Minimal access surgery training of general surgical residents in Karachi, Pakistan; where do we stand?

Objective: To evaluate post graduate surgical residents’ training in minimal access surgery.
Methodology: This cross sectional survey was based on a 16-item self reporting questionnaire
that was provided to 48 third, fourth and fifth year postgraduate general surgical trainees doing
residency in seven Karachi institutions accredited by College of Physicians and Surgeons Pakistan
for Fellowship training. All 48 trainees completed and returned the given questionnaire.
Results: Eleven were 3rd year, 33 were 4th year and four trainees were 5th year residents. Mean
age of the trainees was 30.31(SD 2.8) years (range 27 to 43), Males were 35 (72.92%), females
were 13 (27.08%). Forty six (95.83%) answered that laparoscopic surgery was performed in their
department, while two (4.17%) replied in negative. Nine (18.75%) said that they had performed
Laparoscopic Cholecystectomy under supervision, while 39 (81.25%) responded “no”. Regarding
“Dry Lab” access 18(37.5%) responded “yes” while 30 (62.5%) said no. Similarly regarding “Wet
Lab” none said “yes”, all (100%) responded by saying “No” as was the case of Virtual Reality
Simulator where 45 (93.75%) said “No” while three (6.25 %) did not answer this question and
none responded “Yes”. Out of the 48 trainees questioned only nine (18.75%) had ever attended a
Basic Laparoscopy workshop while 39 (81.25%) had not. Trainees own perception regarding their
skills and status in laparoscopic surgery training was such that none said Excellent, 7(14.58%)
said Good, eight (16.67%) labelled themselves as Average while nine (18.75%) thought they were
below average, 23 (47.92%) said they were Poor in this Skill and one(2.08%) did not respond. Most
41 (85.42%) would prefer to do a One Year Fellowship in Minimal Access Training following FCPS,
while one(2.08%) said “No” and six (12.5%) were not sure.
Conclusion: Education and training in Minimal Access Surgery within Institutions of Karachi is not
standardized and access to training facilities is limited.