SET GENERIC SURGICAL SCIENCE EXAMINATION AND SET CLINICAL EXAMINATION

CURRICULUM CONTEXT SET 1 Surgical Science Curriculum Knowledge of Anatomy, Pathology and Physiology is fundamental to safe and comprehensive surgical practice. SET Trainees consolidate knowledge, understanding and application of these basic sciences at the outset of their surgical training. During SET1 Trainees gain an understanding of the basic sciences as they apply to the principles of surgery and acquire skills in basic surgery, clinical assessment and the use of diagnostic modalities. Learning SET 1 trainees gain knowledge and skills during clinical placements, by attending courses, by utilising online resources and through text-based study. SET Trainees are also required to participate in hospital resident training programs. The College provides a Recommended Reading List, Case Studies other online learning resources and examples of practice Multiple Choice Questions on the College website to assist trainees to learn the basic surgical sciences. Online Resources have been developed by the College to provide a context for trainees to learn and apply the basic surgical sciences. Case studies, examples of practice multiple choice questions and discussion forums are presented on the College website, complementing trainees' in-depth reading and study of basic sciences. Trainees are encouraged to use the College online resources as a flexible, self-directed learning resource to be accessed in any order at convenient times. The Case Studies also provide opportunities for trainees to practise applying different kinds of knowledge to clinical situations to use basic sciences, patient history and the results of physical examination and investigation to build judgement, make diagnoses, make clinical decisions and recommend treatment. Clinical scenarios are presented in a format that encourages trainees to apply their knowledge as they progress sequentially through a number of stages of unfolding information. Trainees are challenged at each stage with questions and discussion points. Trainees can practise answering multiple choice questions online. Practice questions include answers and explanations, allowing trainees to self-correct their responses. Surgical Science Assessment SET trainees knowledge and skills are formally assessed by examination: the Generic SET Surgical Science Examination (SSE), the Specialty-specific SET Surgical Science Examinations and the Clinical Examination (which has elements of applied surgical science as well as clinical skills). Other assessments are conducted in the workplace. The SET Surgical Science Examinations relate to the College Competency of Medical Expertise; these examinations test candidates knowledge, understanding and application of Anatomy, Pathology and Physiology, in health and disease as they apply to generic and specialty specific situations. Every trainee must complete the Generic Surgical Science Examination, the Clinical Examination. Specialty-specific Surgical Science Examinations must be completed in accordance with each specialtys requirements. The Specialty-specific Surgical Science curricula are outlined by the nine surgical specialties and further information about these examinations is available from specialty websites.

 The generic component of the SSE presents an equal number of questions in Anatomy, Physiology and Pathology. In the speciality specific SSE there is a variable balance between the three disciplines

Specialty-specific Surgical Science Examination In 2008, General Surgery and Urology have a common specialty-specific examination. Trainees in these specialties will all undertake the same Surgical Science Examination. Cardiothoracic Surgery, Neurosurgery, Otolaryngology Head and Neck Surgery, and Vascular Surgery have separate specialty-specific Surgical Science Examinations. Orthopaedic Surgery, Paediatric Surgery and Plastic & Reconstructive Surgery will continue with their current examination processes. Please refer to specialty websites for specialty training regulations.

SET Surgical Science Examination and Clinical Examination requirements Generic Surgical Science Examination Specialty-specific Surgical Science Examination* Clinical Examination 1 examination 1 examination 1 examination 2 days x 2 hours written examination, MCQ format, 240 questions 1 day x 2 hours written examination, MCQ format, 120 questions 2 to 3 hour practical examination, OSCE format

* See the notes above the table on the specialty specific Surgical Science Examination.

Pass requirements and timing of the SET Surgical Science Examinations Once selected into a specialty training program a candidate may sit the Generic Surgical Science Examination. The generic and specialty specific components of the examination will be considered separately Candidates may carry forward a pass in one component of the SSE (generic or specialty specific). Each specialty has established time limits for the successful completion of the different components of the examination (refer to individual specialty training regulations).

CURRICULUM TOPICS
The following tables describe Anatomy, Pathology and Physiology topics included in the Generic Surgical Science Examination. Trainees are advised to refer to specialty websites for Specialty-specific Surgical Science Examination content.

CURRICULUM TOPICS

ANATOMY
TOPIC Abdomen Text Last Content Gross anatomy of o Abdominal wall o Retroperitoneum o Abdominal organs o Vessels o Nerves o Male and female external genitalia Histology of intra-abdominal organs (visual) Embryologic origin of abdominal organs Cerebral blood supply o Venous sinuses o Circle of Willis and major branches Gross anatomy of brain including o Ventricles o named nuclei o major traits Gross anatomy of spinal cord including consequences of injury Major neural plexuses o cervical o brachial o lumbar Cranial nerves Gross anatomy of the skull and cervical vertebrae Gross anatomy of the major structures of the neck and thoracic inlet General cellular histology, structure and function Epithelia Exclude Anomalies of intra-abdominal anatomy

CNS

Last

Head and neck Histology

Last

Anatomy of orbit, internal ear, nasal cavities, oral cavity, facial muscles Bone and cartilage

Wheater

ANATOMY (continued)
Text Content Exclude

Lower limb

Last

Pelvis

Last

Thorax

Last

Upper limb

Last

General features of o Bones o Muscles o Nerves o Vessels of lower limbs and their actions o Joint anatomy Gross anatomy of o Abdominal wall o Retroperitoneum o Abdominal organs o Vessels o Nerves Functional anatomy and musculature of o Organs o Vessels o Nerves Bony anatomy of o thoraco-lumbar spine o pelvis overview Surface anatomy Gross anatomy of the chest wall and major intrathoracic structures including diaphragm and pleura Nerve supply to chest wall and thoracic organs Vascular anatomy, lymphatic drainage Embryology o Thoracic wall o Diaphragm General features of o Bones o Muscles o Nerves o Vessels of upper limbs and their actions

Embryology Foot

Detailed musculoskeletal anatomy of pelvis Skeletal embryology Detailed anatomy of male and female reproductive organs Joints

Embryology Joint anatomy

PATHOLOGY
TOPIC Antibiotics Text Rang Content Cell wall active agents Specific antibiotic activity profiles Exclude

Genetics and molecular biology Immunology

Yung Infectious Diseases, a clinical approach Robbins

Robbins

Infection Robbins Yung Infectious Diseases, a clinical approach Robbins

Mendelian Genetics Cyto genetics Molecular biology Cell division Immune response Transplantation and immunogenetics Antibodies structure and function Hypersensitivity HLA typing Auto immune conditions Major histo-compatibility complexity Immunity to infection General bacteriology, virulence Entecic infections, toxic shock Infection (e.g. IVDUs, post splenectomy, post operative, tetanus) Disinfection, sterilisation Fungi, viruses, parasites antibiotic resistance Neoplastic growth and spread Carcinogenesis Pathology of individual neoplasms Common tumours Hamartoma

Cloning Rarer genetic-based diseases Specialty specific content

specific localised infections

Neoplasia

PATHOLOGY (continued)
General Pathological Phenomena Text Robbins Content Cellular pathology Antibodies structure and function Radiation damage Apoptosis, cell injury Haemostasis, haemorrhage, thrombosis, oedema Ischaemia Infarction Atheroma Necrosis, degeneration Apoptosis Disorders of metabolism Amyloid Fibrinoid Hyaline Lymploma and myeloma Chronic anaemia Disorders of platelets and haemostasis Intra vascular haemolysis Transfusion Exclude

Pathology blood

Robbins Australian Red Cross Blood Transfusion and Component Therapy

PATHOLOGY (continued)
Pharmacology Text Rang Opie Drugs and the Heart Specific designated journal references Content Drug side effects and interactions Pharmacokinetics and volume distribution Liver disease and drug metabolism Prolonged suxamethonium side effects, including neuromuscular blockade Local anaesthetics Salicylate side effects Narcotics Mechanisms of thrombolytic and cardiovascular drugs (including digoxin and antiarrhythmics), o actions, side effects Lipid lowering agents Fluid therapy Induction agents / reversal of anaesthesia Insulin management / oral hypoglycaemics Aspirin Sedation Anticoagulation Vasopressor / vasodilators Antibiotic - dosing, toxicity Anticonvulsants Analgesia All relevant Acute inflammation Granulomatous inflammation Chronic inflammation Bacterial infection Viral infection Wound healing Radiation and cytotoxic drugs Temperature regulation Growth factors and cytokines Trauma and shock Organ failure TB Basic histological features including: o Neoplasia o Inflammation o Recognition of pathogens and inflammatory cells on gram stain Exclude

Statistics Tissue response to injury

Listed text Robbins

Visual

Robbins

PHYSIOLOGY
Cardiovascular Text Ganong Content Cardiovascular physiology in health and disease with respect to: o Cardiac function o Control of peripheral blood flow o Control of cerebral blood flow o Gas exchange o Lymphatic function Principles of haemodynamics Shock syndromes Central and peripheral control of cardiovascular function Foetal circulation and changes at birth Pharmacologic control of cardiac rate and blood pressure Adrenal Male/female hormones/pregnancy Pancreas GI hormones Pituitary Pineal Thyroid Renin/Angiotensin GI hormones /enzymes Vagal activity and GI function Gut motility Absorptive function Digestion Water absorption Nutritional requirements of humans in health and disease Nutritional management of surgical patients Fluid and electrolyte balance Acid base balance Central and local control of digestion, absorption and metabolism Metabolic consequences of nutritional imbalance Exclude

Endocrine

Ganong Guyton

Gastro

Ganong

Taste

Metabolism and Nutrition

Ganong

PHYSIOLOGY (continued)
Neurophysiology Text Ganong Guyton Content Pain Neurotransmission Neuromuscular transmission and muscle function Neuronal function Homeostasis CNS functions o Brain stem, cerebellum, hypothalamus Spinal cord traits CSI dynamics Sympathetic and parasympathetic functions Respiratory physiology in health and disease with respect to: o Gas exchange o Acid base balance o Cardiovascular responses Cardiorespiratory developmental physiology Effects of surgery on respiratory function Central control of respiratory function Detailed physiology of the kidneys and urinary system Fluid and electrolyte balance Exclude Vision Hearing Taste Sleep

Respiratory

Ganong West

Urinary tract

Ganong Guyton

GENERIC SURGICAL SCIENCE EXAMINATION AND SET CLINICAL EXAMINATION

RECOMMENDED READING LISTS Generic Examinable from October 2008

Candidates with questions regarding the Recommended Reading Lists are advised to contact the Division of Education Development and Assessment. Examinable material is contained in the publications listed below. Prescribed Textbooks for the Basic Science Exam Anatomy Last's Anatomy, Regional and Applied, 9th Edition, 1998 (reprinted 2003) - McMinn R.M.H., Churchill Livingstone Wheater's Functional Histolog,y 5th Edition, 2006 - Young, B., Lowe, J. S., Stevens, A., and Heath, J.W., Churchill Livingstone Langmans Medical Embryology, 10th Edition, 2006 - Sadler T.W., Lippincott Williams and Wilkins Pathology Really Essential Medical Immunology, 2nd Edition, 2005 Roitt, I., Rabson, A., Delves, P. Part 1-4. Immunopathology, including Transplantation Immunology, is referenced from Robbins and Cotran Pathologic Basis of Disease, 7th Edition, Robbins and Cotran Pathologic Basis of Disease, 7th Edition, 2005 Kumar, Abbas, AK; Fausto, N., Elsevier Saunders International, Chapters 1-9, 11, 13 Blood Transfusion and Component Therapy - National Blood Transfusion Committee, Australian Red Cross, January 1994. Current information available at: http://www.transfusion.com.au/. Circular of information Infection Control in Surgery, July 1998 - Advisory Committee on Infection Control in Surgery, (Available on request from RACS) Infectious Diseases: A Clinical Approach 2nd Edition, - Yung A et al (eds). Melbourne: IP Communications, 2005. ISBN: 0-9578617-7-X Chapters: 1-4, 7, 11, 14-16, 18, 20, 22, 24, 28, 39, 42-44 Pharmacology 5th Edition, 2003 Rang.HP; Dale MM; Ritter JM; and Moore PK Churchill Livingstone Online Training: Resource Units (previously known as STEM Units) Immunology/Transplant Surgical Infections General Principles of Pathology/Microbiology Cellular and Molecular Biology Pharmacology/Pharmocokinetics/Drugs and Therapeutics Statistics Neoplasia/Oncology/Cancer Genetics Interpreting Statistics in Medical Literature: a Vade Mecum for Surgeons - Guller V and DeLong ER, Journal of the American College of Surgeons, 2004 198:441 458 Dendritic Cells - Yao V, Platell C and Hall JC. ANZ Journal of Surgery. 2002: 72(7), 501-6 Pharmacology, 5th Edition, - Rang HP, Dale MM, Ritter JM, Moore PK. Churchill Livingston Edinburgh 2003 Drugs and the Heart 6th Edition, - Opie LH, Gersh BJ., Elsevier Saunders Philadelphia 2005 Pathology Journals Rapid Sequence Induction Medications: An Update - Frakes MA. J Emerg Nurse 2003; 29:533-40 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#jen

Guidelines for Conscious Sedation and Monitoring During Gastrointestinal Endoscopy - American Society for Gastrointestinal Endoscopy. Gastrointestinal Endoscopy 2003; 58:317-322 www.guideline.gov Management of Sedation in Mechanically Ventilated Patients - Hogarth DK, Hall J. 2004; 10:40-46 Curr Opin Crit Care

Sedation in Neurointensive Care: Advances in Understanding and Practice - Citerio G, Cormio M., Curr Opin Crit Care 2003; 9:120-126 Principles of Office Anesthesia: Part 1 Infiltrative Anesthesia - Achar S, Kundu S. Am Fam Physician. 2002; 66:91-4 www.aafp.org/afp Principles of Office Anesthesia: Part II Topical Anesthesia - Achar S, Kundu S. 2002; 66:99-102 www.aafp.org/afp Am Fam Physician.

Clinical Pharmacology of Local Anaesthetics - White JL, Durieux ME. Anesthesiology Clinics of North America, Volume 23, Issue 1, March 2005, Pages 73-84 www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID =853&ContentID=13946&DirectListComboInd=D Future of Regional Anesthesia - Rosenberg PH. Acta Anaesthesiol Scand 2005; 49:913-918 Current Issues in Spinal Anesthesia - Liu SS, McDonald SB. Anesthesiology 2001; 94: 888-906 www.cjajca.org/cgi/reprint/49/suppl_1/R9.pdf Local Anesthetics and Peripheral Nerve Blocks in the Emergency Department - Crystal CS, Blankenship RB. Emerg Med Clin N Am 2005; 23:477-502 www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID =853&ContentID=13946&DirectListComboInd=D Non-Opoid Post-Operative Analgesia - Dahl V, Raeder JC. Acta Anaesthesiol Scand 2000; 44:11911203 The Pharmacological Basis of Contemporary Pain Management - MacPherson RD. Pharmacology and Therapeutics 2000; 88:163-85 Pain Control in Outpatient Surgery - Schecter WP, Bongard FS, Gainor BJ et al. J Am Coll Surg 2002; 195:95-104 www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavMenuID =853&ContentID=13946&DirectListComboInd=D Analgesia for Patients with Advanced Disease I - Hall EJ, Sykes NP. 154 http://pmj.bmj.com/cgi/reprint/80/941/148 Postgrad Med J. 2004; 80:148-

Analgesia for Patients with Advanced Disease II - Hall EJ, Sykes NP. Postgrad Med J. 2004; 80:190-195 http://pmj.bmj.com/cgi/reprint/80/942/190 Pharmacological Principles of Antibiotic Prescription in the Critically ill - Pinder M, Bellomo R. Lipman J. Anaesth Intensive Care 2002; 30:134-44 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#aic Minimising Antibiotic Resistance., Livermore DM. Lancet Infect Dis 2005; 5:450-59 Optimizing Antimicrobial Dosing in the Critically ill Patient., Goldberg J, Owens RC. Curr Opin in Crit Care 2002; 8: 435-440 Anesthetics, Sedatives and Paralytics. Understanding Their Use in the ICU., Aranda M, Hanson CW. Surg Clin N Amer 2000; 80:933947 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&N avMenuID=853&ContentID=18792&DirectListComboInd=D#scna Nutritional Support of the Critically ill and Injured Patient, Slone DS., Crit Care Clin 2004; 20:135-157 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#ccc Nutritional Support of the Chronically Critically ill Patient., Mechanick JI, Brett EM. Crit Care Clin 2002; 18: 597-618 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#ccc

Crystalloids and Colloids in Trauma Resuscitation: A Brief Overview of the Current Debate, Rizoli SB. J Trauma 2003; 54:S82-88 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#jt Perioperative Fluid Management and Clinical Outcomes in Adults, Grocott MPW, Mytheb MG, Gan TJ. Anesth Anal 2005; 100:1093-106. http://www.anesthesia-analgesia.org/cgi/reprint/100/4/1093.pdf Excessive Use of Normal Saline in Managing Traumatized Patients in Shock: A Preventable Contributor to Acidosis., Ho AM-H, Karmakar MK, Contrardi LH, NG SSW, Hewson JR., J Trauma. 2001; 51:173-177 http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&Template=/MembersOnly.cfm&NavM enuID=853&ContentID=18792&DirectListComboInd=D#jt Physiology Respiratory Physiology: The Essentials, 7th Edition, 2005 - West, J.B., Lipincott, Williams and Wilkins Review of Medical Physiology, 22nd Edition, 2005 - Ganong W.F., Lange. http://www.surgeons.org/AM/Template.cfm?Section=Online_Library&CFID=1031476&CFTOKEN=302179 40&jsessionid=f030c766ca2e$D4$AE$2#books Textbook of Medical Physiology, 11th Edition - Guyton, A.C., Hall, J.E., Saunders 2005 Visual Questions A proportion of questions used in each examination will refer to photographs, photomicrographs, radiographs, C.T. scans, etc. These visual questions may include illustrations from: Color Atlas of Anatomy, 5th Ed., - Rohen, J.W. & Lutjen-Drecoll, E., Williams & Wilkins Colour Atlas of Anatomical Pathology, 2nd Ed., 1995 - Cooke R., Stewart B., Churchill Livingstone (the illustrations from this publication are from the files of the Royal Brisbane Hospital.) CD-ROM McMinns Interactive Clinical Anatomy - Mosby - Williams & Wilkins Pty. Ltd. Wheaters Basic Histopathology: A Colour Atlas and Text, 3rd Ed., 1996 Burkitt HG: Stevens, A; Low JS, and Young B. Churchill Livingston

Clinical Examination Reading List* ATLS/EMST Course Manual 7th Ed. (2004) CCrISP Course Manual 2nd Ed. 2003: Anderson, D. RACS: Infection Control in Surgical Skills Course Handbook (1998) Bailey and Loves Short Practice of Surgery 24th Ed Basic Surgical Skills Manual Skinner, I., (2000) (reprinted 2005) Australian and New Zealand Surgical Skills Education and Training (ASSET) Course Manual (2006) All prescribed texts for the Basic Science Examination Online Training: Resource Units (previously known as STEM Units) * The recommended reading list for the Clinical Examination is not prescriptive or exhaustive, nor is it guaranteed to cover every possible question. Candidates are expected to demonstrate competency in history taking, examination of all systems, counselling and performing procedures commonly undertaken during SET1.

ROYAL AUSTRALASIAN COLLEGE OF SURGEONS SPECIALTY SPECIFIC SURGICAL SCIENCE EXAMINATIONS

READING LISTS specialty specific
Examinable from October 2008 Candidates with questions regarding the Recommended Reading Lists are advised to contact the specialty boards.

Specialty Cardiothoracic Surgery

Anatomy

Pathology Robbins 7th Edition Chapters: 11 Blood Vessels 12 Heart 15 Lung 17 Oesophagus only

Physiology West Ganong Guyton

General Surgery Robbins 7th Edition Chapters: 24 27 Peripheral Nerve and Skeletal Muscle 28 Central Nervous System

Neurosurgery

West Ganong Guyton West Ganong Guyton

Orthopaedic Surgery Otolaryngology Head and Neck Surgery Robbins 7th Edition Chapters: 16 Head and Neck 17 Oesophagus only 24 Thyroid, Pasathyroid and Aspects of Multiple Endocrine Neoplasia only 25 Skin - common tumour only Surgery of Infants and Children: Scientific Principles and Practice Oldham K et al, Lippincott Raven)

West Ganong Guyton West Ganong Guyton Cummings: Otolaryngology: Head & Neck Surgery, 4th ed. 2005 Mosby, Inc.

Paediatric Surgery

Last's Anatomy, Regional and Applied, 9th Edition, 1998 (reprinted 2003) McMinn R.M.H., Churchill Livingstone

none

Plastic and Reconstructive Surgery Urology Robbins 7th Edition Chapters: 11 Blood Vessels

Vascular Surgery

West Ganong Guyton West Ganong Guyton West Ganong Guyton