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General Surgery is one of the major departments in Mahatma Gandhi Medical College and Research Institute. It has been around since the inception of the institute (2001) and over the period has grown into a large force boasting of academically renowned professors, competent faculty, well equipped operating theatre and an endoscopy suite. It now caters to a large population base in and around Pondicherry as well as patients from afar. It is also one of the premier referral centres in this area.

For almost a decade now, the department has been imparting knowledge to the undergraduates (MBBS) and since the year 2007 has been training the postgraduates through the MS programme. Both are certified and recognized by the Medical Council of India.

We provide comprehensive health care to all the patients who are in need. Apart from the routine surgical work all major surgical as well as minimally invasive procedures are performed at our institute.

 


CLINICAL

The department is equipped with well furnished operating theatre. The patients are operated on an elective basis on all working days.

The procedures range from hernioplasty through mastectomy, thyroidectomy to supra-major surgeries such as abdominoperineal resection and Whipple’s procedure. Laparoscopic cholecystectomy and appendicectomy are also performed routinely. The department also accepts patients from the Casualty 24 x 7. If any surgical procedure is deemed necessary, it is preformed the same day. The faculty on duty are available round the clock.

Endoscopy Suite
The endoscopy suite is replete with an upper and lower GI videoendoscopes with recording/playback facility. We routinely perform diagnostic and therapeutic procedures endoscopically. Large number of patients benefit from this minimally invasive procedure. Diagnostic procedures include H.pylori testing, tissue biopsy, brush cytology. Deployment of stents in inoperable oesophageal cancers as well as banding or injection sclerotherapy for bleeding are done.

TEACHING

Undergraduate training
The undergraduates are taught by extensive use of audio-visual aids to reinforce their understanding of the subject. The curriculum followed is as prescribed by the Medical Council of India. Clinical demonstrations and case presentations are always done in small groups to reach out to every last student. In addition seminars, symposia and integrated teaching are conducted weekly. The students are exposed to operative procedures performed in the theatre by the use of modern Audio-Visual telecast system from the operating table. This facility allows a two-way interaction between the operating team and the students to put the matter into perspective. These are complemented with periodic tests in both theory and clinics as well as a model examination in preparation for the University examinations.

Postgraduate training
The Institute has been accepting students as a part of the MS post-graduation programme since 2007. Four students are undergoing training in each of the first two batches and the recent batch consists of five students. Teaching programme for the month is planned in advance and are conducted in the afternoons. It includes lectures, seminars, journal club and clinicals.

All the postgraduates have to present the aforementioned and their performance assessed, through a prescribed assessment format by the faculty. The first batch of postgraduate students have appeared for the University examinations in March 2010 and the model examination in preparation for the same was conducted a month prior.

Significant achievements by the students

  1. Success rate of UG students in surgery is always greater than 90%.
  2. Dr. Rakesh of 2001 batch – University gold medallist in General Surgery.
  3. Dr. Ram of 2005 batch – University gold medallist in General Surgery.

Seminar room and Computers
State - of - the - art air-conditioned seminar room with an LCD projection system aids the students fathom the nuances of the subject. The department is also computerized for official as well as academic work.

Departmental Library and Museum
The library is well equipped with over 150 books in General Surgery and allied specialties. It remains up -to-date with all recently published books. It is readily accessible by the faculty and students alike as it is situated in the heart of the department.

 


CME AND WORKSHOPS ATTENDED
CME on “Head & Neck Cancer” conducted on 14th November 2010, RCC, JIPMER Pondicherry.

Dr. T.Tirou Aroul
CME on “Head & Neck Cancer” conducted on 14th November 2010, RCC, JIPMER Pondicherry.

Dr. G.S. Ramachandran , Dr. K.V. Rajan & Dr. Kannan
MODERATED.

CME on “Head & Neck Cancer” conducted on 14th November 2010, RCC, JIPMER Pondicherry.

Dr. Robinson Smile.

CME on “Head & Neck Cancer” conducted on 14th November 2010, RCC, JIPMER Pondicherry.

Dr. N. Anathakrishnan.
Moderated a session in the first national conference on “INFECTION CONTROL AND RATIONAL ANTIMICROBIAL THERAPY” Conducted by MGMC & RI & Indian Council of Medical Research ( ICMR) on 23rd October 2010.

Dr. T. Tirou Aroul & Dr. G. S. Ramachandran
Presented a Paper Surgical Site Infections – “ RATIONAL ANTI MICROBIAL THERAPY” first national conference on “INFECTION CONTROL AND RATIONAL ANTIMICROBIAL THERAPY” Conducted by MGMC & RI & Indian Council of Medical Research ( ICMR) on 23rd October 2010.

Dr. K.V. Rajan

Department CME-2010 – External Faculty Dr. VITTAL’S PG Clinics- December-2010

CME in Vascular Surgery held on 31 July 2010

Department of General Surgery in collaboration with the department of CTVS, organized a CME on “Vascular surgery” on the 31st of July 2010 at Mahatma Gandhi Medical College & Research Institute, Pondicherry.

The topics for the CME were carefully selected by a team of experts including Prof. D.R. Gunasekaran, Prof. S. Robinson Smile, Prof.N.Anathakrishnan, Prof.G.S.Ramachandran, Prof. T.Tirou Aroul and Prof.G. Muthurangan.

The speakers were experts in their respective field of cardio-thoracic & Vascular Surgery. The topics and the profile of speakers were as follows:-

  1. Approach to a case of peripheral arterial disease - Dr. G. Muthurangan, Prof & HOD of CTVS, MGMC & RI.
  2. Upper limb ischaemia - Dr. S. R. Subramaniam, Consultant Vascular Surgeon, Vijaya Hospital, Chennai.
  3. Indications, techniques and outcome of surgery for peripheral arterial disease - Dr. M. Rajkumar, Prof & HOD of Vascular Surgery, Stanley Medical College, Chennai.
  4. DVT & Pulmonary embolism, Current concepts in prevention, diagnosis and management - Dr. Vidyasagaran, Prof. & HOD of Vascular Surgery, MMC, Chennai.
  5. Pathophysiology and management of venous ulcer - Dr. K.S.Vijayaraghavan, Vascular Surgeon, KS Hospital, Chennai.
  6. Quiz.
  7. Aortic Aneurysms - Dr. C. S. Vijayashankar, Chief consultant, Cardiothoracic Surgery, Apollo Hospital, Chennai.
  8. Endovascular interventions - Dr. N. Sekar, Consultant Vascular Surgeon, Apollo Hospital, Chennai.

 


 

The department encourages the faculty and postgraduates actively to partake in clinical research and publications.

Ongoing Projects:
 

S. No. Name of Investigator Title Guide Co-Guide
1 Dr. Alex J.Christopher Clinical and Investigatory profile of liver abscess Dr.N.Ananthakrishnan Dr. Manoj Kumar R.
2 Dr. Bragatheshwaran Sclerotherapy vs bandligation in treatment of haemorrhoids Dr.Tirou Aroul Dr.Murali
3 Dr. John Mathew Necrotising fasciitis -A clinical and microbiological study Dr. Robinson Smile S. Dr. Sudeepta Kumar swain
4 Dr.Sujith Chronic groin pain after hernia repair Dr. Sivaprahasam N. Dr.Manish Kumar
5 Dr.Vinoth Triple assessment in ca breast Dr.Ramachandran Dr.K.V. Rajan
6 Dr. Arun. T Effects of off-loading devices in diabetic foot ulcer healing – A randomized control study. Dr. Robinson Smile. S Dr. Alok Mohanthy
7 Dr. Nikhil
Nanjappa. B. A.
Incisional hernia repairs –A clinical study Dr.Robinson Smile. S. Dr. Alok Mohanthy
8 Dr. Jigar Patel
Nitinkumar
Evaluation of modified alvarado scorings in diagnosis of acute appendicitis Dr. Tirou Aroul Dr. Manish
9 Dr. Senthil. P. Comparison of efficacy of 2% diltizemtopical application with lateral sphincterotomy in the management of chronic ananlfissure Dr. Ramachandran. Dr. K.V. Rajan
10 Dr. Ravi Desai. P. A correlative study of antithyroid antibodies level:
Thyroid functional studies and histological evidence of thyroiditis in patients subjected to thyroidectomy
Dr.N. Ananthakrishnan Dr. Nasserrudin

 Completed Projects:

S. No. Name of Investigator Title Guide Co-Guide
1 Dr. Balachander M Morbity and morthlity of perforated peptic ulcer. Dr.Sivaprahasam Dr. Alok Mohanthy
2 Dr. Vinoth Kumar R. Diagnostic value of with reactive protein in acute appendicitis Dr. Robinson Smile S. Dr. Manoj Karthik
3 Dr. Sheik Abdullah Randomized clinical trial of single dose versus multiple dose cefazolin prophylaxis in acute non - perforated appendicitis Dr.Ramachandran G.S. Dr. Rajan K.V.
4 Dr. Abhilash .K Incidental thyroid carcinoma in patients operated for benign thyroid disease Dr. Tirou Aroul Dr. Sudeepta Kumar swain

Out-reach Services
Our department believes that health care should not only be limited just to the hospital but also to carry it to the community. Our faculty have been involved in this programme and camps (governmental and nongovernmental) are conducted every fortnight in the neighbouring villages. Patients who are in need of further care are treated back at our hospital.

Best practices
The department strives its best to uphold the cause of education and training. To further this cause, it engages in certain best practices such as...

  • Small group teaching and bed side clinics
  • Integrated teaching for UG students.
  • Monthly General Clinics for the final year students
  • Audio visual presentations.
  • e-Learning.
  • Live telecast of operative procedures.
  • Well supervised PG academic activities and operative training with immediate assessment by the faculty .

 

GOALS

  • To practice surgery safely and effectively, backed by scientific knowledge and sound skills.
  • To have a keen interest in patient care and develop a caring attitude.
  • To maintain high ethical standards.
  • To have sufficient understanding of basic sciences related to surgery, to diagnose and manage majority of the surgical conditions clinically and with the help of relevant investigations through comprehensive training and experience necessary for independent practice.
  • To exhibit competence in the basic concepts of research methodology and teaching skills.

DURATION

The duration of the course will be 3 years to be followed by the “exit” or specialty examination in General Surgery

CLINICAL POSTING

  1. Surgical Posting: Each postgraduate (PG) is posted in a surgical unit soon after joining the course.
  2. Rotations in Specialty Departments is done after the PG has spent six months in learning basic ward work and surgical skills in the surgical unit. This rotation includes allied departments like Pediatric Surgery, Urology, Cardiothoracic surgery, Neurosurgery, Oncology, and Radio diagnosis, for a minimum period of four weeks each and Anesthesiology, & Orthopedics for period of 2 weeks each.

TEACHING AND LEARNING ACTIVITIES

Most of the teaching is conducted within the unit by the consultants of the respective unit. Various  learning activities are Journal Club presentations, case presentations, clinic-pathological exercises, ward rounds and teaching rounds. Seminars are held every week which are attended by the whole department. Each postgraduate presents about two to three seminars and Journal clubs every year. Interdepartmental
meetings are held monthly with the Radiology and Pathology departments. Interesting cases are discussed in these meetings.

Clinico-Pathological, Surgico-Radiology conferences are held every month and Clinical combined rounds and Clinical Grand rounds (CGR) are held weekly. All postgraduates should attend these. They are also encouraged to attend CMEs & conferences.

All the teaching / learning activities should be entered in a log book which should be signed by the authorized teacher and head of the department periodically.

THESIS

All postgraduates are required to carry out a dissertation under the guidance of faculty of the department. They are encouraged to select the project of their choice. The emphasis while during dissertations would be to train the postgraduate student in research methodology, planning a study, collection of relevant literature, fixing aims and objectives, planning detailed methodology including statistical analysis, analysis of data collected, presentation of data in the form of text, tables and figures, discussing the relevance of the study with reference to other published literature, summarizing the study and listing in proper format the references consulted in the process.

CONTENT OF TRAINING

General Objectives of Training

Trainees should develop:-

  1. Clinical and operative competence in both emergency and elective general surgery. Additionally they require knowledge and some experience across a wide range of surgery to ensure appropriate referral.
  2. The competence to be responsible for both the emergency admissions in general surgery and elective referrals.
  3. A knowledge of the basic sciences related to general surgery including Anatomy, Physiology, Biochemistry, Pharmacology, Microbiology & Pathology.
  4. The ability to teach medical students.
  5. The ability to work as a member of a clinical team, bearing in mind the needs of the society and the hospital.
  6. An understanding of the particular requirements of day care surgery.
  7. A knowledge of palliative care.
  8. A knowledge of subjects such as medical ethics, health economics, medico-legal matters, risk management, medical statistics, information technology, disaster management and health service management.
  9. A knowledge and experience of clinical audit.
  10. An understanding of research methods and review of articles published in peer reviewed medical journals.

Syllabus

The following pages comprise schedules of knowledge and operative skills, which provide a syllabus for training in general surgery and its subspecialties. The knowledge required includes the basic science relevant to each topic. There is no intention to limit knowledge and operative experience and the students must know the entire syllabus. Trainees, as part of their general surgical training, must acquire competence in the scheduled operations but will also have experience of other procedures from the sub-specialty departments.

Knowledge: The Postgraduates are required to acquire sound knowledge of following topics. The PG’s should also be familiar with recent advances and current controversies.

Minimum pass marks for theory will be an overall 50% in all papers put together and not less than 40% in any paper.

Clinical Examination:

There will be four examiners for clinical examination, all of whom will sit together to examine each candidate. There will be one long case and three short cases 80 marks for the long case and 40 Marks for each shortcases 80 marks for the long case and 40 Marks for each short case and a total of 200 Marks will all allotted for the clinical examination. A minimum of 50% Marks exclusively in clinics will be required for a pass.

ORAL Examination:

All the four examiners will sit together to examine each candidate. The sections covered and marks will be:
 

  Defense of dissertation - 25 Marks
  Gross Pathology - 25 Marks
  Imaging - 25 Marks
  Instruments and operative surgery - 25 Marks
  Total - 100 marks


A minimum of 50% marks in oral be required for a pass.