1. Safety for patients: Our primary job as a surgeon is to deliver the best outcomes and amongst them, patient safety is of utmost importance – the beneficence. Small slips can have disastrous consequences and it should be the duty of every surgeon, to recognise it, accept it and put in practices to avoid it. There are many aspects to patient safety and each of these will need your wholehearted support.
a. Reduce hospital acquired infections: An awareness must be created amongst health care workers regarding sound hand hygiene in the wards and proper hand washing in the operation room. Holding awareness camps in hospitals for nurses, ancillary staff, distribution of hand wash technique pamphlets, use of hand sanitisers, classes for OT technicians regarding theatre and instrument sterilizations etc will be carried out.
cb. Reduce complications in surgery: There are serious concerns regarding some ‘Never Events’ that still happen in our country just like in any other country of the world. In our country unfortunately they are not reported and are often brushed aside, under the carpet. Our duty as a surgeon and leader of the team is to ensure that these ‘Never events’ do not happen. It can be eradicated by following the WHO checklist meticulously. Judicious use of energy sources to prevent untoward cautery injuries and creating awareness regarding antibiotic misuse amongst our colleagues too will figure in my agenda as part of the Safe ASI campaign.
2. Safety for surgeon: To have a safe patient, it is important that we surgeons feel safe in the environment where we are working. We have schemes, like the ASISSS and the Professional Indemnity scheme, which are already running well but may need to be further bolstered by the active involvement and participation of our members. These will surely be encouraged in our state chapter meetings and conferences to further strengthen them.
a. The Social Security scheme has been reorganised with its own charter and constitution a few months ago and they now have their new President and Secretary, with whom I shall be working closely, hand in hand. The more the numbers in the scheme, the more benefits will be accrued by the family members of the unfortunate deceased member, in case of a mishap. To achieve this, I request all state chapters and members of ASI to actively help in increasing membership. It can be done by simple measures of displaying the advantages of these schemes to our members, during state conferences and programmes.
b. Professional Indemnity scheme is run by ASI through a third party. This scheme should give maximum advantage to the member somewhat more than what insurance schemes available on the shelf, offer us. I shall be working further on it, to present a more lucrative policy with added benefits. Lot of our members have their own indemnity insurance but also many don’t. Professional Indemnity must be made mandatory for all surgeons before they start their surgical practice and career and I propose to take this message to the attention of young surgeons in practice.
c. NABH accreditation of hospitals is now required by most organisations. To help and facilitate our members owning hospitals, we have training programs which will be reinforced further.
d. Support at District and City level. This is one of the most challenging issues facing all surgeons practising today. ASI helplines have to be made, support groups mobilised, legal support and liaison with local Police have to be considered. This is not an easy task, but a start has to be made.
Skill of a surgeon is not measured only by their Psychomotor skills, but also by other qualities like Cognitive and Affective skills, now mandated by the NMC as well.
a. Cognitive skills. For Residents and for practising surgeons
i. For Residents: Our Flagship program, the Regional Refresher Course (RRC) is the prodigious child of our hard working and tireless Dr Santhosh J Abraham. By the dint of his efforts and giving endless time to this program, the RRC has gained strength and popularity with each passing year. It will be nearly impossible for anyone to fill in the shoes of the maestro, but as they say, the show must go on. It will be conducted with equal enthusiasm by Dr G Siddesh, our new Director Academics. Four Zones, faculty and sponsors will be akin to in the past, but of course with a new set of students as they join the residency program.
ii.For Surgeons: I propose to continue with the National Skill Enhancement Programme (NSEP) online. The frequency may change, so will the topics. They will be of prime importance and will be dealing with issues and topics relevant to the practising surgeon. Another initiative which started on my behest last year of jointly conducting webinars with the RCPSG, Glasgow, on common topics of interest to both countries will continue with further zest. It will surely help get a global perspective to local problems. The next few webinars for the year 2024 have already been planned and will be released from time to time to the membership. Video presentations of commonly performed surgeries will also be relayed from centres of excellence.
b. Psychomotor Skills. For Residents and Practising Surgeons
i. For Residents: ASI runs basic surgical hands-on training for residents during the RRCs in each of the zones, conducted by experienced faculty from the concerned zone.
ii. For Practising Surgeons: SEPA (Skill Enhancement Program of ASI). This is a program where a mentor invites a handful of surgeons to his/her Operating room and demonstrates basic surgery or surgery of intermediate difficulty to them. It will be headed by a state head, who will identify centres in his/her state and the faculty to be involved. It will be a one-to-many program, of small groups with training imparted by the mentor in the OT itself at no cost to the trainee. It will be OT based and no transmission will be required.
OGD training: Endoscopy has and is evolving at a rapid pace and I feel that we surgeons missed the bus when we should have boarded. Surgeons who started, when endoscopy was evolving, are today some of the country’s finest Endoscopists. This initiative started with a flourish last year and I am sure we shall be cruising along with more trainers and adding more centres in this current year.
USG training: Surgeons need to know the basics of ultrasound in their practice, especially for doing USG guided diagnostic procedures and for handling emergencies involving FAST scans and central venous catheterisations. USG training programs will be initiated by ASI.
National Fellowship Programs: I propose to consolidate our existing National Travelling Fellowship program for young surgeons, for short training courses under supervision of stalwarts of surgery. These will be made more attractive to suit the demands of young surgeons. The details of which will be communicated to the membership in due course of time.
c. Affective skills-For Residents and For Practising Surgeons: Non-technical skills programme (NOTTS) of the RCS, Edinburgh is a program which deals with aspects of soft skills that a surgeon must possess. The RCS has been conducting this course since 2016, having done a few courses here in India as well. It is a good model to follow in the initial phases till we possess or develop a similar program, suited to the Indian context. We are planning for two NOTTS courses in the coming year with the help of the Royal College of Surgeons of Edinburgh.
We as the torch bearers of our society have a lot of social obligations to follow. We are all certainly doing good work on an individual level and at the HQ level. To make it even better and more incisive, our service to humanity and to the public at large must be more synchronised and visible.
a. Project Life Saver- Training of First Responders. Basic Life support demonstrations will be carried out in all city branches targeting initially hospital workers, ambulance drivers, teachers in schools and the Police personnel. We shall impart basic training in CPR, Airway management, management of Haemorrhage and smooth patient transfer for these lay people who are often first responders in an accident scenario.
b. Blood donation. We have been holding camps all over the country, but it is time that we do it in a more synchronised and effective way. I propose to mark a couple of days in a year, as the day of ASI Blood donation Day .
c. Social service camps; ASICS Camps. Under the supervision of the Director Social Service, surgical camps must be streamlined. State chapters will be requested to instruct city branches for holding at least 2 surgical camps in a year for each branch which will go a long way in cherishing our desire to living up to the ASI motto of vayem sevamahe.
d. The highly successful National camp at Dharmawala will continue and we shall encourage further similar camps across the country. I request more colleagues to join and urge them to give their services free for a good cause. This camp at Dharmawala is conducted at a remote location near Dehradun, every 2nd and 4th Sunday of the month, where all common open surgical, Laparoscopic and Endo urologic surgery are performed by our members, especially members from the UPASI.
1. International coordination must be strengthened, and new bridges built. We are currently doing joint programs with RCPSG, Glasgow, RCS Edinburgh, and surgical bodies of many other countries. We have made a reciprocal arrangement with the Japanese Surgical Society for a short-term training assignment for 3 our residents, chosen by merit through the RRCs. Similar arrangement with the Malaysian college and the Sri Lankan colleges are in the pipeline and will soon be announced. USA is also taking two lady members of ASI for fellowship programmes. My dialogue with many other international bodies shall continue and hope it will bear fruit for ASI soon.
2. National Coordination entails dealing with various Government agencies, other sister Associations like the Indian Medical Association, IAGES, SELSI and others. A national team will be construed to advise the association regarding matters of national importance affecting surgeons and our members.