gms | German Medical Science

Objectives/Interrogation: Hand surgery training remains a vital part of surgical education in Low and Middle Income Countries (LMIC). Often neglected in respect to more 'life-threatening' conditions, the neglected injured or congenitally malformed hand has a profound impact on the quality of life of the affected individual. Traditional volunteering has focused on solving crises by performing surgeries in quantity, in short trips by surgeons with their trainees, with the educational component neglected. The British Foundation for International Reconstructive Surgery and Training (Figure 1 [Fig. 1]) was set up as the charity arm of BAPRAS to teach plastic and hand surgery in LMICs. In close collaboration with other organisations, BFIRST aims to equip the local surgeon 'so that one day they can teach their own' through feedback, community-oriented curriculum and clear entrustible professional activities.

Methods: Hand surgery-specific projects were chosen for reflection for the purpose of this presentation. A total of five projects were included: Bangladesh, Cambodia, Sri Lanka, Vietnam and Zimbabwe. For each of this project, the specific needs of the country were analysed and experiences gathered from the volunteers, in conjunction with the local hosts. A strategy of Defining the curriculum, Designing the curriculum and Delivering the curriculum was used.

Results and Conclusions: Each of these five countries present with different needs. For example, there was a high proportion of electrical hand burns in Bangladesh and efforts were made to design a specific classification to guide the treatment. For Cambodia, valuable experiences were shared with expert collaborators that crystallised the theories of education including Pareto's analysis, targeted workshops and robust feedback systems. In Sri Lanka and Zimbabwe, the focus was on congenital hand anomalies; local surgeons asked for this and the specific curriculum was delivered. Finally, in Vietnam (and Cambodia), brachial plexus was the main focus and allowed competencies to be developed over a few years.