Clinical Course:Neurosurgery

 
Master Surgery – Neurosurgery [M.S (Neurosurgery) USM]
 
 
1. BACKGROUND AND COURSE DESCRIPTION:
 
The USM Department of Neurosciences of the School of Medical Sciences which is part of the University’s Neuroscience Center of potential excellence in Services and Research awarded in December 2011 by the Minister of Higher Education Datok Seri Khalid Nordin  is currently the leading provider of the comprehensive neurological and neurosurgical services to cater the needs of the whole population in the East Coast of Peninsular Malaysia. This civil responsibility and achievement is made possible with the availability of state of the art facilities for patient services whilst ensuring concurrent high quality teaching and research for  medical, surgical and other allied health trainees. As the Malaysia's forerunner in providing clinical and basic neurosciences training for both undergraduate and postgraduate levels, the Department is proud to be the first to offer residency training program in neurosurgery in Malaysia since 2001.
 
This is a four-year residency training program by coursework leading to the award of USM Masters in Neurosurgery. Candidates selection are based on candidates' academic achievement as well as prior general surgical and neurosurgical experiences. This selection is made by a conjoint board appointed by the University. The main objective of this program is to train young surgical trainee to become competent neurosurgeons who will extend their expert neurosurgical skills with the community, conducting research in neurosciences and provide continuing training for medical under- and post-graduates.To date, the program has produced 30 trained and qualified neurosurgeons since 2001, serving the various hospitals/health institutions in Malaysia including Sabah and Sarawak.
 
Although the course is intended for local Malaysian surgical trainees only for the next 5 years to fulfill the Economic Planning Unit of the Government of Malaysia’s needs.
Foreign nationals working abroad(not working in Malaysian institutions) are invited and encouraged to apply, provided that they meet the following minimum entry criteria: completed M.R.C.S or equivalent qualification and completed at least 48 months* of general surgical posting/rotation in a recognised post (such as a medical officer) within recognised institutions/establishments. Bear in mind that there will be no exemption for such candidates whereby the course duration remains a minimum of 4 years and to sit all examinations required with successful submission and defense of a dissertation. The maximum duration allowed is 7 years. (*: 24 months for Malaysian candidates).The governments sending these candidates will need to make sure that the degree will be recognized in their country when they return back to work as recognized specialist in their country.
 
Candidates are strongly advised to discuss their expression of interest ahead of submitting a formal application with the Program Coordinator (see details below) to avoid disappointment with their applications for this highly competitive neurosurgical residency training program.
 
2. FORMAT OF ASSESSMENT:
 
The continuing course assessments is divided in 3 phases of this 4-year training program:
 
Entrance Examinations:
  • MCQs on General Surgery and Neurosciences and Viva Interview.
  • Must pass this exam to be able to entry Year One.
Phase 1 (Year 1): Part 1 examination.Theory 60% (MCQ 30%, MEQ/Essay 30%) and Clinical/OSCE 40%.No viva borderline since 2013.Candidate attends the Medical statistic course where after a topic for dissertation is presented to Head of Program and thereafter to Ministry of Health Supervisors.Human and Animal ethics Clearance is requested for approval at this stage prior to sitting for the Year one exams.
 
Phase 2 (Year 2 and 3): Continuous assessment on  log books, case write ups, dissertation experiments by the respective supervisors and pass
 
1.BLS,ALS,MTLS,ATLS,PLS
2.High Speed Drill course
3. Principles’ of Microscopy ,Neurovascular and anastomosis course
4.Stereotactic,Functional,Tractography and Image Guided Surgery Course
5.Spine Course
6.Pediatric Neurosurgery course
7.Radiotherapy and Radiosurgery course. 
 
Phase 3 (Year 4):
Part 2 examination.Theory 40% (MCQ 20%;MEQ/Essay 20%). Clinical 60% (Long/short cases 40%;Viva 20%).
Pass all components separately especially Long Case,Short Case and Viva
(Note that the successful completion of each phase is  mandatory before recommendation can be made to ensure the candidates moves  into the next phase; Discipline, attitude unbecoming of a future neurosurgeon may lead to the delay in the movement of the candidate to the next phase till he is rehabilitated:A USM-MOH board meets every 6 months to decide this matter based on supervisor’s report,log books,surgical skills,dissertation progress and case write up progress)
 
3. ENTERENCE CRITERIA FOR NEUROSURGERY :
   A) Basic Qualification:
  1. The candidate should possess a medical degree (MD, MBBS, MBBCh or equivalent) and registered/recognised with/by Malaysian Medical Council (MMC)
  2. The candidate must have 12 months experience in surgical specialties whereby general surgical posting is a compulsory posting of at least 6 months in duration AND 12 months experience in Neurosurgery after completing houseman years. The last (another) 6 months posting can be in any surgical specialty posting (even general surgical posting again). Those attachments must be done in hospitals or institutions recognized by the University/Ministry of Health
  3. Bahasa Malaysia (BM) with Credit in SPM (for Malaysian citizen) – it applies to USM candidate: If did not obtain credit in BM, the candidate must resit BM papers prior to graduation
  4. Foreign candidates are required to attach to the respective university neurosurgical department/unit for 3 to 6 months and have to pass the attachment evaluation before being accepted as master of neurosurgery trainee. Besides, foreign candidates must also have: a) temporary registration certificate (TPC) or annual practice certificate (APC); and b) those with unrecognised undergraduate degree in Medicine must undergo Malaysia Quality Examination (MQE) before proceeding to year 2 in the actual neurosurgery programme. At current moment, the entrance MCQ examination and interview/viva are not applied to them yet. They are assessed internally by the respective university committee
  5. The candidate must pass with Grade 1 for Sijil Pelajaran Malaysia (SPM) or grade 1/4A (old system) or CGPA of 4 (new system) for Sijil Tinggi Pelajaran Malaysia (STPM) or Good Grade for Matriculation Examination. The foreign candidates must have good grade/score for the equivalent examinations in their own countries
  6. Good physical and mental state

  B) Other Criteria Required are Entrance MCQ examination and VIVAs:

  1. The candidate must sit for entrance MCQ examination. About the MCQ Examination:- The candidate should answer all 50 questions in total time of 60 mins (1 hour). There are two formats: single-best or one-true answer (SBA./OTA) format (25 Questions); and True-False (TF) format (another 25 Questions). Minus marking is not applied to this examination.
  2. The candidate must attend entrance interview/viva (s)
  3. The academic syllabus would cover ‘Principles and General Sciences in Neurosurgery’ and ‘Principles and General Surgery Sciences’ for both entrance MCQ examination and interview/viva (see the syllabus)
  4. Entrance MCQ examination is compulsory to all candidates (KKM and university candidates). Exception applies to foreign/overseas candidates (see above notes at A.4)
  5. Ranking and/or band of MCQ, together with entrance VIVAs results will finally determine the entry into the programme
  6. Those failed to enter the programme in that particular year and obtained less than 50% mark and/or poor band for the entrance MCQ examination results, suggested to resit the MCQ entrance examination for the subsequent application year. The intention is to have higher chance of getting into the programme with obvious improvement in the results. Noteworthy: application process follows like before.
  7. Those passed the entrance MCQ (with result 50% and above and/or with good band) but failed to enter the programme. Candidate must reapply via a standard application process like before, and be likely asked to come for the entrance VIVAs again for the next admission year [unless other factors judged by neurosurgery viva committee prohibiting/delaying him or her to be called for viva (s) again]. Noteworthy, he or she may also resit the MCQ examination with intention to improve the results
  8. Majlis Peperiksaan Malaysia (MPM) will announce where and when the entrance MCQ examination will be conducted (normally in November for Neurosurgery).
  9. Vivas for entry into the programme will be done twice for MOH (KKM) candidates, and once for the University candidates (i.e. a final viva). Viva one is for general screening to look for some factors. Viva two is a “final Viva” in which some questions in principles of neurosurgery and surgery are going to be asked again to the candidates

  C) Other use of entrance examination.

  1. Results of entrance examination obtained by medical officers currently working at non-neurosurgical centre, may be used to support his or her application to be posted in neurosurgical centre throughout Malaysia.
  2. Do take notes that the certificate is valid for 3 years, thus further application for interview to enter the actual neurosurgery programme must be done within that 3 years (i.e. 3 years counting as time after gaining the certificate).
  3. Neurosurgery experience for 1 year, 6 months experience in general surgery and another 6 months in surgical specialty as pre-requisite postings for neurosurgery seems appropriate with that 3 years validity of the entrance examination certificate.
  4. If needed, he or she can indeed take another entrance exam prior to entrance interview to obtain better results or band.
  5. Once he or she obtained reasonable good results in entrance examination, he or she should start soon applying for neurosurgical posting as medical officer in any neurosurgical centre in Malaysia (don’t forget to attach the entrance examination results together with change-in-posting application fom). This statement meant for those being posted in non-neurosurgical centre, clinic or district hospital but interested to be a neurosurgeon.

Details on MEDEX or Medical Specialist Pre-Entrance Examination should easily be available at web: http://apps.mpm.edu.my/medex/public/register

4. SYLLABUS FOR ENTRANCE MCQ EXAMINATION, AND INTERVIEW/VIVA

  A) Principles and General Surgical Sciences

  1. Prophylaxis of Thromboembolic Disease
  2. Surgery in Hepatitis and HIV carries – special precaution
  3. Pain control, Pathophysiology of Pain, differences between acute and chronic pain
  4. Respiratory Failure – recognition and treatment
  5. Assessment and Maintenance of Fluid and Electrolyte Balance
  6. Blood Transfusion – indication; hazard; complication; plasma substitutes
  7. Surgically Important Micro-organisms / Principles of Microbiological Diagnosis
  8. Septic shock – Pathopysiolgy and Principle of management
  9. The sources of Surgical Infection – Prevention and control
  10. Principles of Asepsis and antiseptic Aseptic technique
  11. Principles of Sterilization
  12. Skin preparation and Antibiotic Prophylaxis
  13. Pathopysiology of the body response to infection
  14. The Spleen – its role in Health and Disease : Spelenectomy and Hypersplenism
  15. Local and Ligature material
  16. Principles of Incision and their closure
  17. Diathermy – Principles and Precaution
  18. Disorders of Coagulation and Haemostatic
  19. Pathopysiology of Wound Healing – classification of Surgical Wounds Principles of Wound management
  20. Complications of Wound Healing – wound dehiscence, scars and contracture
  21. Principle and techniques of Biopsy and Cytological sampling
  22. Haemorrhage and Shock
  23. Respiratory failure – Pulmonary Oedema : ‘Shock Lung’, ARDS, Labour and Pulmonary Collapse
  24. Acute Renal failure in Surgical patients
  25. Carcinogenesis : Principles of Molecular Biology of Cancer and Genetic factors
  26. Benign and Malignant Neoplasm’s and mechanisms of Metastases
  27. Epidemiology of common cancers : Principles of screening and Principles of treatment
  28. Surgical aspects of Disordered Haemopoiesis and Haemolytic Disorders of Surgical importance
  29. Haemorrhagic disorders : Disorders of Coagulation
  30. Immune response to trauma, infection and tissue
  31. Principle of Research, Design and Analysis of Clinical Trials
  32. Post operative Pulmonary and non Pulmonary complications
  33. Principle of Wounds Drainage and Wound Dressings
  34. Diagnostic and Therapeutic uses of Radioisotopes
  35. Monoclonal antibodies and their application clinical practice
  36. Tumour markers in Surgical practice – Uses and Limitations
  37. Electromechanical hazards in the operating room
  38. Patient’s safety in the operating room – Precautions in the Anaesthetized patients
  39. Metabolic response to trauma / surgery
  40. Malnutrition in Surgical patients
  41. Acid-Base Homeostasis and disturbance in the Acid-Base balance and Principles of management
  42. Principles of Transplantation / Advances, uses and limitations 

  B) Principles and General Sciences in Neurosurgery

  1. Neuroanatomy
  2. Neurophysiology
  3. Basic Neurophysiology of pain, spasticity etc
  4. Neurochemistry
  5. Neuropathology
  6. Basic in Clinical Neurology – Localization and neurophysiological studies
  7. Basic in Neurodiagnosis and Neuroinvestigations
  8. Basic Principles in Neurosurgery – hemostasis, wounds in neurosurgery, sutures, etc
  9. Basic component in vascular, tumor, congenital malformation, spine, functional, trauma Neurosurgery
 5. PROGRAM COORDINATOR :
 
You may wish to address any queries to the Program Coordinator:

Associate Professor Dr Zamzuri Idris,
Department of Neurosciences,
School of Medical Sciences,
Universiti Sains Malaysia,
16150 Kubang Kerian, Kelantan, Malaysia.

 
Application is made directly via the USM Institute of Postgraduate Studies (IPS), 11800 Penang, Malaysia at www.ips.usm.my or the Kelantan IPS  branch
 
 
Note:
• Closing date of application: 31st October each year for June intake (or as advertised in all major daily newspapers in Malaysia).

• For foreign applicants: Qualified candidates will be selected by a conjoint board comprising of members from the Ministry of Health, Malaysia and  USM

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Department of Neurosciences
School of Medical Sciences
Universiti Sains Malaysia
16150 Kubang Kerian
Kota Bharu, Kelantan
Malaysia
 
Phone: +609-7676300
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