Contribution of Professor Saidi to Surgical Education in Kenya

Daniel Kinyuru Ojuka

School of Medicine, University of Nairobi

Correspondence to: Dr. Daniel Ojuka, P.O. Box 19762 – 00202 Nairobi, Kenya.

Email: danielojuka@gmail.com

 

Summary

Surgical education in Kenya has grown over the last 40 years from just one medical school to three and from being offered by university to now a combination of university and collegiate system. While the traditionally technical skills were the main focus in surgical training, non-technical skills such as interpersonal communication,professionalism,system-based learning, problem based learning and leadership skills have come to be core competencies. Apprenticeship was the method for training in technical and non-technical skills,  but today  there  is explicit curriculum with various methods of training for both technical and non-technical  skills.  Professor  Saidi  contribution  to  the surgical education in Kenya was from traditional aspects as well as newer aspects. His contribution to the transition from just skills training to the 21st century competency-based training, from basics to technology-based interventions cannot be overemphasized. This article is in memory of his contribution to surgical education in Kenya.

 

Key words: Surgical education, Competency-based

learning, Mentorship

Ann Afr Surg. 2018; 15(2):70-72

DOI:http://dx.doi.org/10.4314/aas.v15i2.8

© 2018 Author. This work is licensed under the Creative Commons Attribution 4.0 International License.

Conflicts of Interest: None

Funding: None

​Introduction

The Halsteadian model of surgical training consisted of three principles-understanding scientific basis of diseases,  repetitive  exposure under  supervision of a skilled teacher and graduated acquisition of complex surgical skills in management of diseases (1). At the University of Nairobi, the structure of the training has retained one year of learning basic sciences-pathology, anatomy  and physiology followed  by  four years of clinical exposure in a graduated manner (2). Professor Saidi was an anatomy teacher, having earned honors in the   intercalated Bachelor of Science in Human Anatomy course of the University of Nairobi.  He introduced to us the concept of surgical anatomy during our  residency, making  the residents understand why they  had to learn anatomy as surgeons  and what difference that would make to a surgeon. So, one would say, looking at the Halsteadian model, Professor Saidi made  the mark in helping residents and medical students understand the basis of not only disease but of not only disease but how anatomy would help the surgeon manage them. In those years of learning basic sciences, he  also nurtured the whole idea of critical thinking through journal club that was a weekly conference  where linkages would  be made  between anatomy and surgery and residents would begin thinking of  topics to  research on  during the clinical years.  He provided leadership in this by ensuring he is available every Friday, and he ensured every published paper is displayed to encourage his staff and resident to publish.  So  in these  early years,  the competency of medical knowledge  on basic anatomy,  and problem-based learning were developed under his leadership.Clinical Years While it is not mandatory for those teaching in the department of anatomy to teach in clinical areas, Professor Saidi had a schedule of weekly attendance to the clinic, ward rounds and operating room. Just before William Halsted came to John Hopkins to introduce the system of surgical training, William Osler had just introduced one of the key changes in medical education; initially student had no direct contact with patients, it is Sir William Osler who introduced the concept of clinical clerkship and incorporated clinical ward rounds in all his classes (3). Having worked with Professor Saidi in the same ward, he truly believed that clinical skills are honed by student interacting with patients, double checking with the textbooks, articles and peer teaching. When he was given a topic to teach medical students, he would change the whole issue to clinical rounds, at times late in the evening he would do ward round with medical students to emphasize the fact that they do not learn surgical skills through didactic tutorials. He was truly a believer in the Oslerian principle of clinical clerkship. For the residents, he would ask questions that help them think through. Most often the resident would not rush to answer his questions because they are well thought through. He would make the environment easy by laughing about his questions. I did a number of wards with him with the resident. That is where I learned the value of asking good questions as a teaching tool (4).

Professor Saidi was an available teacher. I remember he came to help perform Graham patch when I was in residency, he showed me how to perform haemorrhoidectomy and open lateral internal sphincterotomy. When called he would come. When I came back to teach, I joined his operating theatre list. Having known me through the years, he gradually left the operation list for me and appeared only when I was away or when laparoscopy was scheduled. He insisted in allowing student to operate as long as they have scrubbed with him, he has shown them the method, and they have demonstrated the ability. Our operation list always had resident operating as we watch unless they are new residents who we have not operated with and so we could not risk patient safety with them. Professor Saidi espoused the second and the third principle of the Halsteadian model of the need for repetitive exposure as well as giving of responsibility gradually to those who demonstrate that they have increasingly captured the simple skills to complex procedures.

Before being given administratively responsibilities, he was available for students to teach during the surgical outpatient clinics but this reduced with administrative responsibilities. Professor Saidi style