The healthcare environment is continuing to change and so too is education and training of surgeons. We now live in an age of increased specialisation, of technology, of accountability, of greater patient education and expectation and mass media attention. The traditional apprentice method and emphasis too much on examinations will have to be changed to a more structured system of training with training standards, regular assessment and feed back. There are new skills to be learnt for future surgical practice and new ways to learn them to become competent. We need to make changes in the institutions and departments to create a learning environment and an organisational system to implement the training programme. The current shortage of surgical work force in the institutions and lack of sufficient teachers committed to teaching and training are major issues that need to be addressed.
General Surgery ; education ; trends ; Singapore

China ; General Surgery ; trends ; Humans ; Nutritional Status

Technology has become a major driver of the future direction of healthcare and surgery. Likewise, the speed of change has accelerated beyond comprehension, with a number of revolutions occurring during a surgeon's career. Being an agent of change or rapidly adapting to change has become the hallmark of the gifted surgeon. The fundamental challenges to a future surgeon are addressed from a technological viewpoint, with emphasis on the impact upon healthcare.
Biomedical Technology/education/ethics/*trends ; Education, Medical/trends ; General Surgery/trends ; Humans ; Medicine/trends ; Research/trends ; Robotics/trends

Surgery has passed through an intuitive and an empirical era and has now entered its modern phase. The enormous progress in biomedicine, the rise of evidence-based medicine and the consensus on the need for humanistic patient care, have laid a foundation for a new surgical paradigm. Based on a series of studies and practices, we advocated the concept of 'Precision Surgery'. It covers the entire operation-centered surgical practice. The strategy of precision surgery is to seek a balance of maximizing the removal of the target lesion, while maximizing the functional liver remnant and minimizing surgical invasiveness. We propose that the concept of precision surgery should be considered for wider application within liver surgery and various surgical fields, and finally realize the multi-objective optimization with certainty-based practice to ensure maximized recovery for each patient.
Consensus ; Evidence-Based Medicine ; General Surgery ; trends ; Humans

Regenerative surgery is an emerging multidisciplinary field that has the potential to transform the surgical treatment for diseases and injuries. This article provides a brief overview of the history of surgery and regenerative medicine, introduces the new concept of regenerative surgery, describes the surgical procedures, and discusses the role of surgeons in developing and implementing these technologies. Insights gained from recent clinical research of regenerative medicine are beginning to yield three strategies for regenerative therapies for surgical diseases, and this review also provides the challenges and translational perspectives of these different strategies.
Biomedical Research ; General Surgery ; trends ; Humans ; Regenerative Medicine

Endoscopy ; instrumentation ; methods ; trends ; General Surgery ; methods ; Humans

Clinical Competence ; Communication ; General Surgery ; education ; methods ; trends ; Humans ; Philosophy, Medical ; Practice Patterns, Physicians' ; Singapore

The talk traces briefly the development and changes of surgical training in the English-speaking world in the early days and the trials and tribulations of surgical training in Singapore a few decades ago. The factors that brought about the surge of American surgery from late 19th century to the first half of the 20th century are discussed. Structured surgical training leading to the exit point was introduced by William Halsted of Johns Hopkins Hospital around 1892, a system that was later adopted by all other medical disciplines and by all other hospitals in the US. It is considered to be the prime mover of the rapid progress of American medicine. Training surgeons to only the entry point while leaving the competence of trainees to chance, used to be common in the British surgical world. The trend now favours surgical training to the exit point. It is also the system being adopted in Singapore. Increasing demands of high standard of patient care and public accountability no longer allow us to be casual and permissive mentors of future generations of surgeons. Proper surgical upbringing requires a good structured programme that itself needs to be accredited and periodically reviewed. It also requires that discipline be observed on the part of trainees. Knowledge and skills are within the capability of our mentors to impart, but inculcation of good attitude and ethics in trainees is a harder goal to achieve.
Attitude ; Education, Medical ; history ; trends ; General Surgery ; education ; History, 19th Century ; History, 20th Century ; Singapore ; Specialties, Surgical ; United Kingdom ; United States