Neurosurgery Residency Programme

Residency training programme in neurosurgery was initiated in November 1999. It is recognised by the College of Physicians and Surgeons, Pakistan (CPSP), for FCPS training and since its inception three of our residents have passed the neurosurgery fellowship examination of the CPSP.

Objectives

The programme aims to train neurosurgeons in all aspects of neurosurgery to the highest international standards.

Duration of training

We offer a well-structured training programme of four years duration that is monitored at several levels.

Eligibility

• MBBS or equivalent degree approved by the PM&DC
• One year internship with six months in Surgery and allied (preferably General Surgery) and six months in Medicine and allied disciplines
• FCPS Part I
• Two years of training in surgical disciplines, as required by CPSP (those who do not possess this training may be posted in AKU surgical rotation for two years before joining Neurosurgery)

Scope and content

Clinical training

There is supervised training in all areas of Neurosurgery. These include areas of neurovascular, spinal, paediatric, skull-base and neuro-oncology. In addition, the trainees deal with all neurosurgical emergencies including trauma, hydrocephalus and infections on a daily basis.

They are expected to become safe and competent practitioners in dealing with emergency situations in their first year and thereafter increase and expand their clinical skills.

The trainees get regular teaching in neuroradiology, neuropathology, neuro-opthalmology, neuroendocrinology and neurology.

Throughout the training, the stress is on developing critical thinking and evidence-based practice.

Incorporated in the programme is extramural training periods in Pakistan. Suitable residents could be sent abroad for sub-specialty training.

Educational content

The weekly conference schedule is as follows:

• Monday: (am) Surgical anatomy presentation by residents
• Tuesday: (am) Neurosurgical topic presentation and tutorials
• Wednesday: (am) Surgical grand round; pm Neuroradiology conference
• Thursday: (am) Combined neurology, neuro- surgical case presentations, followed by neurosurgical grand round; pm Journal club, neuropathology meeting
• Friday: (am) Neurosurgical teaching by the faculty
• Saturday: (am) Morbidity and mortality meeting, monthly

In addition, there is a teaching ward round nearly everyday by the faculty.

Evaluation

Written examination every three months; six monthly individual interviews are held to get feedback from residents and to give them the evaluation of their performance by the faculty.

Research

There is a major emphasis on the trainees to do research in basic and clinical neurosciences. Currently the residents are doing research on neurotrauma, CNS tuberculosis, hydrocephalus, myelomeningo-coele and spinal surgery. Our faculty is also involved in basic science research that includes, neural stem cells transplantation, effect of intraoperative adjunctive agents on neuronal cell culture, effect of herbal agents on glioma cells in culture. Trainees will be encouraged to get involved in such projects.

On-call duties

The residents work on a one-in-four rota i.e. one night in four being spent on the premises. The weekends (Saturday and Sunday) are similarly worked.

Positions available

One resident is accepted every year.

Administrative set-up

AKUH, Karachi is the only hospital in Pakistan where both the European-trained and the US-trained neurosurgeons deliver service and education. The department comprises of six consultants - one associate and two assistant professors working full time and three part time consultants. We also have one position of an instructor for one year duration usually the graduating chief resident gets this position to groom his surgical skills further in neurosurgical subspecialties.

This faculty, in combination with the strict quality control in AKUH, Karachi and a solid infrastructure of hospital-based practice, has raised the standard of neurosurgical practice and education.

Future plans

An expansion of clinical services to include stereo-tactic and functional neurosurgery and neuro-endoscopy is planned.

In addition, it is expected that the department will develop a fellowship programme in one of the neurosurgical subspecialties soon.

Recently steps have been taken to expand and strengthen the research capacity of the department so as to make it a major Neurosurgical Research Centre.

Full-time Faculty

Associate Professor

Dr Syed Ather Enam
MBBS Karachi; PhD US; FRCS Ireland; FRCS Canada; FACS USA
Diplomate American Board of Surgery
Programme Director

Assistant Professors

Dr Ehsan Bari
MBBS Punjab; FRCS Ireland
Programme Coordinator

Dr Gohar Javed
MBBS Karachi; FCPS Pakistan

Instructor

Dr Atta-ul-Aleem Bhatti
MBBS Peshawar, FCPS Pakistan

Part-time Faculty

Lecturers

Dr Ahmed Ali Shah
MBBS Karachi; FRCS Edinburgh

Dr Khalid Chisti
MBBS Karachi; FRCS Edinburgh; FRCS Glasgow