The transition from resident to registrar constitutes a steep learning curve in most medical practitioners’ careers, regardless of speciality. We aimed to determine whether a six-week orthopaedic surgical skills course could increase resident skills and confidence prior to transitioning to orthopaedic registrar within the Gold Coast University Hospital, Queensland, Australia. Unaccredited registrars, orthopaedic trainees, and orthopaedic consultants, through a departmental peer reviewed process and survey, developed a six-session course (“Registrar Academy”) that included basic knowledge and essential practical skills training for residents with an interest in becoming orthopaedic registrars. This course was implemented over a 3-month period and assessed. Mixed method quantitative and qualitative evidence was sought via a 14-item and 18-item Likert scale questionnaire coupled with open-ended questions. Ethical approval was granted by our institutions Human Research and Ethics Comittee, reference no.: HREC/16/QGC336.Introduction
Materials
Obesity is a direct contributor to degenerative joint disease, and as the prevalence of obesity increases globally it is likely that more overweight patients will present for hip replacement surgery. There are reports that overweight patients in the UK's National Health Service, typically with a Body Mass Index (BMI) over 30 (BMI 30–39 obese, BMI≥40 morbidly obese), are being denied operations on the premise that they are at risk of significant complications. Enhanced Recovery Programmes (ERP) are designed to enable patients to recover quickly and return home safely within a few days. The aim of this study was to compare the outcome of hip replacements in obese and non-obese patients enrolled in our ERP. We prospectively studied 350 patients who underwent primary and revision total hip replacements and were treated through our ERP form March 2010 to January 2011. The mean age was 68 (range 23–92 years). 130 patients (37%) were considered obese with a BMI of >30. 11 patients (3%) were considered morbidly obese with a BMI >40. They were age & sex-matched with the non-obese patients. Outcomes measured included: Length of stay, wound complications (including surgical site infections), deep vein thrombosis and blood transfusion requirements. Data was collected to 42 days following discharge.Introduction
Methods
