heh, i read in the newspapers the other day that they are going to be installing (or have already installed) cc-cameras in the SGH ots and the surgeons are crying foul over it. well, it did irk me too when i saw the news because i guess this would also affect medical students.

the best part about it was that the surgeons were only notified AFTER they cameras were installed. which is really quite sly. beats me though how the installing managed to go unnoticed when sgh surgeons are in the ots hours on hours on hours.

it's only a hypothesis, but i hypothesise the reason is that behind those closed doors in the ot, many 'illegal' things go on, no not stuff like stealing 1 kidney or a lobe of the liver, but stuff that do not follow protocol such as letting students palpate/pr once the patient undergoes GA. or letting the medical student practise stitching.

of course, the problem does not solely lie with the rare nice doctor who is ever so eager to teach and benefit his students, because otherwise the students would have little chance to practise. respect for the patient and all that has an important part to play, but how better would you train surgeons who are skilled with the knife? with slabs or pork? com'on you got to be kidding if you any patient compares him/herself to a pig. there has got to be someway students can be allowed to learn, of course under the close supervision of a senior surgeon, making sure nothing would go drastically wrong.

it would be unfair to extrapolate and conclude that medical students should then be allowed to do heart surgery (clause: under the strict supervision of a cardiothoracic surgeon), because that would probably be unsafe, having unkeen hands working on a delicate procedure. but that doesn't exclude having someone with experience that commensurates the position of student in that circumstance, say a post-grad surgeon working on the op under the guidance of an expert.

there has to be some place to allow young doctors to learn through experience within a safe environment. but sadly, putting those cameras in there would probably resign medical students to holding retractors and suctioning smoke from the cautery. worse, they may not even get to see the surgery close up to learn from the operating surgeon because they might accidently "drop something in there", or "dirty the place". or maybe not even be allowed to scrub up because you would be wasting hospital resources. heck, they might even ration sterile gloves for what our sch fees are worth.

i guess there must come a time when medical student involvement in the care of the patient from admission to d/c must be legitimised some day. not doing so might jepordise the career of the surgeons who have wisely provided for medical students to have hands on experience. these are the surgeons who bother and i truly respect them. paradoxically as it may seem, they are often the nice doctors who care for their patients and bother to take time to clarify doubts and help to solve problems that they have in the clinics. and of course, vice versa.

i don't fancy the idea of having Big Brother watching your every move, because it instills fear in the hearts of people and make them doubt themselves in times when they would have make prudent and quick life-saving decisions. some rules are made more as a guideline rather to be followed to the letter, and i'm pretty sure that many of these rules in everyday life, not only in ots, are broken time and again, but with no detrimental effect on any one, rather facilitating progress and encouraging efficiency. what the hospital administration is doing is introducing red-tape and bureacracy into the ironically sanitary environment of the ot. if nothing more is done for the medical student and surgeon, medical students of the future might find "scrubbing-in" a foreign term.

the hospital admin should make a stand that sgh is also a teaching hospital and their doctors who have pledged to teach in an oath they took when they graduated have every intention of keeping to that pledge. they should make it clear that patients in the subsidised wards should expect to see medical students running around in the wards and ots. by default medical students are allowed to observe and examine their medical condition in a respectful manner, and opting out of their role in the teaching process should be an active one, ala cadaveric organ donation.

there are certain dumb rules which hinder the running of the hospital. for example, in doing surgery for harmorrhoids, does the surgeon really need to go 3 rounds of scrubbing with povidone and chlorhexidine, brush his nails and all? well i stand corrected but it is really quite 'dirty' surgery in itself and time saved on inonsequential nitty gritty details could enable the surgeon to perform another surgery in the next ot. not scrubbing "properly" in this case is not detrimental to anyone, but just makes things less anal.

to me, this camera thing is a mistake and is totally crap. the hospital admin is too obsessed with proving efficiency, patient care and healthcare standards. these do not benefit the patient but only serves to fill up the resumes of the management, and of course their empty heads. ultimately what is worrying is that patients will lose out if every surgeon chooses to do things remembering that everything he does and says is recorded in a tape somewhere.