Pre-operative Management

• Assessment of fitness for anaesthesia and surgery.

• Tests of respiratory, cardiac and renal function.

• Management of associated medical conditions, eg: diabetes; respiratory disease; cardiovascular disease; malnutrition; anaemia; steroid, anticoagulant, immunosuppressant and other drug therapy.

Infection

• Pathophysiology of the body's response to infection.

• The sources of surgical infection - prevention and control.

• Surgically important micro-organisms.

• Principles of asepsis and antisepsis.

• Surgical sepsis and its prevention.

• Aseptic techniques.

• Skin preparation.

• Antibiotic prophylaxis.

• Sterilisation.

Investigative and Operative Procedures

• Excision of cysts and benign tumours of skin and subcutaneous tissue.

• Principles of techniques of biopsy.

• Suture and ligature materials.

• Drainage of superficial abscesses.

• Basic principles of anastomosis.

Anaesthesia

• Principles of anaesthesia.

• Pre-medication and sedation.

• Local and regional anaesthesia.

• Care and monitoring of the anaesthetised patient.

Theatre Problems

• Surgical technique and technology.

• Diathermy - principles and precautions.

• Lasers - principles and precautions.

• Explosion hazards relating to general anaesthesia and endoscopic surgery.

• Tourniquets - uses and precautions.

• Prevention of nerve and other injuries in the anaesthetised patient.

• Surgery in hepatitis and HIV carriers (special precautions).

• Disorders of coagulation and haemostasis (prophylaxis of thromboembolic disease).

Skin and Wounds

• Pathophysiology of wound healing.

• Classification of surgical wounds.

• Principles of wound healing.

• Incisions and their closure.

• Suture and ligature materials.

• Scars and contracture.

• Wound dehiscence.

• Dressings.

Fluid Balance

• Assessment and maintenance of fluid and electrolyte balance.

• Techniques of venous access.

• Nutritional support - indications, techniques, total parenteral nutrition.

Blood

• Disorders of coagulation and haemostasis.

• Blood transfusion - indications, hazards, complications, plasma substitutes.

• Haemolytic disorders of surgical importance.

• Haemorrhagic disorders; disorders of coagulation.

Post-operative Complications

• Post-operative complications - prevention, monitoring, recognition, management.

• Ventilatory support - indications.

Post-operative Sequelae

• Pain control.

• Immune response to trauma, infections and tissue transplantation.

• Pathophysiology of the body's response to trauma.

• Surgery in the immuno-compromised patient.

TRAUMA

Initial Assessment and Resuscitation after Trauma

• Clinical assessment of the injured patient.

• Maintenance of airway and ventilation.

• Haemorrhage and shock.

Chest, Abdomen and Pelvis

• Cardiorespiratory physiology as applied to trauma.

• Penetrating chest injuries and pneumothorax.

• Rib fractures and flail chest.

• Abdominal and pelvic injuries.

Central Nervous System Trauma

• Central nervous system: anatomy and physiology relevant to clinical examination of the central nervous system; understanding of its functional disorders particularly those caused by cranial or spinal trauma; and interpretation of special investigations. Intracranial haemorrhage.

• Head injuries, general principles of management.

• Surgical aspects of meningitis.

• Spinal cord injury and compression.

• Paraplegia and quadriplegia - principles of management.

Special Problems

• Pre-hospital care.

• Triage.

• Trauma scoring systems.

• Traumatic wounds - principles of management.

• Gunshot and blast wounds.

• Skin loss - grafts and flaps.

• Burns.

• Facial and orbital injuries.

Principles of Limb Injury

• Peripheral nervous system - anatomy and physiology.

• Fractures - pathophysiology of fracture healing.

• Non-union, delayed union, complications.

• Principles of bone grafting.

• Traumatic oedema, compartment and crush syndromes, fat embolism.

• Brachial plexus injury.

INTENSIVE CARE

Cardiovascular

• The surgical anatomy and applied physiology of the heart relevant to clinical cases.

• Physiology and pharmacological control of cardiac output, blood flow, blood pressure, and coronary circulation.

• Cardiac arrest, resuscitation.

• Monitoring of cardiac function in the critically ill patient, central venous pressure, pulmonary wedge pressure, tamponade, cardiac O/P measurements.

• The interpretation of special investigations.

• The management of haemorrhage and shock.

• Pulmonary oedema.

• Cardiopulmonary bypass - general principles, cardiac support.

Respiratory

• The surgical anatomy of the airways, chest wall, diaphragm and thoracic viscera.

• The mechanics and control of respiration.

• The interpretation of special investigations; lung function tests, arterial blood gases, radiology.

• The understanding of disorders of respiratory function caused by trauma, acute surgical illness and surgical intervention.

• Respiratory failure.

• Complications of thoracic operations.

• Adult respiratory distress syndrome.

• Endotracheal intubation, laryngotomy, tracheostomy.

• Artificial ventilation.

Multisystem Failure

• Multisystem failure.

• Renal failure - diagnosis of renal failure, complications of renal failure.

• GI tract and hepatic failure.

• Nutrition.

Problems in Intensive Care

• Sepsis, predisposing factors, organisms causing septicaemia.

• Complications of thoracic operations.

• Localised sepsis, pneumonia, lung abscess, bronchiectasis, empyema, mediastinitis.

Principles of ICU

• Indications for admission.

• Organisation and staffing.

• Scoring.

• Costs.

NEOPLASIA: TECHNIQUES AND OUTCOME OF SURGERY

Principles of Oncology

• Epidemiology of common neoplasms and tumour-like conditions; role of cancer registries.

• Clinico-pathological staging of cancer.

• Pathology, clinical features, diagnosis and principles of management of common cancers in each of the surgical specialties.

• Principles of cancer treatment by surgery, radiotherapy, chemotherapy, immunotherapy and hormone therapy.

• The principles of carcinogenesis and the pathogenesis of cancer relevant to the clinical features, special investigations, staging and the principles of treatment of the common cancers.

• Principles of molecular biology of cancer, carcinogenesis; genetic factors; mechanisms of metastasis.

Cancer Screening and Treatment

• The surgical anatomy and applied physiology of the breast relevant to clinical examinations, the interpretation of special investigations, the understanding of disordered function and the principles of the surgical treatment of common disorders of the breast.

• The breast: acute infections; benign breast disorders; nipple discharge; mastalgia.

• Carcinoma of breast; mammography; investigation and treatment.

• Screening programmes.

Techniques of Management

• Terminal care of cancer patients; pain relief.

• Rehabilitation.

• Psychological effects of surgery and bereavement.

Ethics and the Law

• Medical/legal ethics and medico-legal aspects of surgery.

• Communication with patients, relatives and colleagues.

Outcome of Surgery

• The evaluation of surgery and general topics.

• Decision-making in surgery.

• Clinical audit.

• Statistics and computing in surgery.

• Principles of research and design and analysis of clinical trials.

• Critical evaluation of innovations - technical and pharmaceutical.

• Health service management and economic aspects of surgical care.

LOCOMOTOR SYSTEM

Musculo-skeletal anatomy and physiology relevant to clinical examination of the locomotor system and to the understanding of disordered locomotor function, with emphasis on the effects of acute musculo-skeletal trauma.

Effects of Trauma and Lower Limb

• Effects of acute musculo-skeletal trauma.

• Common fractures and joint injuries.

• Degenerative and rheumatoid arthritis (including principles of joint replacement).

• Common disorders of the lower limb.

• Amputations.

Infections and Upper Limb

• Common soft tissue injuries and disorders.

• Infections of bones and joints (including implants and prostheses).

• Pain in the neck, shoulder and arm.

• Common disorders of the hand, including hand injuries and infections.

Bone Disease and Spine

• Common disorders of infancy and childhood.

• Low back pain and sciatica.

• Metabolic bone disease (osteoporosis, osteomalacia).

• Surgical aspects of paralytic disorders and nerve injuries.

VASCULAR

The surgical anatomy and applied physiology of blood vessels relevant to clinical examination, the interpretation of special investigations and the understanding of the role of surgery in the management of cardiovascular disease

Arterial Diseases

• Chronic obliterative arterial disease.

• Amputations.

• Aneurysms.

• Carotid disease.

• Special techniques used in the investigation of vascular disease.

• Limb ischaemia: acute and chronic; clinical features; gangrene; amputations for vascular disease.

• Principles of reconstructive arterial surgery.

Venous Diseases

• Vascular trauma and peripheral veins.

• Varicose veins.

• Venous hypertension, post-phlebitic leg, venous ulceration.

• Disorders of the veins in the lower limb.

• Deep venous thrombosis and its complications.

• Chronic ulceration of the leg.

• Thrombosis and embolism.

Lymphatics and Spleen

• Thromboembolic disease.

• Spleen; splenectomy; hypersplenism.

• Lymph nodes; lymphoedema.

• Surgical aspects of auto-immune disease.

• The anatomy and physiology of the haemopoeitic and lymphoreticular systems.

• Surgical aspects of disordered haemopoiesis.

System Module C

HEAD, NECK, ENDOCRINE AND PAEDIATRIC

The surgical anatomy and applied physiology of the head and neck relevant to clinical examination, the interpretation of special investigations, the understanding of disorders of function, and the treatment of disease and injury involving the head and neck.

The Head

• Laryngeal disease; maintenance of airway; tracheostomy.

• Acute and chronic inflammatory disorders of the ear, nose, sinuses and throat.

• Intracranial complications.

• Foreign bodies in ear, nose and throat.

• Epistaxis.

• Salivary gland disease.

• The eye - trauma, common infections.

Neck and Endocrine Glands

• The surgical anatomy and applied physiology of the endocrine glands relevant to clinical examination, the interpretation of special investigations, the understanding of disordered function and the principles of the surgical treatment of common disorders of the endocrine glands.

• Common neck swellings.

• Thyroid: role of surgery in diseases of the thyroid; complications of thyroidectomy; and the solitary thyroid nodule.

• Parathyroid; hyperparathyroidism; hypercalcaemia.

• Secondary hypertension.

Paediatric Disorders

• Neonatal physiology: the special problems of anaesthesia and surgery in the newborn; and the principles of neonatal fluid and electrolyte balance.

• Correctable congenital abnormalities.

• Common paediatric surgical disorders: cleft lip and palate; pyloric stenosis; intussusception; hernia; maldescent of testis; torsion; and diseases of the foreskin.

ABDOMEN

The surgical anatomy of the abdomen and its viscera and the applied physiology of the alimentary system relevant to clinical examination, the interpretation of common special investigations, the understanding of disorders of function, and the treatment of abdominal disease and injury.

Abdominal Wall

• Anatomy of the groin, groin hernias, acute and elective; clinical features of hernias; complications of hernias.

• Anterior abdominal wall, anatomy, incisions, laparoscopic access.

Acute Abdominal Conditions

• Peritonitis; intra-abdominal abscesses.

• Common acute abdominal emergencies.

• Intestinal obstruction; paralytic ileus.

• Intestinal fistulae.

• Investigation of abdominal pain.

• Investigation of abdominal masses.

• Gynaecological causes of acute abdominal pain.

• Pelvic inflammatory disease.

• Abdominal injury.

Elective Abdominal Conditions

• Common anal and perianal disorders.

• Jaundice-differential diagnosis and management.

• Portal hypertension.

• Gallstones.

• Gastrostomy, ileostomy, colostomy and other stomas.

URINARY SYSTEM AND RENAL TRANSPLANTATION

The surgical anatomy and applied physiology of the genito-urinary system relevant to clinical examination, special investigations, understanding of disordered function, and the principles of the surgical treatment of genito-urinary disease and injury.

Urinary Tract

• Urinary tract infection.

• Haematuria.

• Trauma to the urinary tract.

• Urinary calculi.

• Retention of urine.

• Disorders of prostate.

• Pain and swelling in the scrotum.

Renal Failure and Transplantation

• Principles of transplantation.