General Surgery Residency Programme

The training programme in General Surgery at Aga Khan University Hospital was initiated in 1986. In 1988 and again in 2003, the College of Physicians and Surgeons, Pakistan, approved the programme to fulfill the requirements to take its fellowship examination.

In April 1990, the Royal College of Physicians and Surgeons of Glasgow approved the programme for its fellowship examination.

In June 1992, the Royal College of Surgeons of Edinburgh gave approval to the programme for its fellowship examination.

This programme has graduated 40 surgeons to date; out of whom a majority are serving in various institutions all over Pakistan.

Objective

The goal of the programme is supervised, comprehensive training in General Surgery from which trainees would emerge as clinically and academically competent surgeons.

Duration of training

The General Surgery Residency Programme extends over five years, during which progressively increasing exposure and responsibilities are given to trainees, both in the operating room and in the pre-and post-operative management of patients.

Eligibility

• MBBS or equivalent degree approved by the PM&DC, with 60 per cent or above marks in the final examination
• One year internship with six months in Medicine and allied and six months in Surgery and allied disciplines
• Candidates with FCPS Part one are preferred
• Fresh graduates of less than four years are preferred

The final selection is based on MCQs examination scores and interviews.

Scope and content

Clinical training

Years 1 and 2

As per CPSP requirement, all the residents undergo rotations of 18 months in general surgery, 3 months in orthopaedic and trauma, and the remaining 3 months in other specialties including urology/neurosurgery/plastic surgery/paediatric surgery. They are primarily involved with patient care in wards and clinics with some operating room exposure in General Surgery as well as the specialties. During these two years, they have core curriculum seminars every week. At the end of the Year 2 of training, the residents are eligible for intermediate module examination from CPSP. There is a categorical and a preliminary system in General Surgery programme and only three to four residents will be promoted to Year 3.

Years 3 and 4

These residents have progressively increasing patient care responsibilities and operating room experience, which is more or less tailored to the residents' needs and levels of competence. Year 3 residents have to rotate in Paediatric Surgery, Cardiothoracic Surgery and Urology for six months and General Surgery for three remaining six months. Year 4 residents rotate in General Surgery only with optional three months extra mural rotation.

Year 5

This year is spent as Chief Resident with rotations in the General Surgery teams. The chief residents are responsible for the overall management of the clinical service. In addition to considerable independence in the operating room, they play a critical role in the learning experience provided to the students and junior residents.

Didactic content

In addition to the routine daily ward rounds by consultants of different services, weekly grand rounds, morbidity and mortality meetings, journal clubs, evidence based seminars, operative surgery sessions and service audit are held regularly.

Evaluation

Of the six residents joining at Level I, three to four eventually complete the programme as chief residents. Promotion to the next level is on the basis of continuous evaluation by the faculty and in-training examinations.

On-call duties

Each resident does an average of one night in four on-calls within the Hospital premises, although occasionally one night in three or two may be necessary.

Positions available

Six positions for Level I residents are open from November 1 of each year. Positions are advertised in leading national newspapers.

Administrative set-up

The residents rotate through four General Surgical services and various specialties including Paediatric Surgery, Orthopaedic Surgery, Urology, Neurosurgery, Cardiothoracic Surgery, and the Emergency Room. In each of these areas, a senior resident has the overall responsibility for all the patients and is in close contact with the consultants concerned. All junior residents are expected to work in close liaison with the respective senior residents and a meaningful learning experience is provided to the residents. The Programme Director is Dr Rehman Alvi, Assistant Professor, while Dr Rizwan Khan, Assistant Professor, is the Programme Coordinator.

Full-time Faculty

Professor and Chairman

Dr Amanullah Memon
MBBS Karachi; FRCS Edinburgh

Professor

Dr Shaista Masood Khan
MBBS Karachi; FRCS Edinburgh

Associate Professors

Dr Hasnain Zafar
MBBS AKU; FRCS Glasgow

Dr Inam Pal
MBBS Karachi; MSc London; FRCS England

Dr Rizwan Azami
MBBS Karachi; MCPS, FCPS Pakistan
Director General, Surgery Residency Programmes

Assistant Professors

Dr Abdul Rehman Alvi
MBBS Karachi; FCPS Pakistan, FRCS Glasgow
Programme Director

Dr Rizwan Khan
MBBS Punjab; FCPS Pakistan; FRCS Edinburgh and Glasgow
Programme Coordinator

Dr Sadaf Khan
MBBS Punjab; MD; FACS; FACCRS, USA

Dr Tabish Chawla
MBBS Punjab; FRCS Glasgow

Senior Instructors

Dr Nazia Riaz
MBBS Karachi; FCPS Pakistan; MRCS Glasgow

Dr Irum Naz
MBBS Karachi; FCPS Pakistan; MRCS Edinburgh

Part-time Faculty

Dr Aamir M. Jafarey
MBBS Karachi; FRCS Edinburgh; FCPS Pakistan

Dr Irfan Daudi
MBBS Karachi: FRCS Glasgow

Dr Khalid Hameed
MBBS Karachi; FRCR Dublin

Dr Moiz-ud-din
MBBS Karachi; FRCS England

Dr Turab Pishouri
MBBS; FCPS; FRCS