26 mai 2019

Beneficiile stagiilor in strainatate



In acest video o mica discutie despre avantajele de a merge in strainatate pentru un stagiu: 


Si varianta text a acestei postari: 

De ce cred ca a face un stagiu in strainatate este foarte important?

  1. Te maturizeaza ca om, te invata sa te descurci singur, sa nu depinzi mereu de ajutorul altora, sa  rezolvi probleme singur - sa iti gasesti cazare, sa iti faci abonamente, sa iti deschizi conturi bancare etc.
  2. Te face mai adaptabil - cunosti alte culturi, lucrezi cu alti oameni, vezi pacienti din toata lumea, traditii diferite.
  3. Vezi cum se face medicina in alta tara - pentru ca desi medicina e similara peste tot, modul in care se aplica cunostiintele e diferit
  4. Este o provocare - o alta limba, alta cultura, alt mod de lucru, alt program, alte roluri in spital pentru membrii echipei
  5. Primele luni suferi, e greu sa te adaptezi, dar cand reusesti, si inevitabil reusesti daca iti dai interesul - capeti incredere.
  6. Nu neaparat vei simti ca inveti ceva precis, greu sa spui exact ce ai invatat - dar absorbi in fiecare zi cunostiinte care vor deveni reflexe
  7. Ai acces la tehnologii medicale noi, vezi in practica ceea ce citesti in carti
  8. Intelegi, daca nu stiai deja, cat de important este sa vorbesti frumos cu pacientii, sa explici mai atent (totul in alta limba)
  9. De regula ai mult mai multa independenta - prescrii mai multe tratamente, lumea se asteapta sa faci mai multe proceduri singur - asa capeti experienta, incredere
  10. Te provoci pana afli care iti sunt limitele - afli cat de putin stiai de fapt, cat de mult faceai unele lucruri prost acasa
  11. Devii un medic mai bun
  12. Inveti sa socializezi cu oameni din diferite culturi
  13. Cunosti oameni veniti de peste tot din lume, din tari de unde nu te gandeai vreodata ca vei intalni pe cineva
  14. Afli la sfarsit ca oamenii sunt exact la fel - indiferent de unde provin - la baza sunt exact la fel. Cam aceleasi lucuri ii bucura sau ii intristeaza. Daca aveai vreo umbra de rasism in tine, se pierde
  15. Pe de alta parte - intelegi ca peste tot in lume exista probleme - diferite decat acasa, dar exista.
  16. Nici un sistem medical nu este perfect - vei aprecia ca unele lucruri sunt mai bine facute in Romania decat in Franta, Anglia, Germania. Pe de alta parte vei intelege ce anume poate fi imbunatatit acasa. Si cand te intorci vei avea cu totul alta viziune.

Cred ca fiecare medic la inceput de cariera ar trebui sa se gandeasca sa faca macar un stagiu de 6 luni intr-o alta tara. Este simplu de plecat in Europa, de multe ori doar trebuie sa stii o limba destul de bine. Nu iti trebuie relatii, cunostiinte. Poti gasi singur un stagiu potrivit pentru tine si sa te duci cu curaj. Te vei intoarce mai bine pregatit.

Nu cred asa de mult in chestia asta cu "pleaca medicii, trebuie sa oprim asta". E firesc, e parte din educatia medicala sa vezi cum lucreaza colegii din alte tari. Nu e o drama, e un mare castig. Pentru ca majoritatea medicilor vor sa se intoarca acasa.

Am mare incredere ca in momentul in care medicii vor incepe sa se intoarca unul cate unul, unde se vor intoarce vor "sfinti locul". Vor aduce concepte noi, vor face lucrurile mai bine. Sunt foarte optimist ca in cativa ani sistemul de sanatate din Romania se va transforma radical, poate va deveni unul dintre cele mai bune din Europa, tocmai pentru ca atat de multi medici au plecat sa se pregateasca in alte tari. 

Suna utopic? Poate, dar sunt atat de multi doctori care capata experienta in diverse sisteme medicale performante incat se vor intoarce foarte bine pregatiti. Vor sti foarte bine ce trebuie schimbat, ce este eficient, ce functioneaza, ce trebuie sa fie pastrat.

Nu toate aspectele medicinei din Romania trebuie schimbate. Nu trebuie sa copiem alte sisteme medicale, trebuie doar sa completam golurile care exista. Si asta se va intampla cu siguranta in anii care vor urma.

03 septembrie 2014

Neonatologie


Neurologie


Obstetrica si ginecologie


Oftalmologie


Oncologie medicala


Ortopedie si traumatologie


Otorinolaringologie - ORL


Pediatrie


Radioterapie


Recuperare, medicina fizica si balneologie


Reumatologie


15 noiembrie 2013

Pneumologie


Concluzii dupa aproape 2 ani de la alegerea acestei specialitati:

Pro (de ce sa faci Pneumologie?):
  • Este una dintre cele mai diverse specialitati: boli infectioase (gripa, TBC), oncologie toracica, medicina somnului, boli respiratorii cronice (astm bronsic, BPOC), alergii respiratorii, boli profesionale, boli autoimune si colagenoze cu implicare pulmonara, tehnici interventionale (bronhoscopie diagnostica, bronhoscopie interventionala, toracoscopie), terapie intensiva, ventilatie mecanica, ventilatie noninvaziva in spital si la domiciliu, tuberculoza (care poate afecta orice organ) cu implicatii sociale si de sanatate publica multiple, implicare pulmonara in infectia HIV, hipertensiunea pulmonara, fibroza chistica, consilierea anti-fumat etc.
  • Ingrijirea pacientului cu transplant pulmonar
  • Oportunitatea de a diagnostica afectiuni complexe pornind de la o simptomatologie nespecifica, putin deranjanta
  • Este o specialitate foarte interventionala, situata undeva intre medicina interna, terapia intensiva si chirurgia toracica
  • Anumite ramuri ale pneumologiei sunt in plina dezvoltare in lume si in special in Romania: bronhoscopia interventionala, explorari functionale respiratorii complexe devin tot mai accesibile (TLCO, pletismografie), medicina somnului (apneea in somn foarte subdiagnosticata), noi tratamente pentru bolile respiratorii cronice (combinatii diferite de bronhodilatatoare, terapii moleculare)
  • Pacienti cu povesti de viata extraordinare, o medicina "sociala"
  • Medicina axata pe imbunatatirea calitatii vietii, satisfactii mari sa il ajuti pe un om sa respire normal
  • Orice pneumolog iesit din rezidentiat va avea o serie de abilitati practice extrem de cautate: bronhoscopie, explorari functionale respiratorii, ventilatie non-invaziva, toracocenteza etc.
  • Multiple oportunitati de cercetare deoarece multe lucruri inca nu sunt bine definite in pneumologie
  • In general spor 100% la salariul de baza
  • Nevoie mare de specialisti penumologi pentru tratamentul adecvat al patologiei respiratorii cronice (tratament care s-a modificat radical in ultimii ani, cu imbunatatirea semnificativa rezultatelor clinice)
  • Locuri de munca diverse - centre universitare, spitale judetene, ambulatoriu de specialitate, sanatorii in munti etc.

Contra:
  • Trebuie sa ai toleranta pentru anumite produse patologice (sputa)
  • Risc de infectii severe, dar care poate fi redus prin aplicarea riguroasa a metodelor de protectie (masca cu filtru, antiseptizarea mainilor etc.)
  • Prejudecati - pneumologia nu aduce multa faima, lumea are tendinta sa judece alegerea acestei specialitati (prieteni, membri ai familiei probabil vor zice "daca asta iti place tie…" in loc de "bravo/super tare"). Multi colegi medici nu inteleg valoarea acestei specialitati deoarece au fost putin expusi in facultate la oportunitatile din domeniu. Gandeste-te ca pentru a cunoaste si trata in mod competent afectiuni atat de diverse precum cele intalnite in pneumologie, trebuie sa stii extrem de multa medicina. Poti ajuta foarte mult!
  • Unii pacienti au probleme sociale complexe. Acest lucru poate fi o oportunitate sa devii un medic mai bun, care rezolva situatii cu adevarat dificile.
  • Unii pacienti nu mai pot fi salvati orice ai face...
Eu personal nu m-as vedea facand alta specialitate. Mult succes la examenul de rezidentiat si repartitie!

Traseu curricular
Pathway Evaluation Program - Pulmonary/Critical Care Medicine

01 decembrie 2012

Chirurgie vasculara



Dupa Curriculum de pregatire in specialitatea Chirurgie vasculara:

Chirurgia vasculară este specialitatea chirurgicală care se ocupă cu diagnosticul şi tratamentul chirurgical al bolilor vasculare arteriale, venoase şi limfatice.

- Durata de pregatire: 5 ani

Dupa Pathway Evaluation Program:

Vascular surgery is a subspecialty within general surgery that addresses the diagnosis and treatment of diseases of the vascular tree, including arteries, veins, and lymphatic vessels, exclusive of those within the cranial cavity and the heart.  The principle diseases treated involve those affecting the carotid arteries, the aorta, and those supplying the blood supply to the lower extremities, the kidneys, and the abdominal viscera. Common procedures performed include carotid endarterectomy, repair of abdominal aortic aneurysm, and revascularization of the lower extremities. 

Specialists in this discipline are also experts in performing and interpreting diagnostic studies including ultrasound and angiography. Currently the subspecialty emphasizes minimally invasive treatment, including endovascular treatment for abdominal aortic aneurysm and for relief of obstruction of blood flow to organs and tissues by means of angioplasty and deployment of intravascular stents. 

Five types of illnesses/conditions most frequently encountered:

Peripheral vascular disease
Abdominal aortic aneurysms
Carotid disease
Venous disease/insufficiency
Dialysis access


Dupa Society for Vascular Surgery - VascularWeb.org

A Career of Innovation

Vascular surgery offers versatility and stimulation to medical professionals. These health care professionals master the intricacies of vascular surgery as well as state-of-the-art endovascular techniques. In addition, vascular surgeons build long-term relationships with patients and their families as a primary physician for all vascular needs: medical and diagnostic, endovascular and traditional surgery.

Intricate and demanding, vascular surgery is not “one-size-fits-all” surgery. Each patient presents an individual vascular problem requiring a unique solution. Vascular surgeons train to respond with various modalities:

  • Open surgical procedures
  • Endovascular procedures
  • Even medical therapies

Minimally invasive, percutaneous procedures are advancing rapidly and have revolutionized the ease at which outcomes are obtained for patients as well as offering the opportunity to continuously hone vascular surgery skills. The interventions may be limb or life saving. Vascular surgeons are charged with treating the complete patient.

Now more than ever, the choice to become a vascular surgeon fulfills an acutely growing need created by the aging population in the United States and beyond.  Talented, dedicated, skilled vascular surgeons will be needed to meet this urgent need.

Your Family, Patients, Career

Balance is a word heard all through college and medical school. There is a great deal to be gained by creating that balance in life. Colleagues will state that vascular surgery is one of the few medical specialties that allow for balance in life.

Personal relationships and family are paramount in the lives of vascular surgeons. One female vascular surgeon at a major medical center found her career flexible enough to arrange her schedule to work part-time to accommodate the need to care for her newborn. In the 21st Century, a career in vascular surgery allows for focus on family and home life as well as patients and their lives.

Research Opportunities - Infinite, Diverse, and Exciting

Vascular research runs the gamut from basic science cellular research, engineering/graft and stent development, diagnostic advances to clinical and medical management of vascular diseases. Research is not only done by full-time academic surgeons but also by private practitioners excited by the potential changes in the field.

Link-uri interesante:


Video-uri interesante:




Mult succes!!




26 noiembrie 2012

Chirurgie toracica



Dupa curriculum de pregatire in specialitatea Chirurgie Toracica:

Chirurgia toracică este ramura chirurgicală ce se ocupă cu diagnosticul şi tratamentul operator al afecţiunilorperetelui toracic şi pleurei, traheobronhopulmonare, mediastinului, pericardului, esofagului, diafragmului, precum şi ale graniţelor cervico-toracică şi toracoabdominală.

Durata de pregatire: 5 ani

Dupa Pathway Evaluation Program:

nota: In SUA, chirurgia cardiovasculara si chirurgia toracica sunt grupate in Cardiothoracic surgery sau doar Thoracic surgery, chirurgii supraspecializandu-se fie pe chestiuni cardiace sau pulmonare/legate de peretele toracic. La noi se merge direct pe una dintre cele doua filiere: Chirurgie cardiovasculara sau Chirurgie toracica.

Asadar:

Thoracic surgery, also known as cardiothoracic surgery and cardiovascular and thoracic surgery, encompasses all types of surgery within the chest cavity, which includes the heart, lungs and esophagus.  Thoracic surgeons are concerned with the operative, perioperative, and critical care of patients with pathologic conditions of the chest.  

Surgeons in this subspecialty often focus on certain organs and procedures within the chest cavity. A general thoracic surgeon treats emphysema; tumors of the lung, esophagus, chest wall, and mediastinum; swallowing problems and gastroesophageal reflux; abnormalities of the trachea; and diseases of the diaphragm. A congenital heart surgeon performs surgical corrections of heart defects and furnishes cardiovascular support to infants and children. Any of these subspecialists may perform heart, lung, and combined heart-lung transplantations. A cardiac surgeon deals primarily with the surgical management of diseases of the blood supply to the heart, the heart valves, and the arteries and veins in the chest. 


Les affections traitées par la chirurgie thoracique concernent:
  • les affections chirurgicales de la paroi thoracique
  • les affections chirurgicales des plèvres et de la cavité pleurale
    • Les épanchements pleuraux bénins et malins
    • Les infections pleurales et le pyothorax
    • Le pneumothorax en chirurgie thoracique
    • Le canal thoracique et le chylothorax
    • Le mésothéliome en chirurgie thoracique
    • Les techniques chirurgicales spécifiques à la cavité pleurale
  • les affections chirurgicales du parenchyme pulmonaire, des bronches et de la trachée
  • les affections chirurgicales du médiastin (à l'exception du cœur, qui fait l'objet d'une branche particulière de la chirurgie)
Par ailleurs, la chirurgie de l'œsophage concerne essentiellement les chirurgiens digestifs.

Link-uri interesante:
Recomand in primul rand site-ul CTSnet.org (CardioThoracic Surgery Network). Aici gasiti foarte multe articole legate de Chirurgie toracica dar si video-uri interesante din timpul operatiilor etc. 

Video-uri interesante:




02 noiembrie 2012

Chirurgie plastica - microchirurgie reconstructiva



Dupa Curriculum de pregatire in specialitatea Chirurgie plastica-microchirurgie reconstructiva:

Specialitatea care se ocupă cu diagnosticul şi tratamentul chirurgical al arsurilor, electrocuţiilor, traumatismelor însoţite de distrugeri de părţi moi, ale mâinilor traumatizate (leziuni tegumentare, scheletice, tendinoase, vasculo-nervoase), al tumorilor de suprafaţă, al malformaţiilor congenitale şi al unor suferinţe estetice. Este o specialitate interdisciplinară ce se ocupă cu repararea diformităţilor, corectarea deficienţelor funcţionale  şi modificarea aparenţelor. Chirurgia plastică restaurează şi ameliorează forma în scopul obţinerii unei îmbunătăţiri a aspectului  şi aproprierii de cel normal. Chirurgia plastică foloseşte în afara tehnicilor chirurgicale nespecializate  şi tehnici caracteristice (transferare  şi transplantare tisulară), dintre care unele microchirurgicale.

Durata de pregatire: 5 ani

Dupa Pathway Evaluation Program:

Plastic surgery deals with the repair, reconstruction, or replacement of physical defects of form or function involving the skin, musculoskeletal system, head and facial structures, hand, extremities, breasts and trunk. The specialty encompasses both cosmetic and reconstructive surgery. Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. 

A foundation in surgical anatomy, physiology and pathology is fundamental to this specialty.  Plastic surgeons need to have surgical knowledge, surgical judgment, technical expertise, ethics, the ability to think in three dimensions, good aesthetic sense, creativity, and appreciation for detail. Subspecialty certifications include craniofacial surgery and surgery of the hand.

Dupa The Ultimate Guide to Choosing a Medical Specialty:

No other surgical specialist draws on a wider base of anatomic knowledge or operates in more regions of the body than does plastic surgeon. The field has developed from the efforts and contributions of people from many different backgrounds, including general surgery, orthopedics, oral and maxillofacial surgery, and otolaryngology.

Plastic surgery encompasses all of aesthetic surgery, yet it also deals with clinical entities that are often considered grotesque, including chronic wounds, limb replantation, and head and neck reconstruction. It is considered a surgical subspecialty, yet the fund of knowledge needed for even a basic understanding of the discipline requires a five- to eight-volume text.

The breadth of anatomy seen within a typical week (or even within a single day) often includes the head, neck, chest, abdomen, lower and upper extremities, breast, and hand. Some may view this as a liability. Most plastic surgeons, however, welcome the variety and tend to become bored if repeatedly faced with the same types of clinical problems. They enjoy the beauty of anatomy, especially that of the more intricate regions, such as the hand and face.

Some plastic surgeons say they find their work particularly rewarding because the results are often so visible. For example, after a cleft lip repair, the surgeon’s efforts are seen repeatedly for the next 70 years or more. Seeing a parent smile after their child’s cleft lip has been repaired is one of the most fulfilling experiences in all of surgery and medicine. Likewise, when a patient awakes
upon replantation of a severed limb (or scalp, ear, nose, or even penis) and sees the successfully reattached part, it reaffirms the plastic surgeon’s choice of a career.

Physician–patient relationships in plastic surgery can be quite lengthy and involved. Most plastic surgeons find these relationships in particular to be quite rewarding. For example, in the case of congenital deformities, patients often require 10 or more operations prior to reaching adulthood.

Plastic surgery can be physically demanding. Some operations are lengthy or technically challenging. Most plastic surgeons have participated in operations that lasted more than 24 hours. Some have said that microsurgery, in particular, is a young surgeon’s sport. Not only can these procedures be long, but the anastomosis of small vessels can sometimes be quite challenging.

  • Aesthetic Surgery

Common aesthetic procedures performed by plastic surgeons include rhinoplasty (reshaping of the nose), facelift, aesthetic eyelid surgery, laser skin resurfacing, Botulinum toxin injection, breast augmentation, liposuction, and body lifts.

The field of cosmetic surgery is unique among surgical disciplines. First, aesthetic operations are performed on an elective basis for no truly functional purpose (although it has been argued that the
function of the face, for example, is to look good). In other words, patients are subjected to the risks of anesthesia and surgery despite their being physiologically healthy. These patients can suffer all types of complications that are possible with other types of surgery, including nerve damage, hematomas, infections, skin loss, significant scarring, myocardial infarctions, cerebrovascular accidents, and even death. The aesthetic surgeon must be comfortable knowing that these adverse events will doubtless occur at some point despite even the most careful patient selection, perfect surgical technique, and smooth anesthesia.

Honest two-way communication is essential to be sure that patients’ aesthetic expectations are realistic.

For those with artistic abilities, aesthetic surgery offers a means of sculpting the human body into living art. Patients with facial aging can often be made to look literally decades younger and more energetic.

  • Burn Surgery

Burn surgeons treat patients with thermal injury, chemical injury, and cold-related injury. Plastic surgeons often focus on burn reconstruction rather than acute burn care. The care of these patients can be quite challenging and highly rewarding. Much of burn reconstruction requires bread and butter plastic surgery, such as local flaps, skin grafts, and tissue expansion. However, many cases require multiple stages, strategic planning, and advanced techniques.

  • Craniofacial Surgery

Craniofacial surgeons treat diseases of the bones and soft tissues of the face and skull. They often work with children, treating such conditions as craniosynostosis (premature fusion of the sutures of the skull), cleft palate, hemifacial microsomia (delayed growth of one side of the face), and conditions such as Apert, Crouzon, Treacher-Collins, and Pfeiffer syndromes. They can also work with
adults, treating patients with untreated congenital anomalies, craniofacial trauma, and tumors of the skull base, as well as orthognathic deformities.

  • Hand and Upper Extremity Surgery

Hand surgeons treat a variety of conditions of the hand and upper extremity, including fractures, tendon lacerations, traumatic amputations/devascularizations, rheumatoid arthritis, nerve entrapment syndromes, tumors, and congenital anomalies. In a single day, a hand surgeon may perform a replantation from an industrial accident, see a newborn with complete syndactyly, and perform implant arthroplasties to restore function in a patient with rheumatoid arthritis. Restoring pain-free function is the top priority in hand surgery. Cosmesis is also a secondary goal once pain and function have been addressed.

  • Microvascular Surgery

Microsurgeons are trained to manipulate tissues by creating microvascular anastomoses and microneural coaptations. They can, for example, replant a severed extremity by locating and repairing the vessels and nerves under the operating microscope. Microsurgical techniques are also used to perform free tissue transfers (free flaps). For example, if a woman has a mastectomy for cancer and desires an autologous (from her own tissue) reconstruction, then an excellent option 
is the transverse rectus abdominis musculocutaneous (TRAM) flap reconstruction, in which muscle, skin, and fat are removed from the abdomen and placed on the chest wall to reconstruct the breast. Similarly, in cases of congenital facial paralysis, the gracilis muscle can be transferred to the face to make facial expression possible.

  • Pediatric Plastic Surgery

Conditions treated by pediatric plastic surgeons include craniofacial anomalies (if they have also pursued craniofacial training), cleft lip and palate, velopharyngeal insufficiency (nasal speech), separation of conjoined twins, congenital anomalies affecting the face, hands and upper extremities,
trunk, and chest wall, and vascular anomalies including hemangiomas and vascular malformations. In addition, pediatric plastic surgery encompasses pediatric burn reconstruction, soft tissue tumors, and traumatic reconstruction, particularly of the face, hands and lower extremity.

WHAT MAKES A GOOD PLASTIC SURGEON?
  • Prefers working with his or her hands.
  • Enjoys trying new approaches to the same problem.
  • Is an independent and creative thinker.
  • Likes seeing the immediate results of treatment.
  • Is a perfectionist who pays close attention to details.

Link-uri utile:


Video-uri interesante:





Mult succes!!

30 octombrie 2012

Chirurgie pediatrica



Dupa Curriculum de pregatire in specialitatea Chirurgie pediatrica:

Chirurgia pediatrică este specialitatea, care are ca obiect de studiu patologia chirurgicală a vârstei copilăriei (0 – 16 ani sau elevi ce au depăşit vârsta de 16 ani, până la terminarea studiilor), cu excepţia patologiei ortopedice, neurochirurgicale şi cardiovasculare a copilului.

Durata de pregatire: 5 ani

Dupa Pathway Evaluation Program:

Pediatric surgery focuses on providing surgical care for all problems or conditions affecting children that require surgical intervention. Pediatric surgeons are involved with diagnosis, preoperative, operative and postoperative management of surgical problems in children, and they operate on children whose development ranges from the newborn stage through the teenage years. They cooperate with those physicians involved in a child's medical care—neonatologists, pediatricians, and family physicians—to determine whether surgery is the best option for the child. 

Areas of specialization within pediatric surgery include neonatal surgery (surgical repair of birth defects), pediatric oncology (diagnosis and surgical care of children with malignant tumors and benign growths), and trauma (critical care medicine that may or may not require surgical intervention). Many pediatric surgeons are involved accident prevention programs in their communities that are aimed at curbing traumatic injuries in children. A new forefront in pediatric surgery is prenatal diagnosis and surgery (although application of most fetal surgical techniques remain in the experimental stage). 

Five types of illnesses / conditions most frequently encountered: Hernias, Congenital deformities, Appendicitis, Bowel problems, Need for venous access.

Dupa The Ultimate Guide to Choosing a Medical Specialty:

Do you enjoy working with kids? Although it is considered a subspecialty, pediatric surgery stays true to its general surgery roots because you perform operations on entire body regions: abdomen, chest, extremities, and more. 

Pediatric surgeons deal with the complex surgical problems, and their unique physiology, of kids of all ages, ranging from tiny premature newborns to maturing teenagers. Whether the problem involves a hypertrophic pyloric sphincter or a ruptured spleen, pediatric surgery is delicate, precise, and challenging. Some operations, such as the separation of conjoined twins, can be quite dramatic and life saving. 

Because accidents are the leading cause of death among children, pediatric surgeons deal with quite a bit of trauma in their work. Today, fetal surgery—surgically correcting congenital anomalies in a growing fetus—has become the hot area of this field. Pediatric surgeons naturally have to be quite adept at handling frightened children and their anxious parents.

Dupa Online Guide to Choosing A Surgical Residency (American College of Surgeons):

Pediatric surgeons are primarily concerned with the diagnosis, preoperative, operative, and postoperative management of surgical problems in children and they operate on children whose development ranges from the newborn stage through the teenage years. 

Some medical conditions in newborns are not compatible with a good quality of life unless these problems are corrected surgically. These conditions must be recognized immediately by neonatologists, pediatricians, and family physicians. Pediatric surgeons cooperate with all of the specialists involved in a child's medical care to determine whether surgery is the best option for the child.

Pediatric surgery focuses on providing surgical care for all problems or conditions affecting children that require surgical intervention. They may also have particular expertise in the following areas of responsibility: 

Neonatal 
Pediatric surgeons have specialized knowledge in the surgical repair of birth defects, some of which may be life threatening to premature and full-term infants. 

Prenatal 
In cooperation with radiologists, pediatric surgeons use ultrasound and other technologies during the fetal stage of a child's development to detect any abnormalities. They can then plan corrective surgery and educated and get to now parents before their baby is born. In addition, prenatal diagnosis may lead to fetal surgery, which is a new forefront in the subspecialty of pediatric surgery. Application of most fetal surgical techniques is still in the experimental stage. 

Trauma 
Because trauma is the number one killer of children in the United States, pediatric surgeons are routinely faced with critical care situations involving traumatic injuries sustained by children that may or may not require surgical intervention. Many pediatric surgeons are involved accident prevention programs in their communities that are aimed at curbing traumatic injuries in children. 

Pediatric Oncology 
Pediatric surgeons are involved in the diagnosis and surgical care of children with malignant tumors as well as those with benign growths.

Link-uri utile:

Online Guide to Choosing A Surgical Residency (American College of Surgeons)
Pathway Evaluation Program - Specialty Profile - Pediatric Surgery
Curriculum de pregatire in specialitatea Chirurgie Pediatrica
Leading symptoms in pediatric surgery - An instructional program for undergraduate and postgraduate study in medicine of the Institute for Medical Education (IML) and the university clinic for pediatric surgery of the Inselspital, Bern.

Video-uri utile:










Mult succes!!


29 octombrie 2012

Chirurgie orala si maxilo-faciala



Dupa Curriculum de pregatire in specialitatea Chirurgie orala si maxilo-faciala:

Chirurgia orală şi maxilo-facială cuprinde tratamentul chirurgical al părţilor moi cervico-faciale, al oaselor craniului visceral, al  glandelor salivare, articulaţiei temporomandibulare, diformităţilor  şi malformaţiilor cranio-faciale, plastia reconstructivă în sfera orală şi maxilo-facială şi tratamentul chirurgical al afecţiunilor dento-parodontale. 

Specialitatea cuprinde 2 părţi: 

a.  chirurgia orală, care se preocupă de studiul, prevenirea şi tratamentul chirurgical al afecţiunilor dento-parodontale: 
  • chirurgia endodontică
  • chirurgia preprotetică
  • accidente de erupţie ale dinţilor şi incluziile dentare 
  • traumatisme dento-parodontale 
  • chirurgia parodontală
  • inserarea implanturilor dentare 
b.  chirurgia maxilo-facială, care cuprinde patologia  şi tratamentul chirurgical al traumatismelor maxilo-mandibulare şi ale părţilor moi cervico-faciale, infecţii oro-maxilofaciale, tumori benigne ale părţilor moi şi osoase oro-maxilo-faciale, tumori maligne ale părţilor moi şi osoase oro-maxilo-faciale, bolile glandelor salivare şi ale articulaţiei temporomandibulare, diformităţi şi malformaţii congenitale ale feţei şi maxilarelor, durerea în sfera oro-maxilo-facială, plastia reconstructivă după defecte oro-maxilo-faciale etc.

Durata de pregatire: 5 ani (cu dubla licenta Medicina Generala/Medicina Dentara)

În conformitate cu recomandările organismelor de specialitate ale Comunităţii Europene, specialiştii în chirurgia orală şi maxilo-facială trebuie să posede o dublă licenţă, cea de absolvent al Facultăţii de Medicină Dentară şi de absolvent al Facultăţii de Medicină Generală.  

În acest context, pot fi acceptaţi la specializare în chirurgia orală şi maxilo-facială absolvenţi ai Facultăţii de Medicină Dentară (care îşi completează studiile de Medicină Generală) şi absolvenţi ai Facultăţii de Medicină (care îşi completează studiile de medicină dentară).


What is Oral and Maxillofacial Surgery?

Oral-Maxillofacial Surgery is a surgical specialty which involves the diagnosis, surgery and adjunctive treatment of diseases, injuries and defects involving both the functional and aesthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

More simply put, the oral and maxillofacial surgeon is the orthopedic surgeon of the facial region. He or she is an individual who addresses problems ranging from the removal of impacted teeth to the repair of facial trauma.

What are some reasons to visit an Oral-Maxillofacial Surgeon?
  • Have teeth replaced by having dental implants inserted;
  • Have oral surgical procedures performed in the office under outpatient  ambulatory anesthesia;
  • Have a jaw, oral, or facial cyst or tumor diagnosed, removed and reconstructed;
  • Have your jaw aligned with orthognathic surgery;
  • Have your jaw joint(s) repaired with TMJ surgery;
  • Have facial and jaw reconstruction following cancer surgery;
  • Have your facial bones realigned after facial trauma;
  • Have a consultation to determine whether you are a candidate for aesthetic surgery;
  • Have a tooth extracted.



Their extensive education and training, surgical expertise and unparalleled understanding of esthetics and function uniquely qualify them to treat the conditions, defects, injuries and esthetic aspects of the mouth, teeth, jaws and face. Patients who complain of pain or problems in this area are routinely referred to an oral and maxillofacial surgeon for help.

Oral and maxillofacial surgeons are well-prepared to:

  • Manage diseases of the teeth and their supporting soft and hard tissues;
  • Surgically reconstruct inadequate bone structure in the jaw area;
  • Evaluate, plan a course of treatment and place dental implants to replace one, two or a mouthful of missing teeth;
  • Expertly treat head and neck trauma and injuries to the face, jaws, mouth and teeth;
  • Diagnose and treat facial pain;
  • Diagnose and treat oral cancer and other diseases in the maxillofacial region;
  • Perform corrective jaw surgery to improve the function and appearance of patients with such conditions as cleft lip and palate and other congenital defects;
  • Diagnose and surgically treat obstructive sleep apnea;
  • Perform facial cosmetic procedures to enhance facial appearance and function.

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Mult succes!!


28 octombrie 2012

Chirurgie generala



Dupa Curriculum de pregatire in specialitatea Chirurgie generala:

Chirurgia generală este specialitatea ce se ocupă cu diagnosticul  şi tratamentul afecţiunilor chirurgicale ale abdomenului precum  şi a altor afecţiuni chirurgicale care fac obiectul altor specialităţi, ce necesită tehnici speciale cum ar fi traumatisme, afecţiuni vasculare, genitale, urologice, toracice, endocrine, neurochirurgicale, chirurgie oncologică etc.

Durata de pregatire: 6 ani

Dupa Pathway Evaluation Program:

General Surgery is a discipline of surgery having a central core of knowledge common to all surgical specialties—anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care, and neoplasia. General surgeons are trained to manage a broad spectrum of diseases and injuries affecting almost any area of the body that requires surgical intervention.  These physicians are involved in diagnosis, preoperative, operative and postoperative care of the surgical patient, and they are trained to provide comprehensive management of trauma and complete care of critically ill patients with underlying surgical conditions. Although its scope is broad, general surgery usually involves the abdomen, breasts, peripheral vasculature, skin and neck. 

Today’s general surgeons rarely perform neurologic, orthopaedic, thoracic, or urologic procedures, but they should be familiar with other surgical specialties to know when to refer a patient to another specialist. They should possess excellent manual dexterity and make decisions quickly and decisively.  

Common conditions encountered: Breast disease, Gall bladder disease, Hernias, GI cancer, Acute abdomen/appendicitis.

Dupa The Ultimate Guide to Choosing a Medical Specialty:


Surgeons save lives and heal the sick with their own hands. Surgery is the ultimate curative therapy for many patients and is an essential part of modern medicine. It is a career of constant excitement, high energy, quick decisions, and intellectual stimulation. No day is the same as the one before, and you learn to expect the unexpected. It is extremely gratifying to see the immediate results of your actions: the changes you make in your patients’ anatomy and in the quality of their lives.


General surgery primarily encompasses diseases of the abdominal organs, breast, skin, and endocrine glands.

Surgeons are also knowledgeable in many aspects of critical care, such as manipulating ventilator settings and adjusting powerful blood pressure medications. Many patients undergoing complicated operations are still sick and unstable after leaving the operating room, requiring extensive management in the surgical intensive care unit (SICU).

They treat diseases of the entire body that may or may not require surgical intervention. Some common examples include appendicitis, cholecystitis, pancreatitis, bowel obstruction, peri-anal abscesses, and a myriad of cancers. The diversity of general surgery extends past the strictly surgical into endocrine issues (thyroid, parathyroid, and adrenal disorders) as well as the complications of diabetes (leg ulcers, peripheral vascular disease). Obesity, an epidemic sweeping across the US population, has also become the realm of the surgeon, with stomach stapling and gastric bypass procedures receiving a remarkable amount of media attention. Although the basic principles of surgery have not changed in over a century, the field continues to develop, as highlighted by the introduction of innumerable elegant and ingenious laparoscopic procedures over the past decade. The most avant garde frontier is robotic surgery, which is now gaining momentum in both the pediatric and adult populations. These new and evolving aspects give aspiring surgeons the opportunity use their ingenuity to expand medical horizons.

Knowing the entire anatomy of the human body inside and out is absolutely essential, especially when many patients may have a normal anatomic variant. For instance, a routine gallbladder removal (cholecystectomy) can easily become quite complicated.

The practice of surgery takes a team approach. Although the surgeon performs the procedure itself, they are never alone in the care of the patient.

When choosing a specialty, medical students who dislike the idea of having to wait weeks to months to see if a pharmacologic treatment works gravitate toward the fast-paced surgical specialties, where you can see the results of your efforts right away.


WHAT MAKES A GOOD
SURGEON?
  • Has excellent hand-eye coordination and manual dexterity.
  •  Can think quickly and act decisively.
  • Enjoys mastering new technology.
  • Demands the highest level of perfection.
  • Is an energetic, dedicated, and compassionate physician.
Patients are entrusting their welfare and their lives to your clinical judgment and technical skill. They are apprehensive about undergoing even simple operations like removing an obstructed gallbladder or an inflamed appendix. It is a daunting, frightening experience to allow another person to cut them open and manipulate their internal organs. At this point, patients are unable to answer questions,  express their wants or beliefs, or provide any input regarding their care. A good surgeon takes time to reassure the patient before operating. As a surgeon, you have to convey that you will act in your patient’s best interest and stand by  your word.

The lifestyle of a surgeon—whether a resident, fellow, or attending—is infamous. Before heading off to a full day in the operating room, surgeons have to round on their pre- and postoperative patients quite early in the morning. There is no argument that surgical training is indeed quite rigorous, perhaps the most time consuming and physically draining of all specialties in medicine. 

Students who love a fast pace and high energy will thrive in this field.

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Mult succes!!