INTRODUCTIONConcerns have been raised in the literature about how well the undergraduate curriculum prepares medical students for residency. An assessment was designed and administered to entering postgraduate residents in surgery to test their preparedness vis-a-vis the competence level expected of them at the beginning of their training. This paper explores the role and place of such an assessment in the medical education continuum.

MATERIALS AND METHODSFaculty members from the Department of Surgery at Bharati Vidyapeeth University Medical College (BVUMC), Pune, India and experts from the Department of Medical Education, University of Michigan Medical School, Ann Arbor designed and administered an assessment based on the multiple-choice question examination (MCQE) and objective structured clinical examination (OSCE) in June 2005 to 24 examinees from 3 different training levels at BVUMC.

RESULTSAll subsections of the MCQE showed significant correlation except the breast and endocrine section. The test showed an overall reliability of 0.8 (Cronbach's alpha). The scores and level of difficulty of the OSCE were inversely related. There was a significant difference in performance between the 3 groups and these differences were more pronounced for more complex tasks, specifically the procedural skills station, where the intern performance was particularly poor. Clinical skills reliability was 0.85. The communication skills score correlated well with the clinical skills score and also showed good reliability. Four out of the 5 new residents had below-satisfactory levels of competence for this level.

CONCLUSIONThis pilot study reveals definite educational gaps in both knowledge and skills among the residents studied. Such an intervention can be very informative, providing immense educational benefit to the learner, faculty and programme, and has an important place in the continuum of medical training.

Clinical Competence ; Education, Medical, Continuing ; standards ; Educational Measurement ; General Surgery ; education ; Humans ; Internship and Residency ; standards ; Licensure, Medical ; standards ; Pilot Projects ; Retrospective Studies

Spine surgery has advanced tremendously over the last decade. The number of spine surgeries performed each year has also been increasing constantly. Unfortunately, the reporting of position-related complications in spine surgery has also been steadily increasing. These complications not only result in significant morbidity for the patient but also raises the risk of litigation for the surgical and anesthetic teams. Fortunately, most position-related complications are avoidable with basic positioning knowledge. Hence, it is critical to be cautious and take all necessary precautions to avoid position-related complications. We discuss the various position-related complications associated with the prone position, which is the most commonly used position in spine surgery, in this narrative review. We also discuss the various methods for avoiding complications. Furthermore, we briefly discuss less commonly used positions in spine surgery, like the lateral and sitting positions.

A pig was confirmed to be a true hermaphrodite on the basis of gross and histomorphological studies of the genital organs. The genitalia was consisted of left ovary, oviduct, two coiled uterine horns, body of uterus alongwith right testis and an epididymis. Vagina and vulva were absent but male urethra with prostate gland was present. Grossly the size of all the genital organs appeared to be normal. Histomorphologically, testis and epididymis were underdeveloped as there was no clearcut spermatogenia and sertoli cells but Leydig cells were normal. The ovary presents normal histological features with some portion of testicular tissue. Degeneration of uterine epithelium was observed along with normal endometrial glands.
Animals ; Female ; Genitalia, Female/abnormalities ; Genitalia, Male/abnormalities ; Hermaphroditism/pathology/*veterinary ; Male ; Swine ; Swine Diseases/*pathology

Introduction: Post-operative pain following anterior cruciate ligament reconstruction remains an important challenge. Steroids are used in various surgical procedures to decrease post-operative nausea, vomiting and pain. However, only a few studies have reported the effect of systemic administration of steroids in controlling postoperative pain after anterior cruciate ligament surgery. Materials and methods: We have conducted a prospective randomised trial with 109 patients divided into two groups to determine if administration of dexamethasone in the perioperative period improves pain in the post-operative period. The patients were divided into two groups: D, treatment (dexamethasone) and P, control placebo (saline). Patients in the D treatment group were given the first dose of 10mg of intravenous dexamethasone intravenously intraoperatively and the second dose on transferring of the patient to the inpatient department. The patients in the placebo P group, were administered normal saline in the perioperative period in a similar manner. Result: Post-operative pain was significantly less in the dexamethasone group at rest and on walking (p<0.001) for the first 24 hours after surgical procedure. Subsequently, the VAS pain scores were almost similar in both groups at 48 and 72 hours. The administration of dexamethasone resulted in less requirement of antiemetic and rescue analgesia medication There was no difference in range of motion and wound complications rate during the follow-up period at six months. No adverse side effect, like osteonecrosis of the hip, was detected. Conclusion: The pain following anterior cruciate ligament reconstruction is severe during the first 24 hours and perioperative administration of dexamethasone can decrease the post-operative pain substantially.