Clinical Fellowship in Paediatric Spine Surgery

I About The Programme
II Assessment and Evaluation
III Target Audience and Eligibility Requirements
IV Other Information

I About The Programme

Name of Programme

Clinical Fellowship in Paediatric Spine Surgery

Overview

The aim of this clinical fellowship is to train general orthopaedic surgeons in the subspecialty of paediatric spine and scoliosis surgery.

Priority will be given to fellows from regions in need of paediatric spine care but where training is not locally available.

Aim of Programme

At the end of the rotation, the Fellow should be proficient in the management of paediatric scoliosis. This includes adolescent idiopathic scoliosis, neuromuscular scoliosis, congenital scoliosis, syndromic scoliosis as well as early-onset scoliosis.

Depending on prior experience, the Fellow will also learn to perform posterior spinal fusions for scoliosis using pedicle screws.

There will also be opportunities to learn fusionless techniques, e.g. growing rods, magnetic rods, and posterior dynamic distraction devices.

Duration of Programme

6 months to 1 year

Number of Training Places

One fellow will be accepted into this program at any one time.

Learning Outcomes

This programme allows fellows to gain exposure and experience in:

• all aspects of paediatric spine surgery, including clinical evaluation and hands-on surgical training.
• research projects on scoliosis and paediatric spinal conditions.
  

Content Areas

Outpatient scoliosis clinics

• Frequency: 3 days weekly, morning sessions, 3-4 hours per session
• Exposure to a wide spectrum of paediatric spinal conditions, including adolescent idiopathic, congenital, neuromuscular and syndromic scoliosis, spondylolisthesis, kyphosis etc.

Spine and Scoliosis Peer Review Learning Rounds

• Once every two months, 1 hour per session
• Teaching and discussion of complex and complicated spine cases.

Multidisciplinary Neuromuscular Scoliosis Rounds

• Once every two months, 1 hour per session
• Discussion of complex neuromuscular scoliosis cases with various subspecialities, including paediatric neurologists, geneticists, complex care physicians.

Surgery

• Frequency: 1-2 days per week
• Surgery for deformity correction, spinal trauma, infection etc
• Opportunity for hands-on experience while under direct supervision

Research

• All fellows will be given at least one project to complete and present at an appropriate conference during the period of the programme.
• They will be guided throughout to the point that the project is in a publishable form for peer refereed journals.

The training will be confined to Department of Orthopaedic Surgery, KKH. There are no specific rotations to other departments or institutions in the programme, however, Fellows are encouraged to attend combined meetings or multidisciplinary rounds.

Training Methods

Training methods include:

• Didactic lectures – core and departmental.
• Structured case discussions with pre-planned topics for discussion.
• Combined teaching X-ray conferences with radiologists of pre-planned cases for discussion.
• Journal reading and critique.
• Mortality and morbidity case discussions.
• Teaching by specialists during spine specialty clinics and beside rounds.
• Hands on experience under direct supervision in the operating theatres.

Team of Experts

The fellowship programme is managed by the following experts:

• A/Prof Kevin Lim Boon Leong
• Dr Stacy Ng Wei Ling
  

II Assessment and Evaluation

Aims of Assessment

(A) Patient Care

Fellows are required to continually demonstrate the following six competencies throughout the programme:

• Demonstrate the ability to perform a thorough assessment in order to reach an appropriate diagnosis
• Provide appropriate evidence-based management
• Respond appropriately to emergency clinical scenarios
• Practice within the scope of their abilities
  

(B) Medical Knowledge

• Demonstrate the ability to apply knowledge appropriately within the clinical context
• Demonstrate up-to-date knowledge and keep abreast with the latest medical literature
• Demonstrate sound analytical thinking and problem solving skills
  

(C) Practice-Based Learning and Improvement

• Engage in continuous and on-going self-enrichment and learning
• Understand and integrate the concepts of quality improvement into clinical practice
  

(D) Interpersonal and Communication Skills

• Demonstrate care and concern for patients and their families.
• Communicate effectively with patients and their families.
• Communicate effectively and demonstrate collegiality with fellow healthcare professionals.
  

(E) Professionalism

• Accept responsibilities and follow through on tasks assigned to them.
• Respond to each patient’s unique characteristic and needs.
• Demonstrate integrity and ethical behavior.
  

(F) Systems-Based Practice

• Provide cost-conscious and cost-effective medical care.
• Work to promote patient safety.
• Coordinate patient care with providers in the larger healthcare community.

Assessment Approaches

Fellows are required to continually demonstrate the following six competencies throughout the programme.

a. Patient Care

b. Medical Knowledge

c. Practice-Based Learning and Improvement

d. Interpersonal and Communication skills

e. Professionalism

f. Systems-Based Practice

These competencies are assessed through:

• Journal critique
• Didactic teaching
• Mini-CEX
• Multi-rater 360 evaluation
• Log of surgical cases and procedures as assessed by supervisors and Head of Department
• Criteria for early termination

Evaluation Process

The general overall grading system evaluates the fellow’s performance upon completion of the fellowship programme. All fellows will be given a general overall grading status at the end of the fellowship programme based on the grading criteria requirements incorporating the six competencies-based knowledge, skills and performance that fellows must demonstrate throughout the programme.

For those who were graded with a USP for unsatisfactory performance, either of these will be offered:

• Extension of the duration of the fellowship.
• Early termination from the programme.

III Target Audience and Eligibility Requirements

Target Audience

Orthopaedic surgeons with a specific interest in paediatric spine surgery.

Pre-requisite/Eligibility Requirement(s)

General requirements for Temporary Registration for training (required by SMC):

• A basic medical degree from an accredited medical university/school.
• Passed the relevant national licensing examination in the country of conferment of basic degree, where applicable.
• Evidence of at least 12 months of intern/houseman-ship with a certificate of satisfactory completion of the internship or equivalent.
• Has been fully registered as a medical practitioner in the country where he/she is practicing.
• Been certified to be of good standing by the Medical Council or the relevant national authority.

Note:

The doctor should be in active clinical practice (and has been registered as a medical practitioner in the countries of practice) for the 3 years preceding the application for medical registration in Singapore.

In addition, candidates must have:

• A minimum of 3 years working experience as a medical officer (or equivalent).
• Fulfil English language requirements of SMC if the medium of instruction for the basic medical qualification is not in English.
• Preferably have obtained a postgraduate diploma or medical degree in his/her country or overseas.
• Be sponsored by (i) the government or (ii) regional health authority or (iii) an appropriate institution in the home country. For (iii), the doctor must be on current full-time employment (40 hours or more per week) with the sponsoring institution.

As a clinical fellow, the doctor will be allowed to be involved in patient care, including making entries in patients’ case notes, communication of care plans to patients and fellow healthcare professionals and perform procedures under direct supervision or Level 1 supervision under SMC’s Supervisory Framework.

Furthermore, candidates must be:

• recommended by their respective Heads of the Department OR at least two referees chosen by the applicant.
• return to their parent hospital in their country with the aim of imparting the new skills and knowledge learnt, for the good of their community.

IV Other Information

Course Fees

Course fee will be determined upon application.

Funding

Fellows must be self-funded or sponsored by their parent country or institution, and are to return home at the end of the training programme.

Certification

Upon successful completion of the programme, fellows will receive a certificate of training.