[Magdeburg Medical School - Logbook for Surgical Training of Final Year Medical Students - an Interdisciplinary, Medical School-Specific Concept Based on the Guidelines Issued by the Medical School Association ("Medizinischer Fakultätentag") in 2012]. / Magdeburger PJ-Logbuch der chirurgischen Fächer ­ interdisziplinäre, einrichtungsspezifische Umsetzung der Vorgabe des Medizinischen Fakultätentages (MFT) von 2012.

BACKGROUND: The final year is the last part of the study of human medicine and can be regarded as an essential period, during which medical knowledge should be consequently converted into medical expertise. Since the amendment of the medical license policy ("Ärztliche Approbationsordnung" [ÄApprO]) from July 17, 2012, in particular, since April 01, 2013, German universities have been obliged to provide a training schedule such as a "logbook" for this final year, specifically for the mandatory time periods within surgery and internal medicine. In preparation for this innovation, the German Medical School Association ("Medizinischer Fakultätentag") presented basic logbooks as consensus documents in June 2012. The portfolio for each surgery discipline and the Magdeburg Medical School, had been developed on the basis of individual initiatives and used for years, and was revised, specified and further developed into a "logbook of the medical study's final year" - specific for daily practice and the Magdeburg Medical School, and to the guidelines of the Medical School Association ("Medizinischer Fakultätentag"). The aim of the present commentary is i) to present the Magdeburg Medical School logbook and its clinical planning for cases, diagnoses and (surgical) interventions, as a summary of institutional experience and ii) to describe the mandatory surgical part of the "Magdeburg's final year of the study of human medicine". METHOD: Narrative short overview including individual teaching experiences and topic-related references from "PubMed" using terms for literature search such as "surgical logbook", "practical year" and "medical teaching". The background and aims of the document's modifications are explained for each surgical discipline. RESULTS: The "Logbook" is subdivided into 6 chapters: introduction, basics, statement of requirement, selected surgical diseases and interventions as well as information on final year-associated events and courses and instructions for creating the obligatory case report. CONCLUSION: The presented "Magdeburg Medical School Final Year Logbook of the Surgical Disciplines" has been created according to the requirements of the German Medical School Association ("Medizinischer Fakultätentag") and has been simultaneously adapted to the conditions and established medical teaching at the presenting Medical School. In particular, the medical students are given a document related to daily clinical practice, which allows them, within an overall teaching concept, to acquire indispensable expertise.

Surgical teaching at the Medical School Otto-von-Guericke University of Magdeburg - basic conceptual description.

Teaching in surgery, one of the classical big clinical and main disciplines beside internal medicine, needs to be also associated with great attention in regard to a valuable final result at the end of the study of human medicine. In particular, surgery is not only the subject to a large number of lectures it also represents one third (four months) of the compulsory internship (practical year - in German, "Praktisches Jahr") at the end of the study of medicine. Therefore, medical teaching of students should be always part of serious and steady attempts to optimize course und contents as a component of guiding activities focussing onto the substantial improvement of the study of medicine. In detail, the classical and traditionally established type of teaching, the (oral) lecture, has to be further developed and reasonably completed by numerous interactive and practice-oriented teaching, learning and examining modalities (obligatory or facultative seminars / courses, training in [very] small groups of students, bed-side teaching, individual practical exercises within the SkillsLab, groups of young researchers, research projects in teaching, scientific publications on topics and recommendable experiences ot teaching including students, "Teach-the-teacher" projects etc.). Although many novel concepts have been inaugurated and considerable advances have been achieved, there is a steady need for further improvement. In the presented representative but medical school-specific overview, the current complex surgical teaching concept, which has been continuously optimized over the last couple of years, at the Otto-von-Guericke University Medical School with University Hospital of Magdeburg (Germany) is described as a scientific and systematizing document as well as a manuscript associated with the ongoing preparation of an institutional "Teaching Manual" on surgical teaching and training for medical students. It should - last but not least - provide the basis for a public discussion, which vice versa might hopefully and possibly result in further structural reforms of (surgical) teaching in the near future.

Surgical Treatment Results In Gastroschisis Based On Preterm Delivery Within The 34th Week Of Gestation By Caesarean Section.

UNLABELLED: The aim of the study was to assess the value of the today's appropriate approach, preterm delivery in the 34th week of gestation by Caesarean section and subsequent surgical intervention at the perinatal center, in daily practice of pediatric surgery with regard to early postoperative and mid-term outcome. MATERIAL AND METHODS: Over the time period of 9 years, all consecutive cases diagnosed with gastroschisis at the perinatal center, University Hospital of Magdeburg, were born by Caesarean section within the 34th week of gestation followed by surgical intervention. The registered data were compared with those published by other groups. RESULTS: Overall, there were 19 cases through the investigation period from 01/01/2006 to 12/31/2014. The mean duration of gestation was 237.9 days. The mean birth weight was 2,276 g. In all individuals, a primary closure with no artificial material was achieved. The duration of postoperative artificial respiration was 2.3 days. Oral uptake could be initiated on the 10th postoperative day on average. The mean hospital stay was 37 days. There was no lethality. As complications, postoperative (iv catheter-associated) sepsis occurred in one case and relaparotomy became necessary in a further case because of no possible completion of enteral nutrition by 20 days after primary closure (complication and relaparotomy rate, 10.5% and 5.26%, respectively). CONCLUSIONS: The data indicate that in case of gastroschisis, primary closure can be more frequently achieved by section within the 34th week of gestation. Under the prediction of an optimal neonatological care, the risks of a preterm delivery by a planned section appear to be manageable.

Implantation of human demineralized bone matrix (DBM) for the treatment of juvenile bone cysts.

OBJECTIVE: Definitive bony consolidation in juvenile bone cysts. Prevention of pathologic fractures. Preservation of limb function. INDICATIONS: Juvenile bone cysts at all sites. CONTRAINDICATIONS: Malignant cystic lesions. SURGICAL TECHNIQUE: After opening and curettage, the cyst is packed with human demineralized bone matrix (DBM). POSTOPERATIVE MANAGEMENT: Clinical and radiologic checks after 1, 4, and 6 months, followed by further 6-monthly checks. RESULTS: Over a period of 2 years, nine cysts packed with DBM showed almost totally osteodense images after an average of 8 months, with no other significant changes (follow-up period: 24 months). A typical decrease in cyst transparency on the plain radiographs was already detectable in all patients after 3-4 months. Marked cortical remodeling was visible after 6 months. A significant complication in one cyst in the distal tibial region was a pathologic fracture following distortion trauma; this occurred after 5 months, probably because of insufficient filling of the cyst. The fractured limb was immobilized in a lower-leg cast and healed sufficiently for stable weight bearing after 12 weeks.