Doctors training in King Fahd Specialist Hospital

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Information about Doctors training in King Fahd Specialist Hospital

Published on December 16, 2016

Author: DrShadSalimAkhterAkh

Source: slideshare.net

1. Do Doctors Ned Training? Dr. Shad Salim Akhtar MBBS, MD, MRCP, FRCP (UK), FACP(USA), Member UICC Fellows Consultant Medical Oncologist Medical Director

2. Quality of care • >500 pages published daily in English language • Guidelines developed for most of the common conditions • Protocols created for the management of many acute and chronic conditions • How and Why should a doctor know all this?

3. Why do we need to train doctors? • Quality of care implementation –Standard care –Guidelines –Audit –Outcome measures etc.. • Need a change of behavior

4. Factors affecting doctors’ behavior • Educational • Personal • Patient based • Economic • Environment Cantellon P et al: BMJ 1999;318;1276-1279

5. How can we change the educational aspect? • External audit • Punitive actions • Or may be better is •CME/CPD

6. CME - Definition •Education after certification and licensure Davis D et al. BMJ 2003; 327:33

7. CME or CPD • Lifelong learning process • Develop skills needed which include – Education – Management – Training – IT – Audit – Communication – Team building – Learner centered and self directed Editorial BMJ 2000; 320:393

8. Saudi council for health specialization recertification needs collection of CME hours

9. Reasons for Information Seeking • Varies from stage to stage • Complex changes in practice • Specific patient problem • Higher qualifications • Higher remuneration • Peer challenge Journal of Med Internet Res 2003; 5:e20

10. Why Do Physicians Learn? • Revalidation • Recertification • Ego • Juniors ask questions • Patients’ demands (internet) • Pharmaceutical agencies Shannon S. The Lancet 2003; 361:266

11. Why CME BMJ August 2001

12. 1160 7285 1328 9899 1264 11297 1354 8858 0 5000 10000 15000 1420 1421 1422 1423 Major Minor 1241423 1141422 1171421 1211420 Code Yellow/Year KFSH Trauma Care-Load

13. Trauma care how could we improve it? • A specific training course for all those involved in – KFSH initially and then – Al-Qassim region as a whole

14. ATLS •Justifies the need for Advanced Trauma Life Support Courses and certification of concerned physicians at KFSH

15. Research states that physicians have 3 to 5 clinical questions per day that remain unanswered. The answers are out there, …..

16. Changing Practice • Physicians becoming aware of a gap in knowledge or skill • Learning changes the practice not teaching Shannon S The Lancet 2003; 361:618

17. Variation in Support

18. New Equipments Added • Radiological department – Dexa – Angio suite – Sophisticated ultrasound • Blood bank – Aphareis • OR – Laparoscopic towers • Laboratory – PCR – Immunocytochemistry

19. Physicians or allied staff trained • Apharesis – Cob spectra • Immunocytochemistry • Angiography – Machine idle for 1 yr now – One of our radiologists on his way We are independent now

20. KFSH Workload-Number of Pts Seen 0 20000 40000 60000 80000 100000 120000 140000 160000 180000 1412 1415 1418 1421 1422 1423 1424 ER OPD SS Akhtar Data from Statistics Dept

21. KFSH Workload - Referrals In 0 100 200 300 400 500 1 2 3 4 5 6 7 8 9 10 11 12 1423 1422 Month No of pts Data from Therapeutics DeptSS Akhtar

22. KFSH Workload - Referrals Out -1422 106 89 5946 38 29 23 21 16 12 11 9 8 8 8 16 Neuro Surg Cardiology Oncology Ortho Gen Surg Ophthal ENT Dental Vas Surg Nephro Gastro Pneumo Neuro Urol Endo Misc SS Akhtar Data from Therapeutics DeptTotal No=499

23. Intervention • Training of doctors – Consultants – Residents • Training of nurses • Training of technicians • Other ancillary staff • Subsequently when funds became available new staff recruited

24. ~350 km

25. Referrals Out - 1422 - Indications 331 94 12 62 Lack of Facility Request 2nd Op Unkn Neurosurgery 66 Radiotherapy 51 Angiography 49 Arthroscopy 29 EPS 18 Spinal Unit 16 YAG Laser 15 Isotope Scan 12 Irregular supply PSCC

26. Staff Recruitment • Direct from the outsource contractor – Within the stipulated terms of contract • MOH – Selection team • No on site accreditation system to judge the need – This is changing now • From different countries with different qualifications

27. • Variation in – Level of training and qualifications – Previous type of exposure • Lack of knowledge of policy and procedures • Many lack in the technological know how • Some lack the skills required Staff characteristics

28. KFSH Doctors Status- MOH SS Akhtar MD Office 43 46 35 26 40 38 41 45 30 24 2828 0 5 10 15 20 25 30 35 40 45 50 Consultants Residents 1418 1420 1422 1423 Training Remuneration Incentives Job security Quality!!!

29. Staff Turn Over-1998-2003 0 100 200 300 400 500 1998 1999 2000 2001 2002 2003a 2003 Total New MOH New SHS EOC SS Akhtar Nursing Office

30. Years of Experience at KFSH- Nursing Staff SS Akhtar Data from Nursing Office 142 112 59 28 No of Nurses >=10 yrs 6-9 yrs 1-5 yrs <=1 yr <=1 year Incentives Stagnation In job training Salaries

31. Resources-Staff Contractor MOH • Consultants 58 38 • Specialists 13 57 • Residents 40 69

32. Our Production • More than twenty consultants working in our hospital or the region • More than 70% specialists locally trained graduates • About 30 residents enrolled in national and international postgraduate programs • More than twenty original articles published from our institution

33. Postgraduate Programs • Internship • Accredited for postgraduate training – Saudi board – Arab board – Royal college of physicians – Royal college of surgeons – College of physicians and surgeons of Pakistan • Publications by the faculty

34. Academic Activities-Hospital Based • Intensive courses – ACLS – ATLS – FCCS – Review course with RCP Edinburgh • Training courses/workshops – Suturing technique – Conscious sedation – Bronchial asthma management – Critical care workshop

35. Educational Activities 1425 11 27 41 744 108 11 Club meetings Courses Grand rounds Lectures out Symposia Telemedicine Workshops

36. Academic atmosphere-Impact Paramedical staff Nursing staff Consultant Resident Specialist External teams Quality of care improvement

37. What does all this need • Financial resources – Remuneration for teaching activities – Remuneration for acquiring a skill • Library – Books – Journals • Other teaching aids – Mannequins – Skill labs • Internet

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