General Surgeon

This role requires complete and autonomous management of general surgical procedures (including major surgical procedures), and shared clinical responsibility in post-operative care.

BACKGROUND AND ORGANISATION OF WORK

The General Surgeon will work as part of a team of international specialists – experts or in training – organising and carrying out the training of the local medical and health care staff in his/her area of responsibility, in collaboration with the international international Orthopaedic Surgeon and supervising the local colleagues. On occasion, a resident physician (General Surgery) will be present to support clinical activity or research. The international Surgeon is responsible to the Medical Coordinator, who is in charge of the management and organisation of the project.

The main areas of work are:

• OPERATING THEATRES: 2-3 operating theatres for General Surgery (Emergency and Elective) and Orthopaedic Trauma Surgery based on the admissions criteria of the Centre;
• WARDS: 3-4 wards comprising a maximum of 120 beds.

The General Surgeon is usually present in the hospital from 08 to 16, but is on-call 24/7 in case of emergency (including possible Mass Casualties). Daily activity includes ward round, work in the Emergency Department and Operating Theatres. The team is completed by local and international Operating Theatre specialists – anaesthetist, anaesthetic technicians, theatre nurses.
The general surgeon organises the rota of the local staff in his/her area of responsibility, guaranteeing staff coverage 24/7.

DUTIES AND REPONSIBILITIES

All EMERGENCY international personnel are expected to know and follow the hospital admissions criteria, guidelines, protocols, and the diagnosis and treatment standards in use in the Centre, and to ensure the correct compilation of clinical records and statistics in both computer and paper formats.

The main duties and responsibilities of the international General Surgeon are:

• management of general surgical procedures;
• participation in the post-operative care and clinical management of surgical patients;
• mentoring of resident physicians (where present);
• assisting in clinical research and record keeping as required by the scientific programmes of the specialist sector of the Medical Division of EMERGENCY.

Clinical activity and decisions regarding patient treatment must always be discussed and shared with the Medical Coordinator, national and international medical and surgical colleagues, and the national and international nursing personnel.

MANAGEMENT AND TRAINING OF LOCAL PERSONNEL

Clinical activities and patient care are always carried out alongside and in collaboration with local personnel, who thus benefit from training in the field. There is also provision for more specific teaching activities, managed by the international specialists, in accordance with the clinical protocols in use and as agreed with the Medical Coordinator.

CASELOAD AND EQUIPMENT

The caseload varies according to the project and the admissions criteria of the hospital: War Surgery, Emergency Surgery and Elective Surgery. The technological level of the equipment present in the Centres is suited to the clinical and managerial protocols in use, and the level of professional autonomy of the national staff, with the aim of achieving – and sustaining – high standards of care. Diagnostic equipment, basic laboratory tests, technical and auxiliary services are always available.

SURGICAL AND MEDICAL CENTRE – Anabah, Afghanistan

Opened in 1999 as a centre for the treatment of war injuries, in 2003 the admissions criteria were extended to include Emergency Medicine and Maternity.
From a strictly surgical point of view, the treatment of war injuries occurs less frequently than in the past (the most complex cases are transferred to Kabul). The emergency and elective surgical interventions most frequently carried out are for urological (kidney stones) and gastrointestinal disturbances (cholecystitis) and hernias.
In certain periods or for specific clinical needs, the general surgeon may be required to supervise surgical activity in the department of Obstetrics and Gynaecology.

SURGICAL CENTRE – Kabul, Afghanistan

The Surgical Centre in Kabul is today the most important centre for war surgery in the Country. The Intensive Care Unit has 7 beds with monitoring systems and ventilators. CT scanning equipment is available.
Both paediatric and adult patients are treated. Around 20% of patients are under 14 years of age, and present with bullet injuries, shrapnel, landmine injuries, stab wounds and burns. Abdominal, vascular, orthopaedic trauma, plastic, thoracic, maxillofacial, ocular and neurosurgical interventions are carried out both electively and in emergency.

SURGICAL CENTRE – Lashkar-gah, Afghanistan

This is the only specialist war surgery centre in the region. The Intensive Care Unit has 6 beds with monitoring equipment. The admissions criteria and therefore the caseload are similar to those in Kabul, but with a higher prevalence of paediatric patients.

SURGICAL CENTRE – Goderich, Sierra Leone

Every day over 130 patients are treated at the Surgical and Paediatric Centre in Goderich. Over time the admissions criteria have been broadened in response to the needs of the population: today they include traumatology, emergency and elective surgery (emergencies permitting). In 2012 an 8-bed Intensive Care Unit, guest quarters for relatives accompanying patients living far away from the Centre, and two new operating theatres were opened. Many patients are paediatric medical patients, and often need resuscitation due to cerebral malaria, shock resulting from severe anaemia, serious respiratory infections…

It is the only facility in the Country offering endoscopic treatment for oesophageal lesions caused by the accidental ingestion of caustic soda by children, who are often very young and already suffering from malnutrition.

In all the hospitals, every operating theatre is equipped with single-patient sets specific to the various procedures carried out. The instrumentation varies according to the project.

GUIDELINES, PROTOCOLS AND EQUIPMENT

Further information on the guidelines, protocols and clinical services relevant to the post along with details of the instruments and equipment available will be provided at interview and during the period of preparation for the mission.
The general requirements and conditions apply to all the international staff.

SPECIFIC REQUIREMENTS

• Medical Degree and current professional registration on the medical register of your Country of residence;
• specialisation in General Surgery with at least 5 years’ relevant professional experience as first surgeon;
• hospital experience in the General, Emergency and/or Trauma surgery departments.

For this role, EMERGENCY is also seeking resident physicians.

In order to proceed with the selection process, the following documentation must be produced in addition to the CV:

– surgical case history signed by the Hospital Health Management or Institute where you work, from the beginning of your career to the current date
– certificates of hospital positions held since the beginning of your career, related to clinical and non-academic activity

REQUIRED AVAILABILITY

6 months’ overseas stay including a period of leave to be taken at the end of the mission in agreement with the coordinator. Shorter missions may only be considered for specific needs as defined by the organisation.

HOW TO APPLY

For further information and inquiries (not for applications): fo.recruiting@emergency.it. To apply, please complete the on-line application form: applications sent to this e-mail account will not be considered.

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