Department of Surgery

     

  

Forward

The Department of Surgery, College of Medicine, University of Basrah was established in 1970. It teaches, and trains, the third, fourth, fifth and sixth year students the subject of General Surgery and surgical subspecialities (i.e. Orthopaedic Surgery, Cardiovascular Surgery, Urology, Neurosurgery, Plastic Surgery, Diagnostic Radiology and Anesthaesiology). In addition, fifth year students are separately lectured and trained in Ophthalmology and Otolaryngology. Since its establishment, the Department was headed by nine of its staff, namely:

 

 

 

Objectives

The Department aims at graduating doctors with sound knowledge of Surgery and proper ethical background, who are able to diagnose and manage the basic surgical conditions, especially so regarding emergencies. This objective is achieved through the following protocols:

 

General

To provide the scientific background (including applied anatomy, physiology and pathology) needed by the undergraduate student to understand various systemic disorders that he faces and to correlate this knowledge to his surgical training.

To introduce and explain, in details, the general principles in surgical practice to the student including the effects of environmental and social factors in the causation of certain surgical diseases.

To explain the role of each organ, its disorders and its relation to a specific system on one hand and other systems on the other.  

   

      1-    Clinical training objectives

A- Third year

Students should be familiar with the main principles of surgical problems like fluid and electrolyte balance, blood grouping and blood transfusion, wound healing.... etc.

 

B- Fourth year

Students should be able to:

take, write and present history and perform and record thorough physical examination of the major systems of the body.

know the role of the common and important investigations.

analyze and integrate the information he obtains from history, clinical examination and investigations to formulate a sensible provisional diagnosis.

 

C- Fifth year

Students are expected to get familiar with the OPD and deal with patients presenting with disorders involving various surgical sub-specialties including traumatology.

D- Sixth year

At the end of the graduation-year training, students are expected to have, and express, adequate knowledge and understanding of the following:

Clinical learning objectives; a student should:

- Obtain full medical history.

- Perform comprehensive clinical examination.

- Be confident in assessing the patient's problem.

- Manage the patient as a sick person and a “case”.

- Be able to write a clear and concise record for each of his patient.

 

2. Clinical skills:

A student is expected to be able to perform the following procedures and to know their general indications and contraindications:

Stool examination (general and occult).

General urine examination.

Per-rectal and proctoscopic examinations.

Intra-muscular, intravenous and subcutaneous injections.

Setting of an intravenous line.

Blood grouping and cross matching.

Venesection (venous cut-down).

Fundoscopy.

Indirect laryngoscopy.

 

3. Students are expected to have attended and observed certain surgical procedures and to have adequate knowledge of these procedures along with their general indications and contraindications. These procedures include:

GIT endoscopy (upper and lower).

Thoracic endoscopy.

Urological endoscopy.

Lymph node biopsy.

Needle biopsy (FNAC and Tru-Cut).

Blood transfusion.

 

4. Students should be able to interpret the following investigations:

 Radiological studies of various systems and organs (plain and contrast).

 Hematological analysis.

 Liver and renal function tests.

 Culture and sensitivity tests.

 

Members of the department and their interests

 

 

    

 

Setting of the department

The main office of the department is located in the sixth floor of the Basrah Medical College Building. It contains the following units:

1. The Chairman's and Staff rooms.

2. Secretarial rooms.

3. The Pathology Museum.

4. The Instruments Museum.

5. The Department Library.

6. The CDs Library.

7. The Slides Library.

8. The Clinical Training Model facility.

 

Attached to the department are the three major Hospitals in Basrah, namely: Basrah Teaching Hospital (250 surgical beds), Basrah General Hospital (304 surgical beds) and Al-Mawani Hospital (100 surgical beds), where both under and postgraduate teaching and training take place. Beside the bedside and wards, training also includes the ICUs, OPDs, and Accidents and Casualty Departments.

 

Training Programs

I.Undergraduate Training Program

The undergraduate training program is spread over 4 years (third through sixth) and includes formal lectures, tutorials and clinical training in the wards and outpatient department (OPD). Details of the program are:

 

Third Year

Thirty lectures are given and they include:

                 1. Wound healing and repair            

2. Surgical infections.

3. Fluid and electrolyte balance.

4. Blood transfusion and hemorrhage.

5. Metabolic changes after trauma.

6. Ulcer, gangrene, hydatid disease and neoplasms.

7.Burn and Lymphatic disease.

 

Fourth Year

A- Lectures: Ninety lectures are given. They provide and discuss the scientific background for an understanding of the following systems:

1. Head and neck.                               

2. Breast.

     3. Gastrointestinal tract.          

4. Urology.

     5. Hernias and abdominal wall.        

6. Endocrinology.

B- Clinical Training: The training hours are 240 hrs. in three dividing sessions of 80 hrs each. Students are divided into groups that attend surgical wards 4 days a week for 12 weeks. During these sessions, the students are trained to obtain full history and perform and record thorough physical examination of the following:

1. Head and neck.

2. Chest, breast and axilla.

3. Abdomen (including internal organs).

4. Extremities including movement and vascular system.

5. Sex organs, perineum and rectal examination.

6. Hernias in different parts of the body, stressing on inguinal hernias.

7. Examination of ulcers, lumps and abscesses.

8. Examination of the lymphatic system, stressing on regional lymph nodes and fields of drainage.

 

Fifth Year

a. Lectures: A total of 175 lectures are given to cover the following subjects:

 

b- Clinical Training: The training hours are 156 Hrs. during which students are divided into groups that attend the OPD. The training covers history taking and examination of the attending patients. Students also share in the discussion of the patients’ problem and making decisions in their management. Topics covered are:

 

 

 

Sixth Year

Tutorials are spread over 11 weeks in addition to 11 weeks of problem-solving discussions. Details are explained below:

 

Clinical Training

Students are divided into groups that spend 40 hours every week in surgical wards. Their duties are to deal with the patients problems comprehensively taking full histories, performing complete physical examinations and making daily follow up. They should also perform certain procedures like giving injections and stitching simple wounds and attend the operating theatre once a week. Furthermore, they should discuss the cases with their tutor.

 

II. Postgraduate Training Program

This includes the following:

1.The Arab Board of Surgery: This study was established in 1982 and since then it was supervised by:

 - Hikmat Abdul-Rasoul      (1982-85)

 - Adnan Y. Abdul-Wahab  (1985-86)

 - Ameen A. Ameen              (1986-90)

 - Falih  Al-Obaidy                (1990-96)

 - Adnan Y. Abdul-Wahab  (1996 - now)

Up to now, 68 doctors graduated in General Surgery and 7 in ENT while 17 candidates are still being trained at various stages of the training course in General Surgery and 9 in ENT.

2.The Iraqi Board of Surgery:

a) General Surgery:

     The study started at 1991 under the supervision of Dr. F. Al-Obaidy and is currently supervised by Dr. A.Y. Abdul-Wahab. Twenty one doctors have already graduated from the Basrah Center while 37 candidates are in active training.

b) Orthopedic Surgery: The study started in 1989 under the supervision of Professor Dr. T. A. Hamdan. Twenty doctors have graduated and 7 candidates are in active training.

c) Cardio-thoracic & Vascular Surgery: The study started in 1991 under supervision of Dr. N.D. Sulieman and is currently supervised by Professor Dr. A.K.Z. Benyan. Four doctors have graduated and 3 are in active training.

d) ENT: The study started in 1993.Twelve   doctors have graduated and 11 candidates are in training. The training is supervised currently by Dr. H.H. Salman.

e)Anaesthesia:The study started in 2003.Three doctors are in training.The training is supervised  by Professor Salam N. Asfar.

All students of the Iraqi council for medical specializations (iraqi board candidates) should submit a paper supervised by a faculty member in partial fulfillment of the requirements for the degree of fellowship of the council before entering the final examination.

3. Master (MSc.) in Anaesthesia:

 The study started in 1986 under the supervision of Professor W. Abdalla. The study period was 2 years and during the second year each student should have a dissertation. Six doctors graduated with MSc. in Anaesthesia. The study was subsequently abandoned for technical reasons.

4. The Diploma (study period is two years, 2 years of permanency required before starting training):

a) General Surgery:

            The study started in 1994. Forty doctors have graduated and two is currently under training.

b) Orthopedic Surgery:

            The study started in 1991. Fifty one doctors have graduated and 4 are currently under training.

c) Anaesthesia:

  The study started in 1994. Thirty doctors have graduated and I0 are currently under training.

d) Diagnostic Radiology:

Eight doctors graduated on 1993.

 

Examinations

Third Year:

The examination is held twice a year, mid-term (40%) and final (60%). The questions come in the form of essays and short notes.

 

Fourth Year:

A-Written examination:

Those are held twice a year, mid-term and final. Questions come either as essays, short notes or problem solving.

B-Clinical examination:

This is held at the end of the clinical training and the skills of each student are assessed within 20 minutes. The total mark for Fourth Year students is summed as follows:

 -Final examination             50%

 -Mid-term examination      30%

 -Clinical examination        20%

 

Fifth Year:

Examinations (mid-term, final and clinical) include the following topics:

- ENT.

- Ophthalmology.

- Other surgical subspecialties (Orthopedic Surgery, Cardio-thoracic Surgery, Neurosurgery, Urology & Anaesthesia).

 

Sixth Year:

A-Written examination:

The examination is held once a year to and is the last requirement for MBChB degree. The questions are provided by either the Examination Committee of the Department or by the Central Committee of Examinations, a body formed by the Ministry of Higher Education and Scientific Research.

 

B-Clinical examination:

Two clinical examinations are held for the graduation-year students:

 - Examination at the end of the clinical course.

 - Final clinical examination for the MBChB.

The total graduation mark is calculated as follows:

 - Written examination                                30%

 - Clinical examination                               50%

    (long case, short case and oral)           

 - Course examination mark.                     20%

 

 

The Diploma degree

 

Two examinations are held during the duration of the study:

            - Assessment examination                                    30%

            - Final examination                                                  70%

Details of the marking system are outlined below.

 

1. General Surgery and Orthopaedic Surgery:

A-The written examinations:

- First paper (Basic Sciences)                                15 marks

- Second paper (Principles & Operative)             20 marks

 

B-The clinical examinations:

- The long case examination                                  20 marks

- The short case examination                                15 marks

- The oral examinations:

           1- Principles of Surgery                               10 marks

            2- Operative Surgery                                    10 marks

            3- Emergency Surgery                                10 marks

2. Anaesthaesia:

A-The written examinations:

- First paper (Basic Sciences,

  Intensive care and Resuscitation)                      20 marks

- Second paper (Clinical Anesthaesiology)        20 marks

 

B-The oral examinations:

- Basic Sciences and Toxicology                         15 marks

- Clinical Anaesthaesiology                                   15 marks

 

 

 

 

Departmental Activities

Those include:

1. Publishing “Basrah Journal of Surgery” since 1995, a bi-annual journal concerned with Surgery and related sciences that is produced with self-financing. The journal is currently listed in the Index Medicus (the National Library of Medicine, Bethysda, Maryland), IMEMR (WHO) and carries the ISSN number 633-3589.

2. Faculty members provide therapeutic and consultation services in various hospitals in Basrah.

3. Faculty members run the only specialized centers for Cardiovascular Surgery, Neurosurgery & Plastic Surgery (and burns) in Southern Iraq.

4. Faculty members provide clinical surgical services for “Basrah University Center for Medical Consultations”.

5. Faculty members serve as members of various committees both in the College and in the Ministry of Health.

6. The Chairman also heads the Division of Surgery in Basrah Teaching Hospital, Basrah.

7. A faculty member runs the scientific activities in Basrah Teaching Hospital, Basrah.

8. A faculty members participated in the final examinations for the degree of Arab Board Certificate in General Surgery.

9. Faculty members participate in the final examinations for the fellowship of the Iraqi Commission for Medical Specializations/ General Surgery.

10. Faculty members participate in the final examinations for the fellowship of the Iraqi Commission for Medical Specializations/Cardiothoracic and Vascular Surgery.

11. Faculty members participate in the final examinations for the fellowship of the Iraqi Commission for Medical Specializations/ ENT.

12. Faculty members participated in the final (graduation) examinations of Tikrit College of Medicine for the first time in 2002.

13. A Faculty member participated in the final (graduation) examinations of The Medical College of The University of Science and Technology, Irbid; Jordan, in 2001.

14. A Faculty member participated in the Postgraduate examinations for the degree of the “High Specialization in General Surgery” in The Medical College of The University of Science and Technology, Irbid; Jordan, in 2001.

15. Faculty members actively participated, on a wide scale, in Medical Conferences in various surgical specialties, both inside the country and abroad (arab and international conferences).

16. Various faculty members attended advanced training courses, in various surgical specialties, nationally and internationally.

 

Research activities

Research activities of the Department are numerous and cover a wide range of surgical specialties. Emphasis is particularly directed upon:

1. Gastrointestinal surgical problems.

2. Orthopedic and spinal diseases and injuries.

3. Bone diseases.

4. Cardiothoracic diseases including malignancy.

5. Radiological procedures (diagnostic and therapeutic).

6. Laryngeal and pharyngeal disorders.

7. Anaesthesiology.

The Department witnessed robust research activity, covering various surgical specialties, in the past few years. Some researches involved field visits by Faculty members, along with the students, providing both therapeutic and consultation services. Furthermore, Faculty members have participated with members of other Faculties in joint research projects.