Accessible and sustainable hand surgery international 3.1
1. Accessible andSustainable
Global HandSurgery
MrVaikunthan Rajaratnam
MBBS(Mal),AM(Mal),FRCS(Ed),FRCS(Glasg),FICS(USA),MBA(USA),
Dip Hand Surgery(Eur), PG CertMedEd(Dundee),FHEA(UK),
AFFST(Ed),FAcadMEd(UK).
Senior Consultant Hand Surgeon
INTERNATIONAL
HEALTH AND
EDUCATION
2. Credentials
• > 30 years clinical practice and teaching
• Qualifications in medical education(FAcadMEd)
• Experience in instructional design and technology(MIDT)
• Publications and research in surgical education
• Senior Clinical Examiner – Birmingham/ Singapore
• External Examiner Ortho Exit exams – Indonesia/Malaysia
• Examiner /Faculty Royal College of Surgeons Edinburgh
• Quality Assurance Panel ofVisitor in PG ME&T, UK
• Core Faculty Member Orthopaedic Surgery – ACGME-I
• Core Faculty Member Hand Surgery Residency, Singapore
• Special Committee member for redesign of hand surgery exit exam Singapore
• Fellow HEA UK
• Reviewer for Educational Research Grants HEA
5. ALTRUISM IN
MEDICINE – a
survey of
medical
professionals’
thoughts and
attitudes
: 74% of respondents had used their medical expertise and
experience in altruistic behaviour outside of their normal working
role, with nearly 1 in 5 of respondents spending over 6 month
doing so.
57% was completed in their home country, and 43% abroad.
83% were willing to commit a period of time each year towards
organised altruistic work
6. Altruism in
Medicine
An analysis of
perception ,
definition and
practice of
altruism among
medical
professionals in
Singapore
. 79% of the respondents said they had used medical training in
an altruistic manner outside their work , 32% at home and 36%
at home as well as abroad .
94% said they are willing to commit to a fixed period in a year
towards altruistic activity
19. Sampleof
Clinicalcases
seen and treated
Summary of cases seen
Approx 300 patients seen in out patients
12 orthopaedic cases operated on
Estimate another 1000 cases of reconstruction required with
about 80% involving orthopaedics
20. Summary of
orthopaedic
cases to be done
Nerve grafts and repair
Tendon transfer for peripheral nerve injuries – radial,scaitic
Arthordesis of hip and knee for deranged joints
Limb lengthening for limb length discrepancies
Corrective osteotomy and fixation for malunion
Bone graft and skeletal stabilisation for non union
Shoulder joint reconstruction with vascularised free fibular
transfer
Hand reconstruction with toe transfer
25. MaxStirner
self-interest to be a universal truth or established viewpoint
the individual is dominated by illusory concepts ('fixed ideas' or
'spooks'), which can be shaken and undermined by each individual
in order for that person to act fully.
Max Stirner influence on Nietzsche
26. Makings of an
equitable, just
and accessible
system of
sustainable
global health
for the needy
Glocal
Education
Management
27. annually account for $740 million (in U.S. dollars) and rank first in the order of most
expensive injury types, before knee and lower limb fractures ($562 million), hip
fractures ($532 million), and skull-brain injury ($355 million). Productivity costs
contributed more to the total costs of hand and wrist injuries (56%) than did direct
health-care costs. Within the overall group of hand and wrist injuries, hand and finger
fractures are the most expensive group ($278 million), largely due to high productivity
costs in the age group of twenty to sixty-four years ($192 million).
Why hand surgery
De Putter, C. E., Selles, R.W., Polinder, S., Panneman, M. J. M., Hovius, S. E. R., &Van Beeck, E.
F. (2012). Economic impact of hand and wrist injuries: health-care costs and productivity costs
in a population-based study. TheJournal of bone and joint surgery. American volume, 94(9)
30. 1. Quality care/optimum outcomes - education
2. The current UG curriculum inadequate
3. Currently PG hand programs - exclusive
4. Need
• flexibility,
• student centred
• on-demand learning that is
• universally accessible,
• affordable and
• locally relevant.
31. 1. designed for practising doctors
2. universally accessible
3. e-learning platform
4. modular in nature
5. catering to working doctors educational needs
The Solution
32. An on-line modular programme
Three levels of qualifications:
PG Certificate,
Diploma and
Master’s degree,
MOODLE LMS
International faculty - 8
Deployed on line (handsurgeryedu.com).
Open University Malaysia
33. • Future of learning changing
• Everyone can learn.
• Communities of practice can build programs.
• Ubiquitous learning changing the landscape
• Massively open online course - the model
• Alter the relationship of all stake holders
• Viability of this educational model.
40. Academia in
global health
delivery
1. Delayed presentation of congenital tibial pseudarthrosis and
neurofibromatosis: A difficult union. - Accepted for publication
2.The battle with Osteosarcoma - a 10 year experience of 35 patients
- In completion (95% complete)
3. Development of a novel low cost instrument for removal of a bent
femoral nail: A case report - In submission
4.TOTAL HIPARTHROPLASTY REHABILITATION IN CAMBODIA – BRIDGINGTHE
GAP - In submission
5. Store, forward and conference – a new approach to telepathology in
Cambodia - In submission
6.Acid burns in Cambodia:The human, medical and surgical legacy of
241 victims - In submission
7.Antibiotic beads for the developing world - premade, prepackaged
and preloved - an in-vitro study (accepted as MScTrauma Surgery
Dissertation) - in completion
8.An explosion of MRSA in Cambodia of soft tissue and bone infections
- In completion (50% complete)
9.Twinned cities in friendship and orthopaedics - a telemedicine
experience with Bristol and Phnom Penh - In completion
10. Long distant surgical training and mentoring - is it possible -
In completion
11.An article for Surgeons News, Royal College of Edinburgh -
requested by Journal.
41. WIIFM
Maslow’s need fulfilled
Ethical practice
Pushing the envelope
Enriching your practice
Legacy
47. 5yearoldboy congenital
abnormalities ofbothupper
limbs.
Onthe right, he has aone
boneforearm(ulna), radially
deviated hand andfour
fingers(ofwhich 2arein
syndactyly) Heis able toflex
his elbow actively and
passively.
Onthe left, he has a very
shorthumerus,andthree
fingersin the hand.