My first impressions of the centre were that it is remarkable. CSC is a surgical hub that not only prioritises service provision to the those with greatest need but provides phenomenal teaching opportunities to its junior residents and local medical students.
All members of the team share active responsibility for patients, and you can see the appreciation of patients who may otherwise not have been given the complex treatment they receive here. Things run smoothly with the help of non-medical staff who match cases with the speciality of the surgeon, much like a well-oiled machine.
Pathology here in Cambodia is vast and subverts what I have usually seen in Britain, and therefore the common surgical procedures are unlike those in the U.K. I observed two procedures for pan brachial plexus Injuries. A complex surgery involving the reinnervation of the upper roots of the brachial plexus to assist with shoulder abduction and elbow flexion. The spinal accessory nerve and phrenic nerves are harvested and grafted for this.
In UK medical school we often learn that these injuries to the brachial plexus are quite rare. Here in Cambodia, I have learnt that low-velocity motorbike accidents are indeed quite common, meaning patients fall on their shoulder and then hyperextend the angle between the neck and shoulder, causing brachial plexus injury.
During the preoperative morning ward round, the consultant who was leading the rounds asked one of the residents to perform an upper limb neurological examination and then proceeded to help improve his examination technique and teach him further. For me, watching this was phenomenal, you could see the tangible interest the consultant had in the learning and progress of his junior colleague. I myself, had the privilege to learn from that experience as well.
The local medical students here, much like in England, present cases, scrub into surgeries and clerk new patients. The attitude towards teaching here is one of my favourite parts of this centre, it seems the seniors all have a vested interest in a junior’s improvement.
Now it has only been a week, but I have seen pathology I have only read about in textbooks or on question banks. I have had the privilege of seeing patients with rickets, cleft palate, polydactyly, dinner fork deformity, Erb’s palsy, neurofibromatosis with café-au-lait spots.
For it has just been 5 days, I wonder what the next weeks will bring, but I can be almost certain that the pathology I may see at CSC will be unlike any placement in the U.K, hence I am immensely grateful for the opportunity to be a part of this organisation for the coming weeks.
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