Issue No. 54 - March 2013
Training Around the World
Orthopaedic Training in Turkey
Bezmi Alem VakÄ±f University, Istanbul, Turkey
Undergraduate medical training in Turkey is 5 years in duration with an additional one year of internship. After completing 6 years of undergraduate study, a medical student is entitled to become a medical doctor. However, this does not mean that you can get your medical diploma right away. You are required to fulfil a civil service obligation ranging between 300 and 600 days that varies between regions. However, there is an exemption through sitting the medical specialty examination.Â By passing the examination before completing the civil service, you are then exempted from the compulsory service. The examinationÂ consists of multiple choice questions (MCQ). In order to enter any residency programme, one has to pass and get enough points which is really challenging. After that, your five-year orthopaedic residency programme begins.
Orthopaedic training is done either in medical schools of universities or in the "Educational and Research Hospitals" under the Ministry of Health. Although the workload does not vary much, the universities are more theoretical and research based. On the other hand, more practical trainings are being done in the "Educational and Research Hospitals", contrary to its name. The first year of training is the hardest. The working hours and on call schedule is organised by the clinical director or head of the department, usually up to 130 hours per week is required during your first 12 months. Due to this, residents tend to drop out from the programme during their first year of training.
The standard of training in orthopaedics and traumatology in Turkey is monitored by the Turkish Orthopaedics and Traumatology Association (TOTBID). All residents are given an assistant report card provided by TOTBID. Residents are required to rotate in other specialties apart from orthopaedic surgery, such as general surgery, plastic and reconstructive surgery, cardiovascular surgery, physical therapy and rehabilitation, anaesthesia, and emergency medicine. Attendances at meetings and courses are also recorded in the report cards. At the end of each year, the report cards are collected, evaluated and graded by the clinical director.
In May of each year, an annual assessment is scheduled by TOTBID, which is compulsory for all orthopaedic residents to attend. The results are then sent to the heads of the departments for evaluation of any shortcomings in training where extra clinical seminars are held if necessary.
Orthopaedic training in Turkey is a 5-year training process. As a resident you will undergo intensive training in trauma during your first year. I think surgeons studying for postgraduate orthopaedic degree in Turkey are lucky in this regard because, although this is sad, Turkey has a very high rate of road traffic accidents which provideÂ a high number of trauma cases. In the second year, you need to gain more knowledge of orthopaedic surgery and at the same time improve your surgical skills. Participation in courses, conferences, seminars and workshops is recommended. Through five years of residency, residents will gain enough experience, skills, and knowledge to be able to perform the surgery by themselves in their last year ofÂ study.
However, every resident is required to complete a master thesis in order to complete their training. The content of the thesis can either be a clinical, biomechanical or experimental study. On top of that, they also need to pass a specialty examination with two parts consisting of a practical and oral examination by five examiners where at least three of them are professors of orthopaedics and trauma surgery.
Finally, at the end of five years of hard training, you will receive your diploma of specialisation, but only after completing a compulsory service with an average duration of 450 days.
So, only those who really set their heart on this path are able to do it, as this journey requires a lot of effort and patience...