Peshawar Medical College

1. Introduction

Peshawar Medical College is the first project of PRIME FOUNDATION.

The institute has been established with objectives of contributing towards the quality medical education in line with community health needs of KP & Pakistan. The aim is to train excellent medical doctors, having highest standards of professional competence, integrity, commitment and research.

Peshawar Medical College is recognized by Pakistan Medical Commission (PMC) according to 2019 inspection visit by PMC of various public & private sector colleges. It was our honor to stand first among private hospitals of KP with more than 80% score.

College is managed by a “Board of Governors”; which comprises of highly dedicated professionals & qualified academicians.

The college has opened its portal for Local, overseas Pakistani & students from other nationalities particularly from brother Muslim countries, regardless of color, creed gender, ethnicity and religion.

Peshawar Medical College aspires to produce medical graduates with the following minimum attributes:

In-depth knowledge of basic medical sciences.
Good clinical acumen, coupled with capacity to handle local problems by promoting appropriate solutions.
An ability to deal with emergencies and be able to deliver satisfactory services under pressure and increasing workload.
An ability to apply information technology in conducting research and evaluation.
An ability to take holistic approach to understand patients and their diseases, with due emphasis on biological, psychological & social correlates.
Commitment to ethical values in the context of medical issues.
Be able to be effective community leaders.

Peshawar medical college has three Teaching hospitals i.e., Kuwait Teaching Hospital, Mercy Teaching Hospital and Prime Teaching Hospital where teaching & training programme for post graduates residents in department of surgery is already in progress.

The training programme in General Surgery at Kuwait teaching hospitals was initiated in 2010 after fulfilling the requirements of the College of Physicians and Surgeons (CPSP), Pakistan.

Later on mercy teaching hospital was also approved by CPSP for teaching and training programme.

The eligibility criteria for the training programme in surgery

MBBS from an institution recognised by PMDC/PMC
One year internship with six months in Medicine and allied and six months in Surgery and allied disciplines
Candidates who cleared FCPS Part I exam of general surgery
Fresh graduates of less than two years are preferred

The selection process is based purely on merit.

2. Vision and Mission Statement

Vision Statement

To produce doctors with clear objectives to help in long term development of the community through the following attributes;

Professional competence
Excellence in ethical values and practice
Cognizance of community health needs
Research mindedness and lifelong learning
Competence in IT and current health technologies
Capability to successfully meet the local and global health challenges
Competitiveness at national and global level

Our Slogan
“Come with commitment, grow with wisdom and leave with professional and ethical competence for a bright future”. We believe in creating your tomorrow today.

Mission statement

To Achieve Excellence in professional competence and ethical values

3. Administrative structure/Hierarchy

4. Program Goals

The goal of the General Surgery Residency at the Peshawar Medical College Affiliated hospitals is to provide an educational environment for residents to develop the knowledge and skills necessary to provide a high standard of medical care to patients in their communities throughout their professional medical careers. The program will impart the knowledge necessary to enable the resident to provide complete care of the surgical patient. Upon completion of the educational program, the surgeon will be capable and qualified in all the components of general surgery as defined by the College of Physicians and surgeons Pakistan (CPSP).

Specifically, the program will:

Integrate principles of basic sciences with clinical experiences
Promote a broad understanding of the role of surgery and its interaction with other medical disciplines, such as general medicine, psychiatry, and pediatrics
Provide for progressive responsibility from initial patient care to complete patient management
Foster effective interdisciplinary collaborative relationships
Provide surgical residents with the ability to function as teachers and consultants
Foster continuing education to promote lifelong individual initiative and creative scholarship
Prepare surgical residents to use research technology and skills in conducting studies that assist in solving surgical problems
Develop professional leadership and management skills
Promote understanding of the economic, legal, and social challenges of contemporary and future surgery
Design the curriculum to address each of the CPSP competencies

5. Core values & code of conduct

The outer leaves of the model consist of three mega competencies and each of these consists of multiple elements.

A. Professionalism
B. Pedagogy
C. Advocacy

Professionalism, Ethics and Leadership: The resident should be able to:

A. Professionalism

Demonstrate the highest level of personal integrity: honesty, punctuality, regularity, timely task completion.
Deal with all patients in a non-discriminatory and prejudice- free manner, demonstrating the same level of care for every human being irrespective of gender, age, ethnic background, culture, socioeconomic status and religion.
Establish a trusting relationship with patients, their relatives and care-givers.
Deal with all patients with honesty, empathy and compassion, putting patients’ needs first (altruism)
Facilitate transfer of information important for promotion of health, prevention and management of disease.
Encourage questioning by the patient and be receptive to feedback.
Pursue self-directed and life-long learning. Keep abreast of medical literature and assess new knowledge and apply it to resolve patient problems.
Knows one’s limitations and ask for help as needed from colleagues, consultations or referrals.
Apply quality assurance procedures for improvement in daily work.
Be a role model for others

Ethics

Maintain patient autonomy by demonstrating shared decision-making with the patient and/or family.
Obtain informed consent, maintain patient confidentiality and do no harm.
Provide cost-effective care while ordering investigations and in management and use resources appropriately.

Leadership

Demonstrate accountability for their decisions and actions, and that of their team.
Demonstrate willingness to assume leadership role(s) when needed in given situations or events (rush call/code).
Change and bring about change as necessary, as a leader or supportive leader.

B. Pedagogy

Should be able to demonstrate competence in teaching skills:

Effective clinical/community-based teaching
Some evidence of acquisition of theory regarding learning and education
Practice some of the best teaching methods.

C. Advocacy

Advocacy is needed at multiple levels

Advocacy for the Patient: Doctors and nurses are the advocates of the patients, otherwise patients are likely to be lost in the system. All care should be timely, putting patients first.
Advocacy for the Practice: Working in a service or practice, doctors must highlight limitations and issues. They must identify solutions for the problems, and recommend and implement improvements for the practice(s) and institutional system(s).
Advocacy for the Health System and Society: Know one’s role in the Health System(s) and build strong referral systems. Keep patient and community interests paramount, above one’s own personal or professional interest. Demonstrate advocacy for elimination of the social determinants of health. Demonstrate advocacy for prevention of serious illnesses of their specialty/sub-specialty.
For the Profession: Strive for building trust in the public for your profession. Demonstrate improvement and enhancement of profession, specialty and sub-specialty. Be conscientious gate-keepers of their profession, specialty and subspecialty.

In order to achieve the competencies of CPSP model, all curriculum components including instructional methods should be appropriately aligned to competency network.

The theoretical part of the curriculum represents the current body of knowledge necessary for practice. This can be imparted through lectures, grand teaching rounds, clinico-pathological meetings, morbidity/mortality review meetings, literature reviews and presentations, journal clubs, self directed learning, conferences and seminars.

Clinical learning is to be organized to provide appropriate expertise and competence necessary to evaluate and manage common clinical problems. Demonstration in outpatient and inpatient clinics, and procedural skills training on simulators, mannequins and patients are all practical training modalities.

6. Clinical Objectives

CURRICULUM OBJECTIVES

Objectives for the surgical curriculum identifies what the residents should know and be able to do at the completion of training. These objections include the following:

Manage surgical disorders based on a thorough knowledge of basic and clinical science.
Demonstrate appropriate skill in the surgical techniques required of a qualified surgeon.
Demonstrate the use of critical thinking when making decisions affecting the life of a patient and the patient’s family.
Make sound ethical and legal judgments appropriate for a qualified surgeon.
Collaborate effectively with colleagues and other health professionals.
Teach and share knowledge with colleagues, residents, students, and other health care providers.
Teach patients and their families about the patient’s health needs.
Demonstrate acceptance of the value of life‑long learning as a necessary prerequisite to maintaining surgical knowledge and skill.
Demonstrate a commitment to scholarly pursuits through the conduct and evaluation of research.
Demonstrate leadership in the management of complex programs and organizations.
Provide cost‑effective care to surgical patients and families within the community.
Respect the religious beliefs of patients and their families and provide surgical care in accordance with those beliefs.

Patient Care and Judgment: The development of sound surgical judgment is an integral part of the skills needed to become a capable general surgeon. The ability to acquire information and integrate it with daily patient care through the examination of the patient, data collection, and the consideration of clinical variables is essential for the capable surgeon.

Technical Skills: The ability to safely perform operative procedures is essential for the surgeon. Manual dexterity, along with sound knowledge of wound healing, principles of tissue handling, and safe conduct of elective and emergency operative procedures, is essential to the resident’s development.

Interpersonal Skills: Relationships with patients, hospital personnel, and the community are essential components to becoming a capable physician. Integrity and compassion are considered to be major components of the General Surgery Residency Program.

Scholarly Activity: The acquisition of knowledge and critical evaluation of medical literature is essential to the resident’s education. Personal experience in clinical research is essential to developing sound analytic thought processes and utilizing the scientific method to collate data and enhance the body of knowledge of general surgery.

Teaching Abilities: The institution is committed to education as an essential component of excellence in patient care. Each resident must develop the ability to teach in both informal clinical settings and in the more structured settings of Basic Science and Morbidity and Mortality (M&M) Conferences.

Time Management: Physicians have many demands placed on their most limited resource – time. Residents must learn to appropriately prioritize their activities and commitments to meet the needs of their patients, their ongoing education, their health, and their family. Inability to bring these components into balance will jeopardize the function of a capable surgeon.

Attendance: Each resident is expected to attend to all clinical duties and conferences in a timely fashion. The education of a surgeon is a multifaceted activity that requires group interaction and participation.

Suitability: As determined by the Program Director and the Clinical Competency Committee, each resident must meet the expectations of the Department of Surgery. To maintain good standing in the program, the committee must determine that the trainee is capable of becoming a CPSP certified surgeon in good standing in his/her community.

Progression from the PGY‑1 to the PGY‑4 level involves a graded increase in responsibility at each resident level commensurate with the resident's skills and abilities. Full‑time faculty surgeons who have wide interests and well‑honed teaching skills cover each of the surgical services.

7. Educational outcomes specific to the programme

Goals & Objectives

Goals

The major educational goal of the General Surgery residency training programme in the Department of Surgery at Peshawar Medical College affiliated Hospital is to develop surgeons capable of independently practicing the highest quality clinical surgery relevant to the needs of individuals and families in Pakistan at par with international standards. The four-year residency programme - an organised educational programme with guidance and supervision - facilitates the residents' personal and professional development while ensuring appropriate and safe patient care. The major strengths of the programme include:

It provides experience in preoperative, operative, and postoperative care for patients in all areas of general surgery, including abdominal, alimentary tract, breast, endocrine, head & neck, skin & soft tissue, vascular and trauma surgery including surgical critical care. The residents are also provided experience in minimal access surgery, cardiothoracic surgery, neurosurgery, orthopaedic surgery, paediatric surgery and urology (during rotations)
It provides residents and faculty with educational goals and objectives at the beginning of each rotation, and the opportunity to evaluate each other at the end of the rotation
It provides each resident with evaluation of performance on a bi-annual basis to show progression of expertise
It provides each resident with supervisory lines of responsibility and fair grievance policies
It provides academic activities that are conducted on regular weekly basis within department and within each individual section
It provides a working environment that is optimal for resident education and patient care. This environment is safe and provides adequate space for sleep, food, and study facilities

Objectives

The objective of the programme is to provide supervised, structured and comprehensive training in General Surgery from which trainees would emerge as clinically and academically competent surgeons.

8. Core Competencies

Program Requirements for Residency Education in General Surgery

General Competencies: Residents must become competent in the following six areas at the level expected of a surgical practitioner. Training programs must define the specific knowledge, skills, and attitudes required and provide the educational experience for the resident to demonstrate:

Competency #1: Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.

Surgical residents must:

a. Demonstrate manual dexterity appropriate for their training level.
b. Be able to develop and execute patient care plans.

Competency #2: Medical Knowledge about established and evolving biomedical, clinical, and cognate (eg. epidemiological and social behavior) sciences and the application of this knowledge to patient care.