened in Monkwell in perpetuity. A visit to this John Hall has a strong research record readership has become increasingly Square in May 1969. fascinating and well-organised institution illustrates the Professor John Hall and was awarded the John Mitchell international, with 22 per cent of readers Barber-Surgeons’ Hall is well worth a visit with all its importance of medicinal herbs in the physician’s FRACS Crouch Fellowship, the premier research from Australasia, 22 per cent from the surgical associations, its veritable treasures, paintings, medical therapy of those distant days Award: Sir Louis Barnett award of the RACS, in 1996. He has a United States, 20 per cent from Europe, Physic Garden and the Charter Room containing the [www.chelseaphysicgarden.co.uk]. Medal deep interest in biostatistics and has 7 per cent from the United Kingdom, Company’s royal charters from 1462; the signature of Sir Other places to visit are the major hospitals of London, published clinical trials in The Lancet, 5 per cent from China and 2 per cent Thomas More is on the 1530 ordinances: for any person including St Bartholomew’s the oldest hospital in British Medical Journal and other leading from Japan. Fully 60 per cent of articles interested in heraldry, this is the perfect locale London, having been founded in 1123, still occupying its surgical journals. He has published submitted for consideration come from [www.barberscompany.org]. original site. There is a museum outlining the history ohn Charles Hall grew up in more than 160 articles in peer-reviewed countries other than Australia and The Worshipful Society of Apothecaries has a of “Barts” and on the walls of the staircase leading from JMelbourne and graduated from journals, two of which are citation classics New Zealand. There is now a much magnificent building within the city of London which the official entrance hall to the hospital’s Great Hall are the University of Melbourne in 1969. with more than 100 citations each. more efficient flow of manuscripts, is also a most suitable destination: the apothecaries did two murals painted by William Hogarth, ‘The Pool of His surgical training at the Austin He has a deep commitment to the with Professor Hall having led a team not become an independent body until December 1617; Bethesda’ (1736) and ‘The Good Samaritan’ (1737) Hospital was interrupted by a period promotion of research interests in surgical of conscientious editors and reviewers. the sale of drugs was originally under the control of the [www.bartsandthelondon.org.uk]. of National Service in the Australian Trainees – 20 surgical Trainees have The journal’s format has become more Grocers Company. The long lost operating theatre of St Thomas’ Army. He received the FRACS in 1976 been a first author on peer-reviewed attractive and user-friendly. Their charter incorporated them as the ‘Master, Hospital reached by the ascent of a rather steep and and undertook further training in the publications. Professor Hall has been an Professor Hall’s tenure will also be Wardens and Society of the Art or Mystery of narrow staircase is again worthy of a visit along with United Kingdom at the Essex County active clinical leader. He was Chairman remembered for the development of the Apothecaries’, and the company is one of the few which the adjoining Herb Garret. One of the most unusual Hospital and St. James’s University of the Division of Surgery at Royal Perth journal website – ANZJSurg.com. It is a continue to fulfil the functions for which it was founded. museums in London, the operating theatre is the oldest Hospital in Leeds. He was a Lecturer at Hospital from 1992-1994 and Head of remarkably comprehensive website, with With the Apothecaries Act of 1815 the Society was in Europe [www.thegarret.org.uk]. the Flinders University of South Australia Surgery in the University of Western every article that has ever appeared in the given the statutory right to grant, after due examination, In conclusion, the websites provided should provide before his appointment to the University Australia from 1998-2001. He founded the 80-year history of the journal now able to a licence to practise medicine throughout England a lead for many memorable and worthwhile visits and Department of Surgery at Royal Perth Drug Audit Program, Nutrition Review be retrieved. and Wales. John Keats was possibly the most famous as a guide to many other similar destinations: readers of Hospital in 1985. Group, Antibiotic Review Group, Theatre Professor John Hall, a great contributor person to qualify as an apothecary: he served a four year Surgical News will also be aware that the Royal Society John Hall has been a dedicated ‘hands- Quality Control Group, and the Young to surgical education, is a truly worthy apprenticeship and “walked the wards” at Guy’s Hospital, of Medicine can provide accommodation on’ surgical educator and a consistent Investigators Day at Royal Perth Hospital. recipient of the Sir Louis Barnett Medal. prior to passing the examination on 25 July, 1816, “with [www.rsm.ac.uk]. contributor to surgical education. He has John Hall has been a chairman of ease; a creditable and talented performance”. Peter Burke had a major influence on all aspects of Institutional Ethics committees for both Citation kindly provided by 14 When the apothecaries left the Grocers’ Company, they Victorian Fellow surgical education in the University of human and animal research. Mr Keith Mutimer FRACS u

Surgical News October 2012 / Page 25 College Awards

Workshops & Activities

Inaugurated in 1998, the ESR Hughes Award is designed to recognise distinguished Professional development supports life-long learning. College contributions to surgery by Fellows of the College and others. It was created in activities are tailored to the needs of surgeons and enable you to recognition of the outstanding contributions to surgery by Professor Sir Edward acquire new skills and knowledge while providing an opportunity for Hughes. The sole criterion for the Award is distinguished contributions to surgery. reflection about how to apply them in today’s dynamic world. NSW 13 November, Sydney Keeping Trainees on Track (KToT) award Non-Technical Skills for Keeping Trainees on Track (KToT) Surgery. He has been a member of more Meeting in 1995 and was elected President winner Surgeons (NOTSS) 30 October, 2012 – Melbourne; 3 NZ than 20 committees at the University of in 1997. In 2000, he became President of 23 October, Wellington, NZ; November, 2012 - Wellington; 13 Sydney and more than 12 at the Royal the Australian and New Zealand Society 23 October, Wellington { Non-Technical Skills for Surgeons 30 November,Gold Coast, QLD; November, 2012 - Sydney Prince Alfred Hospital since 1983. for Vascular Surgery. John has received numerous awards John has been a member of the 7 December, Melbourne This 3 hour workshop focuses on how to manage 3 November, Wellington and honours: The Jobst Fellow, Peripheral Executive of the Australian Society of This workshop focuses on the non-technical trainees by setting clear goals, giving effective feedback Keeping Trainees on Track (KToT) and discussing expected levels of performance. You can Vascular Surgery, Northwestern University, Ultrasound in Medicine since 1989 and skills which underpin safer operative also find out more about encouraging self-directed QLD Chicago, 1980; The Travelling Fellow, Honorary Secretary from 1993 to 1995. He surgery. It explores a behaviour rating system developed by the Royal College of learning at the start of term meeting. 30 November, Gold Coast, QLD RACS, Malaysia, 1990; The Toshiba has been an Examiner for the Diploma Surgeons of Edinburgh which can help Non-Technical Skills for Surgeons, prize, annual scientific meeting, Society in Diagnostic Ultrasound and Convenor you improve performance in the operating The Process Communication for Vascular Technology, Boston 1991; of Australian Workshops in Vascular theatre in relation to situational awareness, Model (PCM) SA Membership of Society for Vascular Ultrasound. communication, decision making and 17 November, Adelaide Surgery, North America, 1997; The John has held positions as Councillor leadership/teamwork. Each of these categories 2 to 4 November 2012 – Melbourne Building Towards Retirement Professor John Harris Foundation Visitor, Division of Vascular of the NSW State Branch of the Australian is broken down into behavioural markers that (Introductory) AM FRACS FRCSEng Surgery, RACS, ASC, Auckland, 1999; Medical Association (1987-1990) and was can be used to assess your own performance as PCM is one tool that you can use to detect early signs of VIC the Distinguished Fellow, Society for Chairman of the AMA Health Fund from well as your colleagues. miscommunication and turn ineffective communication 26 October, Melbourne FACS Strategy and Risk Management for into effective communication. This workshop can also Award: ESR Hughes medal Vascular Surgery, North America, 2003; 1990 to 1998. John has had a very active Surgeons the Honorary Membership, Society role in surgical research and teaching and Strategy and Risk help to detect stress in yourself and others, as well as for Vascular Surgery, Great Britain and has received 16 research grants since 1980. providing you with a means to reconnect with individuals 26 October, Melbourne Management for SAT SET ohn graduated MB BS, first in year in Ireland, 2003. As President of the ANZ Society for you may be struggling to understand and reach. The Surgeons PCM theory proposes that each person has motivational Jsurgery, from the University of Sydney In 2007, John was awarded the Order Vascular Surgery, John participated in the 30 October,Melbourne 26 October, Melbourne needs that must be met if that person is to be successful. in 1972 and undertook surgical training of Australia for services to medicine and negotiations that culminated in Vascular Keeping Trainees on Track (KToT) at the Royal Prince Alfred Hospital. advances in vascular surgery, ultrasound Surgery emerging as a separate division This whole day workshop is divided into two parts. Part one includes formulating a Building Towards Retirement 2 - 4 November, Melbourne He became a Fellow of the Royal procedures, medical education and public of RACS. Process Communication Model Australasian College of Surgeons in 1979 strategic plan; the strategic planning process; 17 November, 2012 - Adelaide health administration. John has initiated the RACS Inter- identifying and achieving strategic goals; then continued training at the Southend Surgeons from all specialties who are considering 23 November, Melbourne John has had a very active role in the Collegiate Working Party on Recognition monitoring performance; and contributing Occupational Medicine General and Rochford Hospitals in Essex, retirement from operative or other types of surgical Royal Australasian College of Surgeons of Training in Peripheral Endovascular to an analysis of strategic risk. Part two becoming a Fellow of the Royal College practice will benefit from attending this day long since 1985, both at the NSW Regional Therapy (2000), the Section of Academic focuses on the directors’ knowledge of risk 7 December, Melbourne workshop. Fellows from a variety of disciplines and their Non-Technical Skills for Surgeons of Surgeons, London in 1979. He then level and on a national level and he is Surgery RACS (2002) and the Master of for the organisation and their monitoring partners join with colleagues and corporate speakers in (NOTSS) trained in the United States of America the Vascular representative on the NSW Surgery programme at the University of of management’s ongoing assessment and an interactive discussion format that focuses on three at the Northwestern Memorial Hospital, Regional Committee. Professor Harris Sydney (2003). treatment of risk. Chicago before returning to Australia in sessions on preparing for retirement, options after became a member of the Court of John is currently Editor-in-Chief of retirement and resources to realise options. Contact the 1981 to be a consultant at the Royal Prince Examiners in General Surgery in 1992 ANZJ Surgery. John has published 41 Supervisors and Trainers Professional Alfred Hospital and Senior Lecturer at and in Vascular Surgery from 1996 to chapters in vascular surgical text books for SET (SAT SET) Development the University of Sydney. He became Occupational Medicine: Department on 2003, being the Senior Examiner from and 117 articles and 58 abstracts in referred 26 Oct, Melbourne (AVSM – incl dinner) a Fellow of the American College of 1999. He was a member of the Executive journals. He has written five editorials, Getting Patients Back to Work +61 3 9249 1106, This course assists supervisors and trainers Surgeons in 1986 and in 1988, he obtained and has been Chairman of the Section of four book reviews and three full-length 23 Nov, 2012 – Melbourne (Morning session, by email the Diploma of Diagnostic Ultrasound to effectively fulfil the responsibilities of their Academic Surgery since 2002. He was the published and referred conference papers part of AOA/RACS/MEDLAW meeting) PDactivities@ (Vascular) from the Australian Society of very important roles. You can learn to use surgeons.org or visit Vascular Representative on the Council of as well as eight unpublished conference workplace assessment tools such as the Mini A unique opportunity to see CBD building construction Ultrasound. the College from 1999 to 2003. papers. He has written numerous articles www.surgeons.org Clinical Examination (Mini CEX) and Directly from the ground up. Starting with holes in the ground - select Fellows John has held many senior positions Professor Harris has been a member of for non-referred journals, research and Observed Procedural Skills (DOPS) that have and all stages through to the completion of the buildings. then click on at the University of Sydney since 1989, the Executive of the International Society departmental report. been introduced as part of SET. This workshop You will see all trades at work. The aim is to provide Professional including Sub Dean, Deputy Associate for Cardiovascular Surgery since 1993, Citation kindly provided by is also available as an eLearning activity by surgeons with knowledge useful in proactively advising Development. Dean and then Head of Department of was a Convenor of the Annual Scientific Mr Joseph Lizzio FRACS logging into the RACS website. workers recovering from injury or illness.

Page 26 / Surgical News October 2012 Surgical News October 2012 / Page 27 Regional News Surgeons leading cultural change in patient care

Annual Victorian Scientific & Fellowship Meeting FRIDAY 26 OCTOBER & SATURDAY 27 Paddling together But the small Pacific nations (such as Nauru, Cook Islands, Kiribati and Tuvalu) require general surgeons with the right skill set to respond OCTOBER 2012 The College supporting Pacific Islands surgeons to acute presentations across the surgical spectrum and some elective Venue: Rydges surgery in general surgery, orthopaedics, urology and paediatric surgery. Exhibition St, As on previous occasions, a number of surgeons from New Zealand he ninth Pacific Islands Surgeon’s Conference was – and will continue to do so in the future. Dr Ian Norton, and Australia attended and supported the program. This included, Melbourne held in Tonga in August. The New Zealand National Director of Disaster Response and Preparedness, National for the first time, the President of our College. The Tongan medical TBoard and the New Zealand Office have supported Critical Care and Trauma Response Centre (in Darwin) gave community hosted him superbly. this meeting since its inception in Rarotonga in 1994. a keynote presentation on disaster preparedness. Michael Hollands may have been prepared to contribute to the The Conference was officially opened by HRH the Hon A number of Pacific surgeons have attended an AusMAT teaching sessions and conference program, but I doubt he had Dinner Venue: Princess Frederica Fatafehi o Lapaha Tuita with the Queen training program; all acknowledged the importance of anticipated his attendance would include active participation in the MCG Salote School of Nursing Choir providing wonderful music preparing for disasters, as well as regularly reviewing and dancing and singing that is always such a large part of the social (pre-drinks in the National Sports prior to and during the opening ceremony. updating disaster protocols. programme at these Pacific surgical meetings! However, he responded Museum with guest speaker Prof In his blessing during this ceremony the Reverend The Pacific Islands Surgeon’s meetings have come a long admirably, displaying great dancing agility and singing ability, with Savinata Moala spoke of the importance of Pacific Island way since the conference was previously held in Tonga. In willing participation in the cultural events. David Fletcher) nations “paddling together” to improve the health of their 2000, seven Pacific Island nations were represented by nine PISA meetings rely on financial assistance from New Zealand or Prizes for the following citizens, recognising that a canoe moves cleanly through the surgeons, and there were no surgical Trainees. Fast forward Australia; without this the opportunities for information sharing and categories: water when the paddlers work together. 12 years and we find 10 Pacific Island nations represented by networking across these nations would be very limited. Funding from 2012 DR Leslie Prize – For the 17 surgeons and 15 surgical Trainees. NZAID and from SSCSiP (Strengthening Specialised Clinical Services best clinical registrar paper The themes of this 2012 Conference were: While everyone involved can be proud of the increase in the Pacific, an AusAID funded initiative) made attendance at this 2012 RC Bennett Prize – For > surgical response to non-communicable diseases; in training numbers and improved retention of surgical conference possible for 12 of the Pacific Islands’ surgeons and the 15 the best laboratory based research > disaster preparedness; and graduates within the Pacific (and the considerable increase Pacific Islands’ Trainees. > developing a sustainable Pacific surgical workforce. in the number of Pacific Island surgeons), these are The goal is to promote surgical self-sufficiency in the Pacific to the paper presented

still small numbers for the population of the region. So degree possible with the resources available, identifying and meeting Diabetes is a major cause of the burden of non- workforce development and retention of surgeons continue the needs of these dedicated surgeons. The meeting’s organisation was Royal Australasian communicable diseases in the Pacific. In many Pacific Island to be key concerns for these countries. supported by the NZ Office of the College and the Pasifika Medical College of Surgeons nations at least 50 per cent of their non-acute surgical The “generalist versus specialist” debate is important Association (PMA), with in-country support from the Tongan Medical Denice Spence, admissions are related to diabetes. This absorbs a large in the Pacific, just as it is for Australia and New Zealand. Association. Victorian Regional Manager, proportion of the Pacific’s scarce health resources. While we debate maintaining general skills to deliver care Kiki Maoate (President of PMA and a member of the College’s Royal Australasian College of The keynote address on this topic by Lord Tangi o Vao- in provincial hospitals and meet on-call commitments in International Committee and Rowan Nicks Scholarships Committee) Surgeons, College of Surgeons nukonuka FRACS (Chief Surgeon, Vaiola Hospital, Tonga) metropolitan units, the Pacific is debating where and when once again played a major role in assisting with the structure and Gardens, 250 - 290 Spring Street, stressed a surgeon’s role as a health advocate. Surgeons must they should move away from a “surgery in general” model content of the Conference program. East Melbourne , play their part in managing non-communicable diseases of care. PISA has decided that the next conference will be held in Fiji in 2014. VIC 3002, Australia at all levels. This could range from counselling individual Variations in population numbers and population This gives plenty of time for interested New Zealand and Australian Telephone: +61 3 9249 1254, patients and their families about canned drinks, to actively distribution challenge the ability of these nations to provide surgeons to prepare to support the meeting – and this may possibly Fax: +61 3 9249 1256, supporting public health initiatives. surgical care. In the larger nations, such as PNG and Fiji, a include honing up on your dancing and singing skills! Email: [email protected] Pacific Island nations have experienced many natural dis- degree of ‘sub-specialisation’ into general surgery, urology, Scott Stevenson asters in recent years – earthquakes, tsunamis and cyclones orthopaedic surgery and paediatric surgery occurs. Chair, NZ National Board

Page 28 / Surgical News October 2012 Surgical News October 2012 / Page 29 Article of Interest

Farewell: Professor Bruce Barraclough, Dean of Education

College staff gathered in the decades of enthusiasm in people like Gordon Trinca. It is dialogue and discussion with the governments of the day. ABOVE: 2012 a matter of record that he was knighted for his services Again, like Sir Edward, Professor Barraclough is a giant ASC KL Post Hughes Room on Convocation to medicine and surgery; he was awarded the Sir Hugh among surgeons. Bruce Barraclough the cool afternoon Devine Medal of the College. After being President, he continued in senior roles Leigh Delbridge of Tuesday, August But he was also the rarest of College Fellows. He was in many organisations taking the issues of quality, Gerard Doherty a three year President. There is something about a three surgery and engagement quite literally to the front line 29, to hear David year President. Their peers acknowledge they understand internationally. In progressing issues to make our health Hillis farewell the strategic imperatives for surgeons and the strategic system safer, he has been Chairman of the New South Professor Bruce imperatives for surgery in the community. To understand Wales Clinical Excellence Commission, Chairman of the how the College needs to change, must change and will Australian Council for Safety and Quality in Health Care Barraclough; this is a change. Sir Edward was a three year President. He was a and President of the International Society for Quality in copy of the speech giant among surgeons. Health Care. So, why the focus on Sir Edward Hughes and three He has written the World Health Organisation year Presidents? The College in its history has only had Curriculum for Safety and Quality. He has been four, three year Presidents. A Councillor recognised by honoured by many Fellowships of many Colleges, ruce has contributed enormously and in a most in a world of leaders. A renowned colo-rectal surgeon, his peers who stands as a giant among surgeons. One Academies and Associations. He has been awarded distinguished manner to many senior roles in his he worked at the Royal Melbourne Hospital along with was Sir Edward Hughes. Professor Bruce Barraclough is Honorary Doctorates. He is an Emeritus Professor in Bcareer. As we farewell him from the role of Dean others like Sir Albert Coates and Sir Weary Dunlop. also a three year President. recognition of his substantial academic contributions. of Education at the College I would like you to consider He was then appointed the Professor of Surgery at Professor Barraclough is described in the Mantle of Australia has honoured him with the Order of Australia. three key words over the next few minutes. The first is the Alfred Hospital. He was Censor in Chief of the Surgery1 as being “gifted with the ability to enunciate the Inside this College, he stands as a giant. He is a three Hughes-Room, the second is shoulders and the third is College, at the time when the Surgical Training Boards deep truths of surgical philosophy in a way that leaves year President. different. were established, and the first days of international little room for misunderstanding or dispute”. It goes Why did I make my first point to remember the We are deliberately farewelling Professor Barraclough comparability and recertification were being addressed. much further than this. Hughes-Room? Because, I wish you to understand the in this room, the Hughes-Room because it speaks so However, Sir Edward went beyond this. When initially An outstanding breast and endocrine surgeon with a stature of three year Presidents. They are giants. And on much to what the College is, what it does and how it appointed to Council, he agitated the College to be substantial profile in cancer related services, as President that point I wish to move to the second word I asked you contributes not only to surgery, but also to society as a actively involved in public health. The public health he revolutionised the way the College functioned. to think about, which is shoulders. whole. issue of the day – and this was 1969 – were motor car He clearly identified the requirement to be a modern It is highlighted in the words of John of Salisbury in The portraits around these walls are some of the accidents. In those years, over 1,000 deaths occurred on educational organisation, to advocate on issues to 1159 when he stated, “We are like dwarfs sitting on the outstanding surgeons who have contributed enormously roads in New South Wales and also in Victoria. Hospital government and to be regularly involved at the highest shoulders of giants. We see more, and things are more as individuals to their patients and their communities. beds were ‘clogged’ with the young and the maimed. level of health policy and debate. distant, because they raise us up, and by their great They are then involved with their profession to ensure Through a combination of highly publicised seminars, While Sir Edward focused on road trauma, the stature add to ours.” its development, the maintenance of its standards and establishment of committees and development of challenge at the turn of this century was to be actively People sometimes ask me, why work at the College educational programs. All the surgeons in these portraits policies in which Sir Edward was highly involved, involved in ways to improve the quality of health service of Surgeons? College structures and professional have been recognised as outstanding leaders, as people changes were introduced that we now know have delivery, the assessment of technology and the standards organisations can be unusual and demanding. However, respected and honoured by their peers of the day. dramatically reduced the road toll. Compulsory wearing of the training programs. again as highlighted in the Mantle of Surgery, the College However, this is the Sir Edward Hughes Room. Let of seat belts legislation was introduced. Cars were The College during his three year Presidency changed inspires and challenges men and women of goodwill to me speak about Sir Edward just briefly. He was a leader actually scrutinised for safety. His efforts generated the forever, embracing quality initiatives, the necessity of give freely of their time and their wisdom. u

Page 30 / Surgical News October 2012 Surgical News October 2012 / Page 31 Audits of Surgical Mortality SURGICAL RESEARCH SOCIETY ANNUAL MEETING 2012 QASM connects Queensland The Surgical Research A successful seminar for all Society; 49th Annual health professionals healthcare professionals Scientific Meeting will be held in Adelaide on n August 2012, the Queensland Audit • the Queensland Health models for QASM asked: Which Friday 9th November of Surgical Mortality (QASM) held safety and quality improvements This meeting is open aspects of the seminar Iits first one-day seminar for nurses, did you find most useful? to those involved in or midwives, and paramedics. This seminar The seminar ended with case studies “Understanding the difficulties that interested in research, followed from the success of QASM’s being explored and discussed by a panel remote areas can face was very useful including surgeons, annual November seminars for surgeons, of the presenters. This session proved in understanding the way patients with a similar theme of Distance, Delays, popular with attendees who were able surgical or medical present to us. And the importance of Alan Merry and Bruce Barraclough at the Surgical Safety Checklist launch, 2009. and Deteriorating Patients. to ask questions and exchange their trainees, researchers, communication in these cases.” QASM has always acknowledged and experiences with the panel. scientists and medical CEWT: seeing the problem early and promoted the importance of the interface QASM also sought feedback from students. diagnosing the deteriorating patient We all reflect on the commitment and button for our computers, Professor between surgeons and other health attendees to better understand the (Children’s Early Warning Tool – the enthusiasm of College Fellows with Barraclough is chairing one of the peak professionals. Effective communication professional challenges they face and to JEPSON LECTURER: www.health.qld.gov.au) Professor John A Windsor which we work. They are truly involved groups for IT innovation in the country. is the cornerstone of this interface, evaluate the usefulness of this seminar for “Examining scenarios with the high FRACS for noble reasons. So you work with The strategic imperatives of surgery, and when managed well, it can greatly nurses, midwives, and paramedics. standard of professional presenter was Professor of Surgery, Director of organisations where you can honestly include quality, include standards, contribute to better patient outcomes. Surgical Research, The University excellent.” feel a difference will be made. but will always include innovation, The Brisbane-based August seminar of Auckland, New Zealand QASM asked: What “Aspects of each presentation had Secondly you wish to work with research and new ways of doing things. provided an opportunity for QASM to Chair, Section of Academic professional challenges some very useful points.” Surgery people who can inspire you. Giants like In the time that Professor Barraclough connect clinical health professionals and do you encounter when “Presenters from multiple specialties Lecture title: “Streams in the Professor Barraclough enable us to see has been here as Dean of Education, for surgical challenges to be reviewed and and multiple facilities.” Desert” further and look at things differently. we have made enormous strides in discussed. managing deteriorating We can stand on their shoulders. We are so many things. Quality, standards, patients? ASSOCIATION FOR ACADEMIC Most seminar attendees were from “As I work in a tertiary obstetric facility, QASM asked: Do you SURGERY GUEST SPEAKER: in awe of their skills. IT support, e-health, audit. All of this metropolitan hospitals. Importantly, Associate Professor Heitham T And I would highlight at this has been pushed and encouraged by however, four regional Queensland we constantly are faced with deteriorating think this seminar will Hassoun MD, FACS point, in thinking about Professor Professor Barraclough in ways that are towns were also represented. These towns patients, but in a controlled environment. help you in your future Medical Director – Global Barraclough, the descriptor that most both obvious and subtle. The work of a (regions) included: Bundaberg (Wide One area of concern is the rapid decline Services, Johns Hopkins Medicine assessments of patients? frequently comes to mind is masterful. master, sharing his wisdom. Bay-Burnett); Kilcoy (Somerset); Mt our patients can face and the acceptance of • 90 per cent of respondents said yes. International in Baltimore, patients in an already deteriorated state. My Maryland, USA Understanding the deep truths of So, in farewelling Professor Bruce Morgan (Central); Toowoomba (Darling Thank you to all presenters and Lecture title: “Kidney-Lung surgical philosophy in technical, Barraclough, I have really given you Downs). Attracting more attendees from biggest concern would be when a registrar attendees for their contribution to Crosstalk during Surgical AKI” political and diplomatic skills and five key words, not three to consider regional Queensland is part of QASM’s does not want to ‘bother’ the consultant to QASM’s first seminar for nurses, ask for assistance.” CALL FOR ABSTRACTS: delivering on these at international carefully. They all have a purpose and a planning strategy for future seminars. midwives, and paramedics. The call for abstracts will be open levels for decades is masterful. reflection on the enormous contribution Fifteen surgeons and three health “Communication with numerous on Monday 30 July 2012 and must Aligning Australia and New Zealand he has made. professionals presented to more than 90 teams (and staff) involved with the care be submitted no later Monday 24 with the health imperatives of the The first was Hughes-Room so attendees. A full day’s program resulted in of deteriorating patient and ensuring September 2012. Abstract forms United Kingdom, United States and you have an understanding of a three the following issues being addressed by continuity of information and care.” will be available from the email “Having senior staff not agreeing below. Canada is a substantial act. And to that, year President; the second was the experts in their fields: he brings my second descriptor, which shoulders of a giant on which we can • the complex patient – role of first- that someone is actually deteriorating; AWARDS AND GRANTS is wisdom. Across many domains. Many stand, and the third is different for on-the-scene; the local hospital; the normalising abnormal observations.” John North The following will be awarded to “Staff not acting as soon as possible when the best presentations: of us, on staff have been blessed to be things are truly that. However, to that I regional hospital; and the tertiary QASM Clinical Director Young Investigator Award able to stand on his shoulders and purposefully add both Masterful and hospital there are clear signs (that is, change in Developing a Career in Academic admire his skills. Wisdom, descriptors that are Professor • the deteriorating patient – organising trends) that the patient is deteriorating; and QASM’s next surgeons’ seminar Surgery Award I now wish to move to my third word Barraclough. and managing related issues when lack of communication between treating will be on Friday, 9 November, Three Travel Grants which is different. Giants see things Bruce, we will all miss you. I will miss teams (between doctors and nurses).” distance is involved 2012. Complex Decision Making in Best Poster Award “Senior staff being unapproachable differently. The world is a different you. As our mentor, our coach, and our • the communication networks for Modern Surgical Practice will focus Professor Guy CONVENOR: place. The horizon includes so many three year President. retrieval – trying to get medical staff to listen to on a range of related issues for Maddern other things. Is it any wonder that 1. Beasley, A.W., The Mantle Of Surgery. 2002, Mel- • the differences in surgical concerns. A ‘them and us’ attitude between surgeons. If you would like to attend PRESIDENT: Professor John Professor Barraclough also chairs the bourne: Royal Australasian College of Surgeons. management of children specialities. Emergency department staff this seminar please email QASM at McCall Australian ehealth research centre? David Hillis, • the obstetrics and gynaecology issues trying to manage sick patients without [email protected]. Whilst we struggle to find the on-off CEO at a distance getting early intervention from specialities.”

Page 32 / Surgical News October 2012 Surgical News October 2012 / Page 33 Professional Standards

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A AnA meansnumber E means shows you you thehavehave number been met exempt.of theCPD requirement. points you have earned. If you accidentally click Submit when your diary is incomplete, contact the CPD IfAIf younumberyou want want shows to see to thespecific see number specific details, of CPD click details, points on the youlink clickhave to theon earned. the link to the activity type. > Once the administrator has printed your statement, you A number shows the number of CPD points you have earned. willOfficer also be to given have the it unlocked. functionality to print off your own How CPD Online works If youA wantactivity tomeans see type. specific you details, have clicknot onyet the met link tothe the requirement. activity type. If youADD want ACTIVITIESto see specific details, click on the link to the activity type. statements. ACCESS 1300 073 239 ADD ACTIVITIES > To access CPD Online, you must be logged in to the CollegeADD ACTIVITIES AnADD E means ACTIVITIES you have been exempt. [email protected] You can add new activities as you complete them. CPD in 2013 website. You can add> You new can activities add new as activities you complete as you them.complete them. www.roomswithstyle.com.au You can add new activities as you complete them. As you will be aware, the College is in the process of implementing > Go to My Page. A number >Click shows the number of CPD points you have earned. Click Click . . a new CPD Online Diary in 2013 which will coincide with changes > On the right side, in the My CPD Progress area, click on theClick . If you want to NOTE:see specific you can only details, add activities click foron the the current link CPD to the year. activity type. to the CPD program. Further details about these changes will be link to CPD Online Diary. NOTE: you can only add activities for the current CPD year. NOTE: youNOTE can only: you add canactivities only for addthe current activities CPD year. for the current CPD year. included in the next edition of Surgical News. > The main view on the page is a summary of your completed From the Category drop down list, select the type of activity you ADD ACTIVITIES Fellows who wish to discuss any aspect of the CPD Program CPD activities. have completed. Once you do, the page will display further fields may contact the Department of Professional Standards on for you to complete. NOTE: If you are currently under Verification, thereYou will can add new activities as you complete them. +61 3 9249 1282 or via e-mail at [email protected] be a notice at the top of the page advising the status. This notification will be displayed until the VerificationClick has been NOTE: . each activity type will display a different form to Graeme Campbell either completed or exempted. complete. Chair, Professional Standards Committee NOTE: you can only add activities for the current CPD year. Page 34 / Surgical News October 2012 Surgical News October 2012 / Page 35 From the archives

The College Medical tour of China, Peking 1958 Benjamin Rank in India 1954 Douglas Miller in Thailand 1959 has a long history in helping our neighbours

Douglas Miller at dinner with Aris bin Kolop, c1953 Dr Yeoh, Singapore 1955

RACS and the Colombo Plan

n the late 1940s, post-war Australia, the Colombo Plan’s original membership Approached by Richard Casey on operations, carried out 75 consultations medical specialists, journeying to India, On a more serious note, the Colombo shielded by the ‘White Australia of seven countries had spiralled to 17 by behalf of the Commonwealth government and given five lectures, all of them on Thailand, Hong Kong and Japan. China Plan and the College’s involvement with IPolicy’ had little knowledge of our 1954. R.G. Casey who succeeded Spender in 1954, Benjamin Rank was the first reconstructive rather than destructive was a new experience for him: it established important links with Asia. near neighbours in the countries of as Minister for External Affairs in 1951 surgeon to participate in the Colombo surgery’. The first sight of China from the With a twist on Commodore Perry’s South and South East Asia. This was to was an enthusiastic advocate for the Plan. Rank was an obvious choice. Not surprisingly Douglas Miller, who windows of the train was like pictures from bombastic attempt to open up Japan in change primarily due to the efforts of two Colombo Plan and through his surgical An advocate for the training of Asian was asked to demonstrate neurosurgery a book; then there were strange contrasts the 1860s, Japan’s stigmatised for its role in External Affairs ministers; Percy Spender contacts, involved the College in this students in Australian Medical schools in Singapore, was the next participant in such as the masked white-clad individuals World War II, was slowly reinstated as an and his successor, Richard Casey. new initiative. and post-graduate facilities, he had also the Colombo Plan. Miller was inspired by who dispensed food on the railway stations. acceptable forum for the sharing of ideas. In a post-war world rocked by incidents By the 1950s, Casey who was later operated on Aris bin Kolop, a six-year-old the experience. He even found that ‘flying It was another world. The Association of Asian and Australian relating to the ‘Cold War’, a term created to become an Honorary Fellow of the Malay boy with facial disfigurement. In was somewhat of an adventure’ – and that …I asked my neurosurgical colleague Neurosurgeons with Douglas Miller as by George Orwell in his essay, ‘You and College, had several indirect associations 1953, Aris was flown to Australia by the there was a great deal of interest in brain in Peking about head injuries. He gave its first president and societies such as the Atomic Bomb’, it is interesting that with surgery. He was married to Maie RAAF and received free treatment at the surgery. the astonishing reply, ‘We don’t have head the Asian Surgical Association routinely Spender and Casey were far sighted Ryan, the daughter of Sir Charles Royal Melbourne Hospital. After the rather difficult removal of a injuries – our Chairman says we must not.’ involved College representatives in their enough to see the value of what was to Snodgrass ‘Plevna’ Ryan, known for his Following Rank’s appointment, tumour from the spinal cord, Yeoh told me meetings. Asian patients continued to be become the Colombo Plan. surgical exploits in the Russo-Turkish war The Age of November 11, 1954 carried that every surgeon from Singapore and India with its pockets of alcohol sent to Australia for specialised surgery; By 1950, Spender, who led the Australian of 1877/78. this caption: Johore had been in the theatre. prohibition was a more predictable and training for young Asian surgeons delegation to the British Commonwealth The Caseys were intimates of Daryl and There is a touch of imagination in experience. While commenting on the and the opportunity to attain FRACS Foreign Ministers meeting in Colombo, Joan Lindsay. Lindsay had been at the the decision that Australia should send When he returned to Australia, Miller efficiency of hospitals like the Christian continued to expand. Ceylon (modern Sri Lanka), had Queen’s Hospital, Sidcup with Sir Henry a distinguished plastic surgeon to Asian who was soon to become President, Medical Centre in Lahore, Miller laments In 2001 a Virtual Colombo Plan, the formulated a plan for an international aid Newland and later, donated Newland’s Countries to help them in correcting suggested that the College become the lack of ‘any alcoholic reviver from the culmination of Alexander Downer’s program in South and South East Asia. photograph album to the College. When disfigurement and deformity resulting from involved in the training of overseas heat and fatigue’. However, he recounts efforts to revive the ‘Casey tradition in A key aspect of the plan was the Casey was Treasurer in the Lyons cabinet, the diseases with which they are cursed. surgeons for Fellowship. Consequently, in that when he was in Bombay: Australian Foreign Policy’, was launched provision for Asian students to study he had met Douglas Miller and they 1956 with approval from Richard Casey, When we got to the party our hostess, in Sydney. Its aim was to provide in Australian tertiary institutions. But, appear to have been good friends. In his There is a touch of paternalism in this the College sent a team to Singapore to Mrs Bharucha asked whether I would developing countries with access to new ultimately, its effect was more far reaching autobiography A Surgeon’s Story, Miller statement, but it also flagged a positive train surgeons for the Primary Fellowship like lemon or lime juice. I think I rather technologies – this was another branch and it was to have profound implications mentions his purchase of the Casey’s beginning to surgical involvement in exam. despairingly elected lemon and found it for the sapling that had been planted for Australia from a cultural, economic Triumph car and how he was given a Asia. After visiting Indonesia, Malaya, Douglas Miller went to Asia on several strongly fortified with gin. I exclaimed ‘what more than 50 years earlier. and foreign policy perspective. ‘beautiful cocker spaniel’ bred by Singapore and India, Rank was able to occasions during the 1950s, returning to lovely lemons you have’ and she whispered, Developing from the ‘Spender’ plan, Maie Casey. report to Casey that he had ‘performed 39 Singapore, visiting China with a group of ‘Say nothing, there are always spies about.’ With Elizabeth Milford

Page 36 / Surgical News October 2012 Surgical News October 2012 / Page 37 Younger Fellows

2012 Younger Fellows Forum Experience from Councillors contributed to an interesting and enjoyable 2012 Younger Fellows Forum Younger Fellows Forum

3 – 5 May 2013, Auckland, New Zealand

All Younger Fellows are invited to nominate for the 2013 Younger Fellows Forum. The Forum focuses on future challenges for surgical practice and the changing face of health care delivery. The core objective is to provide an environment that encourages Younger Fellows to address he Younger Fellows Forum this plate organisation that feeds more than academia and college commitments. the forum; some unexpected, but resulting from From Left: challenging issues relevant year was held at the Golden a million people in developing nations Our two councillors, Cathy Ferguson the lateral thinking of the younger Fellows within Younger Fellow to personal, professional Palm Tree Resort, just outside of worldwide. His other interests include an and the vice Treasurer-elect, Marianne the forum – yet another acknowledgement by the attendees at the T Forum outside of and collegiate life through Kuala Lumpur. Thirty five participants, alternative energy company, as well as an Vonau, spoke to the topic of what is younger Fellows of the resources available within Kuala Lumpur. discussion and debate. It is including Younger Fellows and not-so- ambitious (but already partly-fulfilled) expected of a surgeon by the public the College and a wish to know more about and President Mike young Fellows, attended. aim of eradicating scabies in Australia. system, as well as what a surgeon needs engage with the College. Hollands taking a great opportunity to share Everyone worked hard. We started John Quinn generated much from the system. Both councillors were Some of the social highlights included a Master part in the team ideas and experiences. In early, ran late into tea breaks and often discussion. Like our Younger Fellows, he key to our successful forum, guiding our Chef team-building exercise, which appealed to building cooking 2013 discussion will focus on class; and into meal times. We had limited pool was asked to come back for overtime the recommendations and, above all, being the creative and competitive spirit of the surgeons. Cathy Ferguson supporting underprivileged time but, despite this, the meeting was next morning. Denis King and Michael part of the fun. Interestingly, different team dynamics were used to practising her patients through leadership enjoyed and all Fellows participated Grigg brought a wealth of experience I stressed out about speakers not skills. come up with a three course meal. and health advocacy. actively. The resourceful surgeons made and valuable insights in managing turning up – silly, given the responsible We also enjoyed a beautiful barbecue on the up for the lack of pool time by taking bar administrators and clinicians with guest list I’ve just mentioned. I then beach, as well as a dance show – an eclectic mix Attendance at the Forum and time – also by the pool – after dinner. different perspectives, but the same goal. stressed out about whether the people of music that had everyone up on the improvised airport transfers to the venue The value of the meeting was entirely Many also came back the next morning, would get into the spirit of the forum and beach dance floor. On the last night, before we were are covered by the College. in its contributors. Our guests included: on overtime, to provide a contribution contribute – even sillier, given that most to write the recommendations, the resort even put the President-elect, Michael Hollands; valued by all participants. surgeons have opinions we are more than on an amazing lightning and sound show typical of Applications are open from the Vice President-elect, Michael Grigg The President-elect Michael Hollands, happy to share. the tropics. 1 September to and the Executive Director of Surgical Michael Talbot, Association for Most of all, I am happy to report that I particularly enjoyed having John Morrow and Affairs, John Quinn. Academic Surgery (AAS) visitor Allan the May 2012 forum was a mixture Andrew McCormack at our forum. Their sense of 8 December 2012. Other guests were Sam Prince, who Tsung and Steve Leibman (outgoing of fun, positive spirit and a sense of fun guarantees an even better forum in 2013. Good gave an inspirational talk on how he chair, Younger Fellows Committee) achievement in that we’ve come up luck guys for 2013! Contact the Professional began with an investment of $12,000 at contributed to the Forum further with recommendations: some new, and Development Department Seema Bagia on +61 3 9249 1122 the age of 21 and now heads a plate-for- with their angle on balancing surgery, expected from the topics covered in Younger Fellows Forum Convener 2012

Page 38 / Surgical News October 2012 Surgical News October 2012 / Page 39 Surgery as a career

2012 Australasian Students’ Surgical Conference The enthusiasm of students was demonstrated in the successful inaugural Australasian Students’ Surgical Conference

n June 30, 2012, College Surgical Workshops – Academia, President, Professor Michael Anatomy and Skills Grant applications open OHollands, and the Associate In many respects the delegates found the highlight of the day to Dean of the UNSW Faculty of Medicine, be the variety of surgical workshops which they were exposed pplications for the Royal Australasian College of Professor Philip Jones, welcomed over 500 to. From Mr Richard Hanney’s overview of the College/AAS ASurgeons $10,000 Convention Travel Grants for 2013 delegates from all the 22 medical school Developing a Career as an Academic Surgeon course, Dr Dzung are now open. As an initiative of Perth Convention Bureau across Australia and New Zealand, JMOs, Vu’s and Dr Joga Choganti’s perspectives on what comprised (PCB) under its Aspire Program, the grants are awarded to and RMOs, to the inaugural Australasian essential surgical anatomy, Mr Sri Darshn’s surgical suturing skills two RACS Fellows and Trainees to assist in their professional Students’ Surgical Conference (ASSC), workshop where students practiced on pork bellies and synthetic development through attendance at a relevant international Sydney. skin models, Mr Anthony Chambers’ chest drains workshop conference. The ASSC was presented by the UNSW where students practiced insertion on pork rib cages, a bone The 2012 Western Australian recipients were Professor Surgical Society at the Sir John Clancy school workshop where students practised using lag screws and Christobel Saunders, a professor in Surgical Oncology at the Auditorium and Matthews Pavilions, compression plates, and Mr Paul Bannon’s aortic valve replacement University of Western Australia, and Dr Peter D’Alessandro, a was fully endorsed and supported by workshop where students practised on bovine hearts. specialist orthopaedic registrar at Royal Perth Hospital. the UNSW Faculty of Medicine, and was Indeed the attendees of Mr Paul Bannon’s cardiothoracic For more information and to obtain the application developed with the active involvement of workshop scored it a flawless a 10/10 with respect to how much guidelines, email Dr John Quinn FRACS, FACS, Executive the College; the ASSC Staff Convenor was they learnt, enjoyed and were inspired by it. Director for Surgical Affairs at [email protected] should be an academic surgeon” and Charlie Teo (Neurosurgery). Mr Phil Truskett, Chair, Board of Surgical In future incarnations of the ASSC, we look forward to conveyed that, “the best doctors treat The delegates found it educational to Education and Training. providing more skills workshops to cover all the nine surgical patients, do research and train tomorrow’s learn of the enormous variety and breadth Erratum The theme was “Australasian Students’ specialties, and with the support from the College Section of health care providers”; being an academic of work available in the discipline of single one-liner apologising for my mis-identification of Surgical Horizons” and it aimed to Academic Surgery, Professor John Windsor, a more interactive surgeon facilitates the marriage of these surgery, the nine competencies required the First President of the RACS, Sir George Adlington provide a unique insight into the world academic surgery workshop too. A of surgery so the delegates would learn, competing duties. of a College Surgical Trainee, and the Syme, is not sufficient. enjoy, and be inspired. Moreover the majority of surgeons, are upcoming restructuring of the entrance Outreach, Feedback, and Future To summarise, Sir George Adlington Syme was the in some way ‘academic surgeons’, and requirements for SET. founder and first President of the college with honorary belong to the collective of surgeons who The ASSC proudly supported UNSW ASPIRE (Student Equity Keynote Addresses and Disabilities Unit organisation), UNSW Nura Gili, and the appointments at the Melbourne Hospital, St Vincent’s and College President, Professor Michael are always learning, and discovering, to Student Surgical Queen Victoria Hospital for Women. He was on the surgical improve the healthcare of their patients. LIME (Leaders in Indigenous Medical Education) Network by of- Hollands highlighted the future Research Presentations fering seats to 32 high school students from these programs. It was staff of the first AGH and was present at Gallipoli, and with expectations and pathways for the From a competitive field, the Consultant Hamilton Russell and Hugh Devine signed the foundation Surgical Specialty also an opportunity to receive students’ perspectives on a variety upcoming generation of surgical Panel, which partly consisted of Mr Phil of surgical issues, and this data is being collated and analysed and letter of 19 November, 1925. It should be stated also that candidates, the historical and ensuing Speeches Truskett, Professor Michael Hollands, will be submitted for review, publication and presentation. in 1926 he was given authority to proceed with setting up role of the College in the surgical and the With the support of the ASSC Staff Professor Phil Crowe, and Mr Shing Furthermore with the support of the College and the New constitutional machinery for the organisation, and at the wider community, and the developments Convenor, Mr Phil Truskett (General Wong, chose nine abstracts for podium Zealand student body, developments are underway for the 2013 Australasian Medical Congress in Dunedin in February that lay ahead for all the stakeholders in Surgery), and the College President, the presentation and 14 for poster presentation ASSC to be held in conjunction with the 2013 College Annual 1927, he was unanimously elected President of the RACS, the surgical arena. ASSC was fortunate to have leading and (see photos and program), and the overall Scientific Congress, in Auckland, and the 2014 ASSC will be dying in office in April, 1929. His widow left a donation Feedback from the delegates showed inspirational surgeons from all of the winner of the best presentation at the presented by the Victorian medical student body. for the subsequent Syme Oration, the first being delivered that they were excited to hear about the nine surgical specialties: Mr Michael ASSC was Kiryu Yap (UMELB). in Melbourne at Wilson Hall, University of Melbourne in Geoffrey Lee, ASSC Founder & Convenor College’s humanitarian International McGlynn (Plastic Surgery), Dr Yishay He was awarded a certificate and $300 February 1932, with the presentation of the Great Mace. This with Phil Truskett Development Program, and were Orr (Cardiothoracic Surgery), Professor prize that was endorsed by the President oration is now delivered in conjunction with the convocation heartened to learn of the efforts the John Harris (Vascular Surgery), Professor of the Surgical Research Society of at the Annual Scientific Congress. I must admit not having College is making to provide them with Andrew Brooks (Urological Surgery), Mr Australasia, Professor John McCall. All All proceeds from the non-profit 2012 ASSC have attended many such orations, my knowledge was wanting, training positions and the community Guy Henry (Paediatric Surgery), Professor presented abstracts were also considered been donated to the College Foundation in support but as a bonus look what we have all found out. with excellent future surgeons. Ian Harris (Orthopaedic Surgery), for publication in a special supplement of the International Development Program. Reference: Royal Australasian College of Surgeons - Past Office Bearers. UNSW Professor of Surgery, Professor Professor Kelvin Kong (Otolaryngology, publication in the Australian Medical www.assc2012.com www.youtube.com/assc2012 Felix C Behan Phil Crowe, discussed “why every surgeon Head and Neck Surgery) and Professor Student Journal. Victorian Fellow

Page 40 / Surgical News October 2012 Surgical News October 2012 / Page 41 advertisement All Books now Welcome to the Surgeons’ Bookclub 25% discount

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Page 42 / Surgical News October 2012 Surgical News October 2012 / Page 43 Foundation for Surgery CALL FOR ABSTRACTS thank-you for donating to the Foundation for Surgery

NSW South Australia Mr Geoffrey Coltheart Rotary Club of North Adelaide Victoria Mrs Janet Ellis New Zealand Dr Don Jayasuriya Mr William Gilkison RACS ASC 2013 Melbourne Art Rooms Mr Howard Swan Royal Australasian College of Surgeons 82nd Annual Scientific Congress Yes, I would like to donate SkyCity/Crowne Plaza Convention Centre to our Foundation for Surgery Auckland, New Zealand All donations are tax deductible 6 – 10 May 2013 Name: Address: Telephone: Email: Speciality: Enclosed is my cheque or bank draft (payable to Foundation for Surgery) for $ . asc.surgeons.org Please debit my credit card account for $ .

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Your passion. Card Holder’s Name - block letters Card Holder’s Signature Date Sustainable

Your skill. I would like my donation to help support: Your legacy. General Foundation Programs International Development Programs Surgery Scholarship and Fellowship Programs Indigenous Health Programs I have a potential contribution to the Cultural Gifts Program Your I do not give permission for acknowledgement of my gift in any College publication Please send your donation to: Foundation. AUSTRALIA & OTHER COUNTRIES NEW ZEALAND Royal Australasian Foundation for Surgery Foundation for Surgery 250 - 290 Spring Street PO Box 7451 College of Surgeons East Melbourne , VIC 3002 Newtown, 6242 Wellington Australia New Zealand

Page 44 / Surgical News October 2012 Surgical News October 2012 / Page 47 6 – 10 May 2013 Sustainable RACS ASC 2013 SkyCity/Crowne Plaza Convention Centre Auckland, New Zealand Surgery

SuBmiSSiOn OF ABSTRACTS FOR 13. Please ensure that you indicate on the Abstract RACS ASC 2013 PROgRAm OveRview (indiCATiVe onlY) Submission site whether you wish to be considered for: ReSeARCh And inviTed PAPeRS Monday 6 May Tuesday 7 May Wednesday 8 May Thursday 9 May Friday 10 May Section Prize Abstract submission will be entirely by electronic means. Breakfast session masterclasses masterclasses masterclasses masterclasses This is accessed from the Annual Scientific Congress website bariatric Surgery (Trainee) $500 7.00am – 8.20am ‘asc.surgeons.org’ and clicking on Abstract Submission. breast Surgery (Trainee) $500 Session 1 Plenary Scientific Sessions Scientific Sessions Scientific Sessions Several points require emphasis: Cardiothoracic Surgery (Trainee) $500 8.30am – 10.00am 10.00am – 10.30am Morning Tea Morning Tea Morning Tea Morning Tea 1. Authors of research papers who wish to have their Colorectal Surgery $500 Session 2 abstracts considered for inclusion in the scientific (Mark Killingback Prize for Young Fellows & Trainees) Scientific Sessions Plenary Plenary Plenary 10.30am – 12 noon programs at the Annual Scientific Congress must endocrine Surgery $500 submit their abstract electronically via the Congress (Tom Reeve Prize - Best Basic Science & Best Clinical) 12 noon – 12.30pm Pre-Congress Keynote lectures Keynote lectures President’s lecture Keynote lectures website having regard to the closing dates in the Call for 12.30pm – 1.30pm workshop Lunch Lunch Lunch Lunch Abstracts, the Provisional Program and on the Abstract general Surgery (Trainee) $500 Program Keynote lectures Keynote lectures Keynote lectures Keynote lectures head & neck Surgery (Trainee) $500 submission site. AbSTrACTS SubmiTTed AfTer The 1.30pm – 2.00pm and and and and CloSing dATe will noT be ConSidered. hepatobiliary Surgery (Trainee) $500 named lectures named lectures named lectures named lectures 2. The title should be brief and explicit. Session 3 Quality Assurance & Audit in Surgical Practice $500 Scientific Sessions Scientific Sessions Scientific Sessions Scientific Sessions 2.00pm – 3.30pm 3. research papers should follow the format: Purpose, Surgical education (Not exclusively for Trainees) $500 3.30pm – 4.00pm Afternoon Tea Afternoon Tea Afternoon Tea Afternoon Tea methodology, results, Conclusion. Surgical history (Trainee) $500 Session 4 Scientific Sessions Scientific Sessions Scientific Sessions Scientific Sessions 4. non-scientific papers, eg. education, history, military, Surgical oncology (Trainee) $500 4.00pm – 5.30pm medico-legal, may understandably depart from the Trauma Surgery (Trainee) $500 4.30pm – 6.00pm Convocation Ceremony above. upper gi Surgery (Trainee) $500 welcome Cocktail 6.00pm – 7.00pm 5. excluding title, authors (full given first name and family reception Vascular Surgery (Trainee) $500 name) and institution, the abstract must not exceed 1750 Sectional dinners characters and spaces (approximately 250 words). in mS and Younger The submitting author of an abstract will AlwAYS receive 7.00pm – 11.00pm Sectional dinners Sectional dinners Congress dinner word, this count can be determined from the ‘review’ fellows & Trainees email confirmation of receipt of the abstract into the menu. Any references must be included in this allowance. dinner if you exceed this limit, the excess text will noT appear in submission site. if you do not receive a confirmation email the abstract book. within 24 hours it may mean the abstract has not been received. in this circumstance, please email binh nguyen 6. Abbreviations should be used only for common terms. at the royal Australasian College of Surgeons to determine ReSeARCh PAPeR SPeCiALTieS ASC exeCuTive for uncommon terms, the abbreviation should be given why a confirmation email has not been received. Authors of research papers and posters are invited to submit Congress Convener Prof John windsor in brackets after the first full use of the word. ([email protected]). abstracts for consideration and inclusion in the Scientific Scientific Convener Prof Andrew g hill 7. Presentations (slide and video) will only have electronic Program in the following areas: imPORTAnT inFORmATiOn member of executive mr richard douglas PowerPoint support. Audio visual instructions will be bariatric Surgery Pain medicine available in the Congress Provisional Program and in To SubmiT An AbSTrACT go To ‘asc.surgeons.org’ member of executive mr bruce Twaddle breast Surgery Quality Assurance & Audit correspondence sent to all successful authors. And CliCK on ‘AbSTrACT SubmiSSion’. member of executive dr deborah wright Cardiothoracic Surgery in Surgical Practice 8. Authors submitting research papers have a choice of two The CloSing dATe for All SCienTifiC PAPer member of executive mr Andrew macCormick specialities under which their abstract can be considered. AbSTrACT SubmiSSion iS fridAY 25 JAnuArY 2013. Colorectal Surgery rural Surgery ASC Coordinator mr roger wale Submissions are invited to any of the specialties or PleASe noTe ThAT PAPer or fACSimile CoPieS endocrine Surgery Senior Surgeons group ASC manager ms lindy moffat special interest groups participating in the program will noT be ACCePTed. nor will AbSTrACTS general Surgery Surgical education except cross-discipline. be SubmiTTed bY College STAff on behAlf ASC executive officer ms Katie fagan head & neck Surgery Surgical history 9. A 50 word CV is required from each presenter to facilitate of AuThorS. manager, new Zealand office ms Justine Peterson Surgical oncology their introduction by the Chair. if there are any difficulties regarding this process please hPb & upper gi Surgery Trainees Association 10. The timing (presentation and discussion) of all papers contact binh nguyen, for assistance on +61 3 9249 1279 indigenous health or email ([email protected]). is at the discretion of the Convener of each Section. international forum Transplantation Surgery For further information contact: notification of the timing of presentations will appear Trauma Surgery in correspondence sent to all successful authors. SCienTiFiC POSTeRS medico-legal [email protected] All posters will be presented electronically during the military Surgery Vascular Surgery 11. Tables, diagrams, graphs, etc CAnnoT be accepted in Congress and will be available for viewing on computer women in Surgery the abstract submission. This is due to the limitations of Paediatric Surgery screens in the industry exhibition. Posters will be placed the computer software program. on the Virtual Congress in addition to the abstract. 12. AuThorS muST be regiSTrAnTS AT The meeTing for their abstract to appear in the publications, on the imPORTAnT dATeS website or the Virtual Congress. Abstract Submission opens October 2012 Closure of Abstracts 25 January 2013 Closure of Early Registration 12 March 2013 Sustainable The Royal Australasian College of Surgeons RACS ASC 2013 Surgery Member Advantage Benefit Program

SCienTiFiC COnveneRS COLLege & induSTRY SPOnSORed viSiTORS Bariatric Surgery Mr Grant Beban Dr Alfons Pomp USA Professor Michel Suter SWitZERLAND Breast Surgery Mr David Moss Mr kieran Horgan Uk Dr Barbara L Smith USA Cardiothoracic Surgery Mr indran Ramanathan Professor Robert Mckenna USA Professor Friedrich-Wilhelm Mohr GERMANy Professor David taggart Uk International Colorectal Surgery Dr Mattias Soop Professor torbjörn Holm SWEDEN Dr thomas E Read USA Associate Professor Alexander Heriot AUStRALiA money transfers Endocrine Surgery Mr Win Meyer-Rochow Dr Electron kebebew USA Professor Martin k Walz GERMANy at better rates than the banks! General Surgery Mr Patrick Alley Professor Jane Blazeby Uk Professor Hobart W. Harris USA Dr Jacob Jacob AUStRALiA Head & Neck Surgery Mr Rajan Patel Dr Neal Futran USA Do you need to pay an international invoice, purchase HPB & Upper Gi surgery Mr Jonathan koea Associate Professor William Hawkins USA a property or send money to family members overseas? Professor Juergen Weitz GERMANy indigenous Health Mr Patrick Alley Our partnership with OzForex allows you to transfer Mr Jonathan koea money worldwide at significantly lower rates than banks. international Forum Dr kiki Maoate Medico-Legal Mr Haemish Crawford Military Surgery Mr Ross Blair Col. Dr teun van Egmond tHE NEtHERLANDS Benefits of using OzForex include: Associate Professor Darryl tong NEW ZEALAND £ Paediatric Surgery Dr Neil Price Mr Anthony Sparnon AUStRALiA Free transfers for RACS Fellows and Trainees Pain Medicine Mr James Bartley Dr David Butler AUStRALiA $ No receiving bank fees in most countries Professor Lorimer Moseley AUStRALiA ¤ Phone access 24-hours a day, 5 days a week Quality Assurance & Audit Dr Catherine Ferguson in Surgical Practice ¢ Online access 24/7 Rural Surgery Mr John kyngdon Miss Sarah Prince Uk ¥ Competitive foreign exchange rates Senior Surgeons Mr Patrick Alley across 52 currencies Surgical Education Mr Richard Perry Surgical History Prof John Collins Major General Alan Hawley Uk Register online today to save on transfers, or Surgical Oncology Mr Jonathan koea Dr Monica M Bertagnolli USA speak to OzForex’s accredited dealers for more trainees Association Dr Deborah Wright information about the service. transplantation Surgery Mr Adam Bartlett Professor Charles B Rosen USA trauma Surgery Dr James Hamill Dr Paal Aksel Naess NORWAy Professor Michael Rotondo USA Vascular Surgery Mr Andrew A Hill Dr Alan Lumsden USA Call 1300 300 424 (Australia) or 0800 161 868 (NZ) Professor John Robbs SOUtH AFRiCA www.memberadvantage.com.au/racs/ozforex Women in Surgery Dr Eva Juhasz Convener & Visitor list correct as at time of printing (Aug 2012)

Keep abreast of program developments on the conference website: asc.surgeons.org

Royal Australasian College of Surgeons gardens T: +61 3 9276 7406 College of Surgeons 250-290 Spring Street f: +61 3 9276 7431 Abn 29 004 167 766 east melbourne, Victoria, 3002 e: [email protected] Australia w: asc.surgeons.org Surgical News October 2012 / Page 51 that a second doesn’t skin… irritate the first

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