Introduction to Plastic Surgery

PLASTIC SURGERY CAREER PATHWAY

Dr S.Fatimah Noor Mat Johar

Plastic and reconstructive Surgeon Hospital USM

Introduction to Plastic Surgery

Plastic pathways

My journey

Qualities of aspiring surgeon

Q& A

INTRODUCTIONTo Plastic Surgery

INTERNATIONAL AND LOCAL HISTORY

What is Plastic ?

"About 47.3% of public's opinion and 67% healthcare professional thinks that Plastic Surgery is called "Plastic" because it uses Plastic in the surgery" - Perception of Plastic Surgery among healthcare professional and public in Hospital Kuala Lumpur, Dr Kasthuri Shamugam, USM Final Year Thesis-

Definition of Plastic

• The term ‘plastic’ surgery is derived from the Greek ‘plassein’ or ‘plastikos’. Thus, etymologically it is related to plastic art and consequently has inherited expressions associated with sculpture (to mold or give form).
• Specialized branch of surgery concerned with the repair of deformities and the correction of functional deficits

History

International history

Malaysia history

I. Ancient times II. The middle age III. Islamic conquest IV. The decline of the middle age V. Renaissance VI. Decline of plastic surgery VII. Rebirth of plastic surgery VIII. Golden age IX. World war I X. World war II XI. Evolution after world war II XII. Present

I. The first few plastic surgeonII. The first plastic surgery department & expansion III. The first plastic training programme IV. Birth of plastic societies

Father of Plastic Surgery

Sushruta Samhita

• Sushruta is considered the “Father of PlasticSurgery.” He lived in India sometime between 1000 and 800 BC
• He is notably famous for nasal reconstruction, which can be traced throughout the literature from his depiction within the Vedic period of Hindu medicine

Malaysian history

The first two surgeon

Dr V Sivaloganathan (1965) and Dr S Kandiah (1966)

The first PRS department (1974)

• Dr S. Kandiah and the next generation of plastic surgeon Dr Lal Kumar and Dr V Surendranathan at KL General Hospital
• Expansion of services to Terengganu, Sabah, Sarawak and Johor

Birth of local plastic surgery training program

• Prof Dr Ahmad Sukari Halim started Reconstructive Sciences Unit in USM back in 1996
• Together with Datuk Dr Ahmad Ridzwan Arshad the first plastic surgery training program was started back in 2001

Birth of plastic surgery societies

• Malaysian Association of Plastic, Aesthetic and Craniomaxillofacial Surgeons (MAPAC, 1984)
• Malaysian Society of Plastic and Reconstructive Surgery (MSPRS, 2012)

Plastic surgery world

Reconstructive

Aesthetic

• Congenital anomalies ( e.g Cleft lip and palate cases, microtia)
• Post traumatic deformities (e.g craniofacial trauma, vascular injuries, burn surgeries)
• Post oncological resection deformities (e.g breast reconstruction, soft tissue reconstruction of limb/face)

• Facial plastic surgery ( facelift, blepharoplasty, rhinoplasty)
• Body contouring ( tummy tuck, liposuction)
• Minimally invasive (botox, filler, lasers)

Plastic surgery pathways

Options of plastic surgery pathways

INTERNATIONAL

DIRECT

INDIRECT

Masters of Surgery in recognized centres: - UM, UKM, USM,UIA Followed by a minimum of 3 years of recognized training in Plastic & Reconstructive Surgery in Malaysia or overseas, and passed the Examination & Certification by the Malaysian Board of Plastic Surgery*

Fellow of the Royal College of Surgeons (General Surgery) of Eng/Edin/Glas/Ire/Canada Or Fellow of the Royal Australasian College of Surgeons (General Surgery) Followed by a minimum of 3 years of recognised training in Plastic & Reconstructive Surgery in Malaysia or overseas, & Certification by the Malaysian Board of Plastic Surgery*

Direct Pathway (4 years – max 7 years):

• Master of Surgery (Plastic Surgery), Universiti Sains Malaysia, Kelantan
• STPRS – Specialist Training in Plastic & Reconstructive Surgery, under MAPACS

Local, direct

International

General Surgery Fellow

Plastic Surgery Fellow

1. Fellow of the Royal College of Surgeons (General Surgery) of Eng/Edin/Glas/Ire/Canada Or Fellow of the Royal Australasian College of Surgeons (General Surgery) Followed by a minimum of 3 years of recognised training in Plastic & Reconstructive Surgery in Malaysia or overseas, & Certification by the Malaysian Board of Plastic Surgery*

2. No further requirements - Fellow of the Royal Australasian College of Surgeons (Plastic & Reconstructive Surgery) - Fellow of the Royal College of Surgeons (Intercollegiate Fellowship in Plastic Surgery, United Kingdom & Ireland) - Fellow of the Royal College of Surgeons (Plastic Surgery) from Royal College of Surgeon of England/Edinburgh/Glasgow/Ireland - Fellow of the Royal College of Surgeons of Canada (Plastic Surgery) - Diplomate American Board of Plastic & Reconstructive Surgery - Fellow, Academy of Medicine Singapore (Plastic Surgery) - Fellow, Academy of Medicine Hong Kong (Plastic Surgery)

Current hurdles in contract doctor

No Scholarship

- Fees RM6800/ semester - Total fees RM 54 400 ( 4 years)

Not eligible for full-paid study leave

Competition

- Too many doctors

Pandemic

- Being pulled to COVID centre

myJourney

The northern girl adventure

How I started

Plastic Surgery Masters programme application 2012

Persona of the PRS team duringa GWR gave me a good impression about the field

Housemanship 2009, HKLExposure to surgical field, handson suturing

Medical Officer 2011, Hosp Sulatanah Bahiyah, Surgery Department

My journey

Clinical rotation in HKLfor 2 years end of 2014 Handson: Cleft and lip surgery, local flaps, Thesis starting.

Final year clinical attachment at Alfred Hospital, Burn Unit and Breast Academy Australia

Accepted to masters programme2013, Kubang Kerian, Kelantan, HUSM Handson: T&S, skin grafting, assisting major cases

Registrarship inHUSM end of 2016, doing procedures independently AVF, pedicle flaps, raising flaps

My journey

2017, thesis accepted for oral presentation at European Burn Association, Barcelona

Passed final exam 2017, convocation 2018

2017, presented my thesis at MSPRS AGM won best paper.

2017, same thesispresented at Australian Plastic Surgery Congress, represented by another plastic surgeon Miss Fatimah M.N

My journey

Microsurgerytraining with Prof Jeong Tae Kim in HUSM, 2019

To date - still learning

Gazettement in USM, 2018Handson: AVF, finger replants, vascular injury, flaps , flap salvage

Fellowship in Tokyo2020

qualitiesof an aspiring surgeon

To our future surgeons

Preseverence

Support

Attitude

• Studying, learning new things,
• Working long hours
• Executing research

• Family support (parents, spouse)
• House chores support (e.g Maid/nanny)
• Financial support/ savings

• Able to work as a team
• Professional
• Honest and sincere
• Empathy
• Open minded

The 10 commandments

Any questions ?

Thank you

IG: surgeonwhobakes

fatimahmj@usm.my

Unit Sains Rekonstruktif, PPSP, Kampus Kesihatan, 16150, Kubang Kerian, Kelantan