Basic surgical skills in medical schools



Prof. Dr. Murtadha Almusafer


Is it mandatory to include practical procedures and basic surgical skills in the medical school curriculum?

It seems that including the basic interventional skills create safe, professional, and competent junior doctors. 1,2,3,4

Competencies in basic procedural and surgical skills are required for all junior doctors regardless of final specialty as they may face critical patients in areas away from hospital and injuries and wounding even of one of their family members and they may be embarrassed when these skills are not well considered. The United Kingdom was one of the first countries which raised  such a necessity to train undergraduates with practical surgical procedures. 5 & 6

The Society of Academic and Research Surgery (SARS) highlighted the need for high quality undergraduate surgical education in 2005. 7 Despite that concern still the undergraduate exposure to the surgical skills remains diluted by a crowded theoretical contemporary curriculum. 8

Core attributes common to specialties, such as communication skills, are becoming increasingly dominant, despite the General Medical Council (GMC) emphasizing the requirement of all newly qualified doctors to be competent in the basic technical procedures [9]

The practical skills like skin suturing, basic wound care, and administration of local anesthetic are essential and required in most specialties, yet most of newest doctors are poorly equipped in these procedure-based surgical skills. 6

Whilst it is generally known that most undergraduate medical students do not go on to become surgeons, and specific surgical skills are not a priority in the undergraduate syllabus, the acquisition of basic, nationally recommended skills is now deemed an essential outcome of undergraduate medical training. 9

The University of Basrah, College of Medicine had been considered this issue during the last years and analyzed feedbacks from the graduated students and Basrah Health Directorate and started to arrange courses to learn undergraduates the basic skills like skin suturing.

1.JChipman JG, Acton RD, Schmitz CC. Developing surgical skills curricula: lessons learned from needs assessment to program evaluation. J Surg Educ. 2009 May-Jun;66(3):133-9. doi: 10.1016/j.jsurg.2009.03.032 . PMID: 19712911.
2. Croft SJ, Kuhrt A, Mason S. Are today's junior doctors confident in managing patients with minor injury? Emerg Med J. 2006 Nov;23(11):867-8. doi: 10.1136/emj.2006.035246 . PMID: 17057141; PMCID: PMC2464387.
3Kneebone RL. Twelve tips on teaching basic surgical skills using simulation and multimedia. Med Teach. 1999;21(6):571-5. doi: 10.1080/01421599978988. PMID: 21281176.
4. Davis CR, O'Donoghue JM, McPhail J, Green AR. How to improve plastic surgery knowledge, skills and career interest in undergraduates in one day. J Plast Reconstr Aesthet Surg. 2010 Oct;63(10):1677-81. doi: 10.1016/j.bjps.2009.10.023. Epub 2009 Nov 18. PMID: 19926544.
5. Fraser RC. Undergraduate medical education: present state and future needs. BMJ. 1991 Jul 6;303(6793):41-3. doi: 10.1136/bmj.303.6793.41. PMID: 1859958; PMCID: PMC1670281.
6. Tallentire VR, Smith SE, Wylde K, Cameron HS. Are medical graduates ready to face the challenges of Foundation training? Postgrad Med J. 2011 Sep;87(1031):590-5. doi: 10.1136/pgmj.2010.115659. Epub 2011 Jun 20. PMID: 21690255.
7. Taylor, M.F. Reed, A.N. Kingsnorth, G.L. Carlson, D.J. Leaper: Surgery in the undergraduate curriculum. Report by the Education and Professional Development Committee of the Society of Academic and Research Surgery (SARS), Ann. R. Coll. Surg. Engl. Suppl., 87 (4) (2005), pp. 138-139
8. Agha RA, Papanikitas A, Baum M, Benjamin IS. The teaching of surgery in the undergraduate curriculum--reforms and results. Int J Surg. 2005;3(1):87-92. doi: 10.1016/j.ijsu.2005.03.017. Epub 2005 Jun 29. PMID: 17462264.
9.GMC Tomorrow's Doctors. Outcomes and Standards for Undergraduate Medical Education. General Medical Council, London (2009)