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Doctors training in King Fahd Specialist Hospital
This document discusses the need for ongoing training of doctors through continuing medical education (CME) and continuing professional development (CPD). It outlines several key points: 1) Medical knowledge is constantly evolving, with over 500 new pages published daily, requiring lifelong learning to ensure high quality patient care. 2) CME/CPD helps change doctors' behaviors to align with guidelines, protocols, and best practices through educational, personal, and environmental factors. 3) Saudi Arabia now requires collection of CME hours for recertification, demonstrating the importance placed on ongoing training. 4) King Faisal Specialist Hospital implemented several academic and training activities to improve staff skills and the quality of patient care.
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Doctors training in King Fahd Specialist Hospital
- 1. Do Doctors Ned Training? Dr.Shad Salim Akhtar MBBS, MD, MRCP, FRCP (UK), FACP(USA), Member UICC Fellows Consultant Medical Oncologist Medical Director
- 2. Quality of care •>500 pages published daily in English language • Guidelines developed for most of the common conditions • Protocols created for the management of many acute and chronic conditions • How and Why should a doctor know all this?
- 3. Why do weneed to train doctors? • Quality of care implementation –Standard care –Guidelines –Audit –Outcome measures etc.. • Need a change of behavior
- 4. Factors affecting doctors’behavior • Educational • Personal • Patient based • Economic • Environment Cantellon P et al: BMJ 1999;318;1276-1279
- 5. How can wechange the educational aspect? • External audit • Punitive actions • Or may be better is •CME/CPD
- 6. CME - Definition •Educationafter certification and licensure Davis D et al. BMJ 2003; 327:33
- 7. CME or CPD •Lifelong learning process • Develop skills needed which include – Education – Management – Training – IT – Audit – Communication – Team building – Learner centered and self directed Editorial BMJ 2000; 320:393
- 8. Saudi council forhealth specialization recertification needs collection of CME hours
- 9. Reasons for InformationSeeking • Varies from stage to stage • Complex changes in practice • Specific patient problem • Higher qualifications • Higher remuneration • Peer challenge Journal of Med Internet Res 2003; 5:e20
- 10. Why Do PhysiciansLearn? • Revalidation • Recertification • Ego • Juniors ask questions • Patients’ demands (internet) • Pharmaceutical agencies Shannon S. The Lancet 2003; 361:266
- 11. Why CME BMJAugust 2001
- 13. 1160 7285 1328 9899 126411297 1354 8858 0 5000 10000 15000 1420 1421 1422 1423 Major Minor 1241423 1141422 1171421 1211420 Code Yellow/Year KFSH Trauma Care-Load
- 14. Trauma care howcould we improve it? • A specific training course for all those involved in – KFSH initially and then – Al-Qassim region as a whole
- 15. ATLS •Justifies the needfor Advanced Trauma Life Support Courses and certification of concerned physicians at KFSH
- 16. Research states that physicianshave 3 to 5 clinical questions per day that remain unanswered. The answers are out there, …..
- 17. Changing Practice • Physiciansbecoming aware of a gap in knowledge or skill • Learning changes the practice not teaching Shannon S The Lancet 2003; 361:618
- 18.
- 19. New Equipments Added •Radiological department – Dexa – Angio suite – Sophisticated ultrasound • Blood bank – Aphareis • OR – Laparoscopic towers • Laboratory – PCR – Immunocytochemistry
- 20. Physicians or alliedstaff trained • Apharesis – Cob spectra • Immunocytochemistry • Angiography – Machine idle for 1 yr now – One of our radiologists on his way We are independent now
- 21. KFSH Workload-Number ofPts Seen 0 20000 40000 60000 80000 100000 120000 140000 160000 180000 1412 1415 1418 1421 1422 1423 1424 ER OPD SS Akhtar Data from Statistics Dept
- 22. KFSH Workload -Referrals In 0 100 200 300 400 500 1 2 3 4 5 6 7 8 9 10 11 12 1423 1422 Month No of pts Data from Therapeutics DeptSS Akhtar
- 23. KFSH Workload -Referrals Out -1422 106 89 5946 38 29 23 21 16 12 11 9 8 8 8 16 Neuro Surg Cardiology Oncology Ortho Gen Surg Ophthal ENT Dental Vas Surg Nephro Gastro Pneumo Neuro Urol Endo Misc SS Akhtar Data from Therapeutics DeptTotal No=499
- 24. Intervention • Training ofdoctors – Consultants – Residents • Training of nurses • Training of technicians • Other ancillary staff • Subsequently when funds became available new staff recruited
- 25.
- 26. Referrals Out -1422 - Indications 331 94 12 62 Lack of Facility Request 2nd Op Unkn Neurosurgery 66 Radiotherapy 51 Angiography 49 Arthroscopy 29 EPS 18 Spinal Unit 16 YAG Laser 15 Isotope Scan 12 Irregular supply PSCC
- 27. Staff Recruitment • Directfrom the outsource contractor – Within the stipulated terms of contract • MOH – Selection team • No on site accreditation system to judge the need – This is changing now • From different countries with different qualifications
- 28. • Variation in –Level of training and qualifications – Previous type of exposure • Lack of knowledge of policy and procedures • Many lack in the technological know how • Some lack the skills required Staff characteristics
- 29. KFSH Doctors Status-MOH SS Akhtar MD Office 43 46 35 26 40 38 41 45 30 24 2828 0 5 10 15 20 25 30 35 40 45 50 Consultants Residents 1418 1420 1422 1423 Training Remuneration Incentives Job security Quality!!!
- 30. Staff Turn Over-1998-2003 0100 200 300 400 500 1998 1999 2000 2001 2002 2003a 2003 Total New MOH New SHS EOC SS Akhtar Nursing Office
- 31. Years of Experienceat KFSH- Nursing Staff SS Akhtar Data from Nursing Office 142 112 59 28 No of Nurses >=10 yrs 6-9 yrs 1-5 yrs <=1 yr <=1 year Incentives Stagnation In job training Salaries
- 32. Resources-Staff Contractor MOH •Consultants 58 38 • Specialists 13 57 • Residents 40 69
- 33. Our Production • Morethan twenty consultants working in our hospital or the region • More than 70% specialists locally trained graduates • About 30 residents enrolled in national and international postgraduate programs • More than twenty original articles published from our institution
- 34. Postgraduate Programs • Internship •Accredited for postgraduate training – Saudi board – Arab board – Royal college of physicians – Royal college of surgeons – College of physicians and surgeons of Pakistan • Publications by the faculty
- 35. Academic Activities-Hospital Based •Intensive courses – ACLS – ATLS – FCCS – Review course with RCP Edinburgh • Training courses/workshops – Suturing technique – Conscious sedation – Bronchial asthma management – Critical care workshop
- 36. Educational Activities 1425 1127 41 744 108 11 Club meetings Courses Grand rounds Lectures out Symposia Telemedicine Workshops
- 37. Academic atmosphere-Impact Paramedical staffNursing staff Consultant Resident Specialist External teams Quality of care improvement
- 38. What does allthis need • Financial resources – Remuneration for teaching activities – Remuneration for acquiring a skill • Library – Books – Journals • Other teaching aids – Mannequins – Skill labs • Internet