EDITORIAL

Post-graduate training in orthopaedics

Post-graduate training is conducted at all medical schools in South Africa. The training is of a high standard and our graduates are well accepted as specialists and in fellowships abroad.

All orthopaedic departments have a highly structured postgraduate programme spanning 4 to 5 years. During this training period, candidates rotate through various areas of orthopaedics and have the opportunity to improve their knowledge and surgical experience.

However, in a recent examination conducted by the College of Medicine an abnormally high number of candidates failed. Many candidates who participated in the examination were not even invited to take part in the second (clinical) examination. This may create the impression that our standards, training and supervision as teachers are below standard.

What lies at the root of the problem?

The problem does not lie in the programme, contents or exposure. We do have a great number of dedicated consultants and registrars. Unfortunately there are some consultants whose interests are not in their job as teachers but rather in making money. This state of affairs, if not controlled, creates a major problem and is very difficult to address.

Another problem is the training in peripheral hospitals scattered over all the provinces. Registrars there do not always have good supervision, are unable to attend academic programmes and lack exposure to regular meetings, discussions, etc. It is also difficult for them to liaise with their fellow registrars and to establish good relations as a group.

Examinations and continuous evaluation also constitute a problem. Currently there is a movement towards a more uniform national examination. There has been criticism of the MMed examination but the current system of College Examinations does not offer an alternative. It rotates through various centres and, with all respect, junior and less experienced examiners are often used. This creates a feeling among the candidates that they are not evaluated fairly to identify their true potential.

The input of heads of departments for the selection of registrars should be taken seriously. It is not fair to appoint registrars who do not have adequate knowledge or experience because after a period of time they cannot cope and then drop out prematurely.

To optimise our training potential we have developed a training centre (Advanced Orthopaedic Training Centre) at Tygerberg Hospital where we have the facilities and opportunities to enhance camaraderie, orthopaedic knowledge and skills. Here we conduct frequent discussions, have regular courses and thus create an opportunity for a creative learning environment under supervision of dedicated consultants.

During the past year we could see improved interaction. Registrars now have the opportunity and an environment in which they can broaden their knowledge in all spheres and also have access to national and international journals. Research projects are initiated and coordinated and they are encouraged to take part in local congresses which they do with great success.

The South African Orthopaedic Journal (SAOJ) is one of the instruments enabling a registrar to see what is happening in the academic field in the country. It is a peerreviewed journal and gives registrars and consultants the opportunity to publish their work. All are encouraged to contribute to the benefit of our profession and standards and to share their knowledge and research.

Prof GJ Vlok