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SICOT e-Newsletter

Issue No. 5 - February 2009

Orthopaedic training in India

Dr Vijay Shetty, Consultant Orthopaedic Surgeon
Dr L.H. Hiranandani Hospital - Powai, Mumbai, India

Who is eligible?

There are two ways a medical graduate can train himself to be an orthopaedic surgeon. In India, two orthopaedic degrees are recognised: Master of Surgery in Orthopaedics (MS-Orth) and Diplomate of National Board (DNB-Orth).

The MS (Orth) degree is imparted by university-affiliated medical institutes. The eligibility for obtaining admission for this course is mainly based on the rank in the national and state level entrance tests. Private institutions offering MS (Orth) also conduct entrance tests. The demand for orthopaedic surgery is huge and, as a result, there is tough competition in the entrance examination.

The National Board of Examinations (http://www.natboard.edu.in) runs (DNB-Orth) in accredited centres in the country. These centres are mostly self-financed or private hospitals and, occasionally, may not be attached to medical colleges. The medical graduate takes a qualifying examination and an interview to be eligible to undergo three years of training.

The course

In either case, the post graduation in orthopaedics is a three-year residency course, which involves rotation between various units within an orthopaedic department of a government university or a private medical school.

At the end of three years, the trainee completes a thesis or a dissertation and appears for a university examination. The trainees are assessed by both written and practical (clinical) examinations. The examiners are invited from different centres in the country. Usually, there are four examiners for each candidate and practical examinations include one long case and two short cases for discussion. Vivas include anatomy and application of basic science in practice. The successful candidate is awarded MS (Orth) or DNB (Orth) as appropriate.

Further training

In a teaching institution, this degree makes the candidate eligible to teach the undergraduates. However, some go for further training, either within the country or abroad, to gain more experience and exposure in orthopaedics. For a post as a consultant orthopaedic surgeon in any institution, the candidates are expected to complete five years of experience after MS (Orth) or DNB (Orth), and an additional Fellowship in the area of their interest is desirable.

Centres of excellence

There are a number of medical colleges in the country offering MS (Orth) and DNB (Orth) courses. Further information is available at http://mciindia.org/apps/search/show_colleges.asp.

Subspecialty training is available in many centres across the country. Subspecialty committees and associations run nationwide training courses for young surgeons. The current team of the Indian Orthopaedic Association is in serious consultation with world bodies such as the American Academy of Orthopaedic Surgeons (AAOS) and the British Orthopaedic Association (BOA) with a view to improving training. So, watch this space!

In our institution, we offer Fellowships in advanced hip and knee surgery. This involves experience in arthroscopy of the hip and knee, primary and complex hip and knee replacements and revision replacements of hip and knee joints. There are dedicated sessions for research and clinical work.