Design, implementation, and evaluation of a postgraduate Diploma in Surgical Anatomy.

After careful planning, a postgraduate Diploma in Surgical Anatomy was launched in 2009. This report describes the structure of the program, the challenges encountered in implementing and running the course, and results of evaluations. The qualification is targeted at junior doctors intending to become surgeons or radiologists and aims to equip them with a sound understanding of regional anatomy relevant to common diagnostic and therapeutic procedures, together with an understanding of common/important anatomical variations. The course is delivered by: (1) 24 weeks' distance learning, comprising selected readings, podcasts, multiple choice questions (MCQs), and research informed essays; and (2) two separate two-week periods of intensive campus-based learning and whole body dissection (four students per cadaver) assessed by oral examination, a class presentation of an anatomical variation, and formal MCQ examination. Campus-based instruction is delivered by two surgical anatomists with additional input from a broad range of specialist surgeons and radiologists. Anonymous student evaluations over three successive courses show that all components of the course were highly rated. The success of the program may relate to several factors: an emphasis on clinically relevant anatomy, clear learning objectives, personalized student feedback, a low student to cadaver ratio, restricted class size, a wide range of supportive material, a dedicated team of surgical/radiological instructors, efficient course administration, and endorsement by the Royal Australasian College of Surgeons. Establishing a Diploma in Surgical Anatomy program requires a dedicated team of individuals, the setting and maintenance of appropriate educational standards, and collaboration with the professional body regulating the training of surgeons.

Accidental human injection of Excenel RTU: ceftiofur hydrochloride in cottonseed oil.

INTRODUCTION: There is little knowledge within the medical community of the existence of veterinary antibiotics in oil-based suspensions and the adverse effects that may occur with accidental human injection. CASE REPORT: A farmer injected an unknown quantity of Excenel RTU into her right thigh. Despite early debridement she developed a deep infection and recurrent chronic inflammation in the subcutaneous tissues and muscle secondary to the cottonseed oil suspension. Radical debridement and extensive split skin grafting was required but she still has had recurrences 12 months after injury. DISCUSSION: Prompt surgical debridement should be performed as in cases of oil based veterinary vaccines. Despite being an antibiotic there is a significant risk of infection from a dirty needle following inoculation and multiple cultures should be taken and appropriate broad spectrum antibiotics used. Radical debridement and skin grafting necessitating specialist plastic surgical attention may be required.