講演情報
[ESY3-5]Challenges and Training in Colorectal Surgery in Thailand
Siripong Sirikurnpiboon (Colorectal Division, General Surgery, Department Rajvithi Hospital)
The field of colorectal surgery in Thailand has advanced significantly over the past decade, aligning more closely with international standards. However, it continues to face a unique set of challenges in both training and clinical practice, shaped by the country's healthcare infrastructure and resource distribution.
1. Training Pathway: A Structured Approach
・ Foundation: After medical school (MD), surgeons complete a 4-year residency in General Surgery.
・ Specialization: Subsequent competitive 2 years Fellowship in Colorectal Surgery, primarily offered by major tertiary hospitals in Bangkok
・ Curriculum: Covers colorectal cancer, anorectal disease, benign colorectal disease, IBD and functional anorectal. And also in techniques in laparotomy , laparoscopic, endoscopy and increasingly, robotic-assisted surgery.
Certification: Regulated and examined by the Royal College of Surgeons of Thailand.
2. Key Strengths & Advancements
・ High-Volume Exposure: Trainees gain significant hands-on experience in large public hospitals.
・ International Standards: Leading programs align with global benchmarks and participate in international societies.
・ Adoption of MIS: Laparoscopic surgery is now a standard and essential skill for all trainees.
・ Multidisciplinary Care: Growing emphasis on MDT meetings and ERAS protocols to improve patient outcomes.
3. Major Challenges
・ Centralization of Resources: Advanced training, technology, and expertise are concentrated in Bangkok, creating a significant gap in care and training access for rural and regional areas.
・ Technological & Budgetary Constraints: High-cost technology (e.g., robotic systems) is available only in a few elite institutions due to budget limitations of the Universal Coverage Scheme (UCS).
・ Workforce "Brain Drain": Highly skilled surgeons are often attracted to better-compensated positions in the private sector or abroad, depleting the public health system.
・ High-Pressure Environment: Extremely high patient volumes in training hospitals can strain educational time, prioritizing service over dedicated learning in some instances.
1. Training Pathway: A Structured Approach
・ Foundation: After medical school (MD), surgeons complete a 4-year residency in General Surgery.
・ Specialization: Subsequent competitive 2 years Fellowship in Colorectal Surgery, primarily offered by major tertiary hospitals in Bangkok
・ Curriculum: Covers colorectal cancer, anorectal disease, benign colorectal disease, IBD and functional anorectal. And also in techniques in laparotomy , laparoscopic, endoscopy and increasingly, robotic-assisted surgery.
Certification: Regulated and examined by the Royal College of Surgeons of Thailand.
2. Key Strengths & Advancements
・ High-Volume Exposure: Trainees gain significant hands-on experience in large public hospitals.
・ International Standards: Leading programs align with global benchmarks and participate in international societies.
・ Adoption of MIS: Laparoscopic surgery is now a standard and essential skill for all trainees.
・ Multidisciplinary Care: Growing emphasis on MDT meetings and ERAS protocols to improve patient outcomes.
3. Major Challenges
・ Centralization of Resources: Advanced training, technology, and expertise are concentrated in Bangkok, creating a significant gap in care and training access for rural and regional areas.
・ Technological & Budgetary Constraints: High-cost technology (e.g., robotic systems) is available only in a few elite institutions due to budget limitations of the Universal Coverage Scheme (UCS).
・ Workforce "Brain Drain": Highly skilled surgeons are often attracted to better-compensated positions in the private sector or abroad, depleting the public health system.
・ High-Pressure Environment: Extremely high patient volumes in training hospitals can strain educational time, prioritizing service over dedicated learning in some instances.