Buku Kurikulum

KURIKULUM
PENDIDIKAN DOKTER SPESIALIS

ORTHOPAEDI DAN TRAUMATOLOGI
KOLEGIUM ORTHOPAEDI DAN TRAUMATOLOGI INDONESIA

PERHIMPUNAN DOKTER SPESIALIS ORTHOPAEDI DAN TRAUMATOLOGI INDONESIA
JAKARTA, JUNI 2012
TIM PENYUSUN DAN EDITOR
Penanggung Jawab : Prof. dr. Errol U Hutagalung, SpB, SpOT(K)

- (Ketua Kolegium Orthopaedi dan Traumatologi
Indonesia )
Prof Dr. dr. Moh. Hidayat, SpB, SpOT(K)
- (Wakil Ketua)
Ketua Komisi Kurikulum: Prof. Dr. dr. Putu Astawa, MKes. SpB, SpOT (K)
Sekretaris Komisi : Dr. dr. Nucki N Hidajat, MKes, SpOT(K)
Anggota : Prof. Dr. dr. Moh Hidajat, SpB, SpOT(K)
- Staf Pengajar PPDS Orthopaedi dan Traumatologi
FKUB
dr. Ifran Saleh, SpOT(K)
- KPS PPDS Orthopaedi dan Traumatologi FKUI
Dr. dr. Ismail, SPOT ( K )
- SPS PPDS Orthopaedi dan Traumatologi FKUI
Dr. dr. Ferdiansyah, SpOT(K)
- Ka Dept. Orthopaedi & Traumatologi FK UNAIR
/RSU Dr.Soetomo
Dr. dr. Dwikora Novembri Utomo, SpOT(K)
- - KPS PPDS Orthopaed dan Traumatologi FUNAIR
dr. Mouli Edward, SpOT(K)
- - KPS PPDS Orthopaed dan Traumatologi FKUNAIR
Dr. dr. Hermawan Nagar Rasyid, SpOT(K), MT(BME),
PhD
- KPS PPDS Orthopaedi dan Traumatologi FK UNPAD
dr. Yoyos Dias Ismiarto, SpOT(K)
- SPS PPDS Orthopaedi dan Traumatologi FK UNPAD
Prof. Dr. dr. H.R. Agung Saifullah, SpB,SpOT(K)
- KPS PPDS Orthopaedi dan Traumatolohi FK UNHAS
dr. M. Ruksal Saleh, SpOT(K), PhD
- SPS PPDS Orthopaedi danTraumatologi FK UNHAS
dr. Ismail Mariyanto, SpOT(K)
- KPS PPDS Orthopaedi dan Traumatologi FK UNS
i
dr. Mujaddid Idulhaq, M.Kes, SpOT
- SPS PPDS Orthopaedi dan Traumatologi FK UNS
Dr. dr. Rahadyan Magetsari, SpOT(K)
- KPS PPDS Orthopaedi dan Traumatologi FKUGM
Dr. dr. Puntodewo, M.Kes, SpOT(K)
- SPS PPDS Orthopaedi dan Traumatologi FKUGM
Prof. Dr. dr. I Ketut Siki Kawiyana, SpB, SpOT(K)
- KPS PPDS Orthopaedi dan Traumatologi FK UNUD
dr. I Ketut Suyasa, SpB, SpOT (K)
- SPS PPDS Orthopaedi dan Traumatologi FK UNUD
Dr. dr. Edi Mustamsir, SpOT (K)
- KPS/Ka. SMF Orthopaedi dan Traumatologi FKUB
dr. Istan Irmansyah, SpOT (K)
- SPS PPDS Orthopaedi dan Traumatologi FKUB
Editor : Prof. Dr. dr. Putu Astawa, MKes, SpOT(K)

- Staf Pengajar PPDS Orthopaedi dan Traumatologi FK
UNUD
Dr. dr. Nucki N Hidajat, MKes, SpOT(K)
- Kepala Dept. Orthopaedi dan Traumatologi FK UNPAD
/RS Dr. Hasan Sadikin
iii
KATA PENGANTAR
Syukur Alhamdulillah kita panjatkan ke hadirat Allah SWT,

bahwa telah bisa diterbitkan buku kurikulum Progam Pendidikan Dokter
Spesialis (PPDS) Orthopaedi dan Traumatologi oleh Kolegium Orthopadi
dan Traumatologi edisi tahun 2012 ini, Buku ini merupakan revisi dan
perubahan format serta penambahan di beberapa bagian dari edisi 2007,
hal ini dilakukan atas dasar bahwa ilmu Orthopaedi dan Traumatologi
merupakan cabang ilmu kesehatan yang terus bergerak secara dinamis
sesuai dengan kebutuhan masyarakat maupun perkembangan ilmu
teknologi kedokteran sendiri.
Penambahan yang paling signifikan adalah dalam aspek
kompetensi afektif serta bidang sport injury, yang menjadi sumber
rujukan adalah Kurikulum pendidikan dari British Orthopaedic
Assossiation (BOA) yang disesuaikan dengan kondisi situasional local dan
tingkatan kompetensi dari KKI (Konsil Kedokteran Indonesia).
Kami sangatlah menyadari buku kurikulum ini jauh dari
kesempurnaan sehingga merupakan keniscayaan adanya asupan dan
kritikan yang dapat membuat buku ini menjadi lebih baik.
Wassalam.
Editor.
.
v
KATA SAMBUTAN
Ketua Kolegium Orthopaedi dan Traumatologi Indonesia
Dokter Spesialis Orthopaedi dan Traumatologi adalah dokter

yang telah mencapai kemampuan tertentu dan secara professional
mengkhususkan diri dalam pelayanan bidang Orthopaedi dan trauma
muskuloskeletal dan mempunyai kemampuan menyerap, mengembangkan
serta mentransformasikan keilmuannya.
Penerbitan Buku Kurikulum Pendidikan Dokter Spesialis

Orthopaedi dan Traumatologi edisi tahun 2012 merupakan hasil
penyempurnaan cetakan sebelumnya, Pada edisi ini dimasukan berbagai
informasi baru yang merupakan hasil pengembangan dan pendalaman
serta penyelarasan dari berbagai sumber.
Buku kurikulum ini disusun oleh Kolegium dan menjadi paduan

bagi seluruh pimpinan, pendidik, tenaga kependidikan, dan paserta didik
program dokter spesialis Orthopaedi dan Traumatologi di Indonesia, untuk
dapat dilaksanakan secara konsisten. Disamping itu, untuk melengkapi
buku ini diterbitkan pula buku Standar Penyelenggaraan Pendidikan
Profesi Dokter spesialis Orthopaedi dan Traumatologi.
Kami mengucapkan terima kasih dan penghargaan setinggi-tingginya

kepada Editor, Tim komisi Kurikulum kolegium Orthopaedi dan
Traumatologi, dan anggota Kolegium lainya yang telah bekerja keras
untuk menuangkan informasi yang relevan dan terkini serta
melakukan kajian-kajian secara berkesinambungan dalam penyusunan
buku ini.
vii
Saran dan kritik untuk penyempurnaan buku kurikulum ini dapat
ditujukan kepada Tim kurikulum kolegium Orthopaedi dan Traumatologi
Indonesia.
Semoga Allah Subhanahu Wataala memberikan bimbingan,

petunuk, dan kekuatan kepada kita. Aamiin.
Jakarta, Juni 2012

Ketua Kolegium Orthopaedi & Traumatologi Indonesia
(Periode Nopember 2010 Nopember 2012)
Prof. dr. Errol Untung Hutagalung, SpB, SpOT(K)
viii
SURAT KEPUTUSAN PENGGUNAAN BUKU
SURAT KEPUTUSAN
Nomor : 013/Koleg-IOT/XII/2012
Kolegium Orthopaedi dan Traumatologi Indonesia
Tentang
PELAKSANAAN PEMAKAIAN BUKU
KURIKULUM
PENDIDIKAN DOKTER SPESIALIS ORTHOPAEDI DAN TRAUMATOLOGI
KOLEGIUM ORTHOPAEDI DAN TRAUMATOLOGI
Menimbang : 1. Bahwa untuk menjalankan kegiatan Pendidikan Dokter Spesialis

Orthopaedi dan Traumatologi diperlukan Buku Kurikulum Pendidikan
Dokter Spesialis Orthopaedi dan Traumatologi.
2. AD / ART BAB 1. Pasal 13.2 Tentang Tugas Kolegium Orthopaedi dan
Traumatologi Indonesia yaitu ayat 13.2.12 : Menyusun katalog
pendidikan profesi dokter spesialis dan spesialis konsultan Orthopaedi
dan Traumatologi Indonesia.
Mengingat : 1. SK Kolegium Orthopaedi dan Traumatologi Indonesia mengenai
Koordinator Pelaksana Komisi Kurikulum Kolegium Orthopaedi dan
Traumatologi Indonesia tanggal 23 Desember 2009 yaitu menugaskan
Komisi Kurikulum untuk merevisi Kurikulum dan Standarisasi Seleksi
Nasional Peserta Didik, yang diharapkan revisi Kurikulum sudah dapat
digunakan pada Januari 2011.
2. Untuk menjalankan kegiatan Pendidikan Dokter Spesialis Orthopaedi
dan Traumatologi diperlukan Buku Kurikulum Pendidikan Dokter
Spesialis Orthopaedi dan Traumatologi.
Memutuskan : 1. Bahwa hasil revisi Buku Kurikulum Pendidikan Dokter Spesialis
Orthopaedi dan Traumatologi dapat mulai digunakan sebagai buku
pegangan Program Studi Orthopaedi dan Traumatologi Indonesia.
2. Surat keputusan ini berlaku sejak tanggal ditetapkan.
3. Bila kemudian hari ada kekeliruan, SK ini dapat diperbaiki sebagaimana
mestinya.
ix
CARA PENGGUNAAN BUKU
Buku ini terdiri atas 4 Bab.
Bab I, Pendahuluan mengambarkan filosofi yang mendasari

disusunnya Kurikulum dan beberapa pengertian tentang istilah yang
dipergunakan didalamnya.
Pada Bab II, Menjelaskan tentang isi atau kontain yang terbagi
dalam bidang Kognitif, Psikomotor, dan Afektif.
Bidang kognitif dikelompokkan berdasarkan kombinasi antara region
anatomis (Spine, Hip, Knee, Ankle Foot, Shoulder Elbow, Hand),
Diseases (Oncology, Paediatrik, Sport Injuri, dan Trauma), dan Ilmu-
ilmu Dasar (Basic science, General Orthopaedi).
Bidang Psikomotor dikelompokkan dalam Trauma Hard Tissue dan
Soft Tissue (General, Upper limb, Pelvic girdle, Lower limb, spine),
dan Non trauma dengan pembagian sesuai dengan regionya.
Bidang Afektif di bagi kedalam 6 kelompok, yaitu Perilaku
Profesional, Komunikator yang baik, mengajar dan melatih, Keeping
Up to date, Menjadi manajer yang baik, Promoting Good Health,
Etika.
Bab III, Menjelaskan secara sistematika tahapan pencapaian

Kompetensi, dan ruang lingkup yang harus di bahas maupun
dikerjakan. Tingkat Kompetensi yan dipakai dalam buku ini adalah
sesuai dengan standar dari KKI, yang matrikulasi semua ini
dijabarkan di dalam lampiran 1, 2 dan 3.
Bab IV, Dalam bab ini dijelaskan secara sistematis cara

melaksanakan Kurikulum dari ketiga aspek Pendidikan, Prasyarat,
serta Ketentuan-ketentuan yang harus dipenuhi, serta bagaimana cara
memonitor dan evaluasinya.
xi
DAFTAR ISI
Tim Penyusun dan Editor. i
Kata Pengantar ...................................................................................... iii
Kata Sambutan Ketua Kolegium .. iv
Surat Keputusan Penggunaan Buku Kurikulum...................................... Vi
Cara penggunaan buku ........................................................................... Vii
Daftar isi ................................................................................................ viii
BAB I PENDAHULUAN............................................................ 1
1.1 Pengertian Kurikulum Ilmu Orthopaedi dan Traumatologi
Indonesia ... 2
1.2 Model Kurikulum. 2
BAB II ISI KURIKULUM............................................................ 3
2.1 Bidang Kognitif (Applied Clinical Knowledge Syllabu).... 6
2.2 Bidang Psikomotor (Applied Clin Procedures Syllabus. 25
2.3 Bidang Afektif (Professional & Management and Good
Clinical 34
Practice).
TINGKAT KOMPETENSI DAN LINGKUP
BAB III 41
BAHASAN...
3.1. Tingkat Kompetensi. 41
3.2 Tahapan Pencapaian Kompetensi..... 43
BAB IV PELAKSANAAN KURIKULUM................................... 47
4.1 Cara Pelaksanaan . 47
4.2 Modul tambahan Kursus . 47
4.3 Karya Ilmiah Wajib.. 48
4.4 Pelaksanaan Stase. 48
4.5 Monitor dan Evaluasi ... 50
4.6 Buku Acuan Wajib .. 52
DAFTAR PUSTAKA............................................................................ 53
LAMPIRAN........................................................................................... 54
Lampiran 1 Tingkat Kompetensi Kognitif Peserta didik berdasarkan
Topik dan Thapan Pendidikan 54
Lampiran 2 Tingkat Kompetensi Psikomotor Peserta Didik
berdasarkan Topik dan Tahapan......... 75
Lampiran 3 Tingkat Kompetensi Afektif Berdsarkan Topik dan
Tahapan Pendidikan 84
Lampiran 4 Modul-modul ..... 91
xiii
BAB I
PENDAHULUAN
Pencapaian kesehatan yang optimal sebagai hak asasi
manusia masyarakat perlu mendapat perhatian. Pelayanan yang baik
dan bermutu merupakan dambaan masyarakat Indonesia. Untuk
mendapatkan itu perlu dihasilkan pelayan kesehatan yang baik
termasuk perawat, dokter umum dan juga dokter sepesialis. Dokter
sebagai salah satu komponen utama pemberi pelayanan kesehatan
masyarakat mempunyai peran yang sangat penting sehingga
Pendidikan Kedokteran akan menjadi penting.
Untuk memberikan perlindungan kepada pasien dan

mempertahankan mutu pelayanan kesehatan pemerintah dengan
Undang-undang RI No. 20 tahun 2003 tentang Sistem Pendidikan
Nasional dan Undang-Undang RI No. 29 tahun 2004 tentang
Praktik Kedokteran menekankan Standar Pendidikan Kedokteran
dam memberi kepastian hukum kepada masyarakat dan Dokter.
Asosiasi Institusi Pendidikan Kedokteran berkoordinasi

dengan Organisasi Profesi, Kolegium, Asosiasi Rumah Sakit
Pendidikan, Departemen Pendidikan Nasional dan Departemen
Kesehatan Kolegium kedokteran dalam menyusun standar
Pendidikan Profesi Dokter berkoordinasi dengan Organisasi Profesi,
Asosiasi Institusi Pendidikan, Departemen Pendidikan Nasional dan
Departemen Kesehatan
1
1.1. Pengertian Kurikulum Ilmu Orthopaedi dan Traumatologi
Indonesia
Kurikulum merupakan seperangkat rencana dan pengaturan

pendidikan yang meliputi tujuan pendidikan, isi, bahan pelajaran,
cara pencapaian dan penilaian, yang digunakan sebagai pedoman
penyelenggaraan Pendidikan Ilmu Orthopaedi dan Traumatologi
1.2. Model Kurikulum

Model Kurikulum berbasis Kompetensi dilakukan dengan
pendekatan terintegrasi baik horizontal maupun vertikal, serta
berorientasi pada masalah kesehatan individu, keluarga dan
masyarakat dalam konteks pelayanan kesehatan paripurna .
2
BAB II
ISI KURIKULUM
Isi Kurikulum meliputi prinsip-prinsip metode ilmiah,

biomedik, ilmu kedokteran klinik dalam hal ini Ilmu Orthopaedi
dan Traumatologi, Ilmu humaniora yang disesuaikan dengan
Standar Kompetensi yang ditetapkan. Prinsip-prinsip metode
ilmiah meliputi metodologi penelitian, filsafat ilmu, berpikir kritis,
biostatistik dan evidence-based medicine.
Ilmu biomedik meliputi anatomi, biokimia, histologi,

biologi sel dan molekuler, fisiologi, mikrobiologi, imunologi,
parasitologi, patologi, dan farmakologi. Ilmu biomedik dijadikan
dasar ilmu kedokteran klinik dalam hal ini Ilmu Orthopaedi dan
Traumatologi sehingga anak didik mempunyai pengetahuan yang
cukup untuk memahami konsep dan praktik kedokteran klinik.
Ilmu-ilmu humaniora meliputi ilmu perilaku, psikologi

kedokteran, sosiologi kedokteran dan profesionalisme. Menurut Dr.
Victor Neufeldt, satu kunci konsep kurikulum baru adalah that
it is not only the sum total of residents experience, planned or
unplanned. A broader view is needed, and the curriculum should be
seen as an activity where residents and faculty learn and work
together
3
Kurikulum berdasarkan Kompetensi terdiri atas dua
komponen utama yaitu Core Kurikulum dan Non Core Kurikulum
(miss program of special study, local content.) Core Kurikulum
sangat penting yang harus dikuasai oleh semua residen dan terdiri
dari :
1. Bidang Kognitif (Applied Clinical Knowledge Syllabus)
2. Psikomotor (Applied clinical Procedure Syllabus)
3. Afektif (Professional and Management and Good Clinical
Practice)
Core Curriculum dapat disederhanakan menjadi General

Core Curriculum kemudian komponen Kurikulum sehingga
memudahkan Peserta Didik untuk mengikuti proses belajar
mengajar.
4
Curriculum communication
resident
Management
of change
Resident How to learn
What to learn
& faculty support (Methods
systems (content)
strategies)
Assessment
Education competency
Fostering conducive environment Curriculum renewal
Gambar 1.1. Skema Tujuan Komprehensif Kurikulum
5
2.1. Bidang Kognitif (Applied Clinical Knowledge Syllabus)
1. BASIC SCIENCE
No. General Core Komponen Curriculum
Curriculum
1A Anatomy: Clinical and functional anatomy with pathological and
operative relevance
Anatomy (and embryology) of nervous and vascular
systems
Surgical approaches to the limbs and axial skeleton
Anatomy (and embryology) of musculo-skeletal
system
1B. Tissues: Bone - Structure & Function
Cartilage - articular, meniscal - Structure & Function
Muscle and tendon - Structure & Function
Synovium - Structure & Function
Ligament - Structure & Function
Nerve - Structure & Function
Intervertebral disc - Structure & Function
1C Physiology, Structure and function of connective tissues
Biochemistry & Application/relevance of modern genetics to
Genetics: orthopaedic disease and treatment
Shock - types, physiology, recognition and treatment
Metabolism and hormonal regulation
Metabolic and immunological response to trauma
Blood loss in trauma/surgery, fluid balance and blood
transfusion
Bone grafts, bone banking and tissue transplantation
1D. Biomechanics & Biomechanics of musculoskeletal tissues
Bioengineering: Biomechanics of fracture fixation
Tribology of natural and artificial joints
Design of implants and factors associated with
implant failure(wear, loosening)
Kinematics and gait analysis
2. BONE, JOINT DISEASE & GENERAL ORTHOPAEDIC
2A General: Osteoarthritis
Osteoporosis
Metabolic bone disease
Rheumatoid arthritis and other arthropathies
(inflammatory, crystal, etc)
Haemophilia
Inherited musculoskeletal disorders
6
Curriculum
2A General: (Cont.) Neuromuscular disorders - inherited and acquired
Osteonecrosis
Osteochondritides
Heterotopic ossification
2B Investigations: Blood tests
Musculoskeletal imaging: x-ray, contrast studies (
myelography, arthrography), CT, MR, ultrasound,
radioisotope studies
Effects of radiation
Bone densitometry
Electrophysiological investigations
2C Operative Topics: Tourniquets
Principles of Sterilization
Design of theatres & Skin preparation
Anaesthesia - principles and practice of local and
regional anaesthesia and principles of general
anaesthesia
Principle treatment of musculoskeletal tumor
Principle surgery of musculoskeletal tumor
Infection, Thromboembolism & Pain:
Infection of bone, joint, soft tissue, including
tuberculosis , and their prophylaxis
2D Miscellanous: Thromboembolism and prophylaxis
Behavioural dysfunction and somatization
AIDS and surgery in high-risk patients
Management of Pain and pain relief
Complex regional pain syndromes e.g. Reflex
Sympathetic
Dystrophy and Causalgia
2E Prosthetics & Principles of design
Orthotics: Prescription and fitting of standard prostheses
Principles of orthotic bracing for control of disease,
deformity and instability
2E Research & Audit: Design and conduct of clinical trials
Data analysis and statistics - principles and
applications
Principles of Epidemiology
Audit
2F Medical Ethics: Duties of care
Informed consent
Medical negligence
7
Curriculum
3. HAND & MICRORECONSRUCTION
3A. Anatomy of: The wrist/MCP/PIP/DIP joints and CMC joint of the
thumb
The flexor and extensor mechanism of the fingers
including interaction between extrinsic and intrinsic
mechanism
The posture of the thumb in pinch, power and key grip
The nerve supply to the hand
The closed compartments of forearm and hand
3B. Pathology: An understanding of the special circum-stances
associated with swelling and the effects of rising
pressure in a closed compartment secondary to infection
and injury
An understanding of the special circum-stances in which
oedema causes fibrosis and permanent stiffness
Tendon injury and healing
Nerve injury and healing
An appreciation of the imbalances and deformities
associated with inflammatory arthritis
A classification system for congenital hand disorders
Langers lines
Hand tumours (e.g. ganglion/enchondroma)
Dupuytren's disease
3C. Clinical History of examination of hand and wrist in the
Assessment: assessment of tendons, distal radioulnar and
radiocarpal joints
Ability to elicit median, ulnar and radial nerve
function and disorders
Recognition of patterns of presentation of common
compressive neuropathies and brachial neuralgia
Assessment of intrinsic and extrinsic motors in digits
and recognition of common deformities and
deficiencies
Awareness of presentation of work-related hand
disorders
Ability to examine and assess common rheumatoid
hand deformities, e.g.: inferior radioulnar subluxation
and carpal translo-cation; MCP subluxation and ulnar
drift; digital Boutonniere and swan neck; thumb
Boutonniere deformity and CMC disease
Ability to recognise and assess focal hand swellings
8
Curriculum
3D. Investigations: Interpretation of plain and stress x-rays of wrist.
A knowledge of other views
Awareness of role of MRI/bone scan/
arthrography/arthroscopy
Place and interpretation of nerve conduction studies
3E. Treatment: Knowledge of a strategy of management for the
osteoarthritic rheumatoid hand.
Understanding of the place of soft tissue
reconstruction, joint fusion, interposition and
excision arthroplasty in the treatment of the arthritic
hand and wrist.
Knowledge of the management of stenosing
tenovaginitis
Knowledge of the principles of treatment for
common flexor and extensor tendon injuries and of
the common surgical approaches to the digital flexor
and extensor compartments
Fractures of metacarpals and phalanges
Familiarity with the surgical treatment of
Dupuytrens disease
Awareness of the principles of tendon transfer for
the reconstruction of mediun, ulnar and radial nerve
palsy and familiarity with simple transfers, e.g.
indicis to EPL
Knowledge of splinting techniques and
rehabilitation principles
Ability to plan management for finger tip injuries
and undertake
closed management
Knowledge of surgical approach to digits with
particular regard to the restoration of function and
prevention of stiffness
Knowledge of the levels for digital amputation
Injuries of ulnar collateral ligament of thumb
Dislocations of carpus and carpal instability
Knowledge of closed and operative options of
treatment for fractures of distal radius and common
carpal injuries including scaphoid non union.
Familiarity with the surgical treatment of common
compressive neuropathy
Ability to manage common hand infections
9
Curriculum
4. KNEE
4A. Anatomy: Knowledge of regional anatomy of the knee, including:
Surface anatomy
Neural and vascular structures and their relations with
particular reference to standard anterior and posterior
surgical approaches
Knowledge of regional anatomy of the knee, including:
Surface anatomy
particular reference to standard anterior and posterior
surgical approaches
Bones and joints
Functional anatomy of ligaments and supporting
muscles
Innervation of the knee including controlling
musculature
The extent and function of the synovium and bursae of
the knee
The structure and function of the menisci, and articular
cartilage
4B. Biomechanics: The mechanics of the patello-femoral mechanism
The medial and lateral weight-bearing joints and their
inter-relationship
The cruciate and collateral ligaments and other
ligamentous and muscular supports
Menisci and articular cartilage
4C. Pathology: The mechanism of ligamentous, bony and combined
trauma to the knee and healing potential
A complete knowledge of arthritides, including
degenerate wear, ageing changes and traumatic
damage
Pathology of inflammatory disease and infection
affecting the knee
The response of synovium to debris
Benign and malignant conditions in the knee and surrounding
structures including recognised classification where
appropriate
4D. Clinical A sound knowledge and understanding of:
Assessment: History and examination of the knee to include relevant
surrounding structures
The standard clinical signs of the knee and relevant
adjacent structures and competent skill in describing
these
10
Curriculum
4D. Clinical A critical understanding of rating and outcome
Assessment: measures in common use
(Cont.)
4E. Investigations: Indications for and interpretations of:
Radiographs standard and specialised
Blood investigation
Aspiration
Special investigations including CT, MRI and
radioisotope scanning
Arthroscopy
Biomechanical testing
4F. Treatment: A sound knowledge of conservative and surgical
management, including the indications for referral to a
specialist of:
Paediatric disorders, including deformity, dislocations,
epiphyseal disorders, osteochondritis and discoid
meniscus
Adolescent disorders including patello femoral and
meniscal dysfunction, osteochondritis dissecans
Young adult disorders including patello femoral and
meniscal injuries, instability and ligament deficiency,
synovial disorders, benign and malignant tumours
Degenerative and inflammatory arthritis, including a
balanced understanding of conservative and surgical
options,including osteotomy, arthrodesis and
arthroplasty
Traumatic disorders including skin and soft tissue
injuries, fractures and dislocations of patella, tibia and
femoral components, ligament ruptures and internal
derangement of the knee. Conservative and surgical
indications and detailed .Methods of treatment.
Outcomes of conservative and operative management
Infections, particularly infections and inflammations
of the bursae, intra-articular sepsis, prevention and
management of sepsis in implant surgery
A sound working knowledge of the range of
arthroplasties for primary and revision surgery for
patello femoral, unicompartmental and total
replacement of the knee with particular reference to
secure bone anchorage, alignment, ligament stability
and optimising range of movement; a good knowledge
of post-operative complications, their Sprophylaxis and
management
11
Curriculum
4F. Treatment A knowledge of the indications and techniques of
(cont): revision surgery particularly for aseptic and septic
loosening
A knowledge of simple arthroscopic surgery including
meniscectomy, trimming and shaving
An appreciation of complex arthroscopic procedures
An appreciation of medical and surgical techniques
available to repair and replace articular cartilage
5. ANKLE & FOOT
5A. Anatomy: Bones and articulations
Ligamentous structures ankle/hindfoot/ midfoot
Plantar fascia and MTP anatomy
Surface markings of neural and vascular structures
Tendon anatomy
Muscle compartments of the foot
5B. Biomechanics: Function of the lower limb and foot in gait
Ankle and subtalar joint
Plantar fascia mechanisms
Tendon function
Orthoses and footwear
5C. Pathology: Arthritides
Degenerative joint disease
Rheumatoid foot disease
Neuropathy
Neuropathic joint and skin changes
Tumours
E.g. osteoid osteoma and plantar fibroma
Clinical Assessment:
History and clinical examination of the foot and ankle
in order to assess pain, joint function, deformity, nerve,
muscle and tendon function
5D. Ability to recognise and assess the following diseases of the ankle and foot:
1) Neurological Charcot joint
disorders: Morton's neuroma
Nerve entrapment
Neurological foot deformity
2) Trauma: Evaluation of skin and soft tissue injury
Compartment syndrome
Recognition of all fractures and dislocations
Ankle and hindfoot disorder:
12
Curriculum
2) Trauma: (Cont.) Hindfoot pain
Ankle instability
Heel pain
Degenerative disease of the ankle
Rheumatoid arthritis
Osteochondritis dissecans of talus
3) Forefoot Hallux valgus
disorders: Hallux rigidus
Lesser toe deformities
Metatarsalgia
Inflammatory arthritis
4) Tumours: Ability to recognise and assess local foot swellings
Diabetic foot:
Complex foot deformity
Flatfoot deformity - mobile and rigid
Cavus deformity
Residual congenital foot deformity
5E. Investigations:
Radiograph: Standard foot and ankle views
CT, MRI and Knowledge of role of these ancillary investiga-
Scintigraphy: tions in certain specific conditions e.g. infection,
tumour, tibialis posterior rupture, osteonecrosis
EMG: Relevance to foot and ankle disorders
5F. Treatment Knowledge of rational basis for the use of
Non-operative: footwear modifications, orthoses and total contact
casting
Operative: Detailed knowledge of closed and operative methods
for management of fractures and dislocations of ankle,
hindfoot and forefoot, including knowledge of common
reconstructive surgical procedures for foot deformity
including hallux valgus, lesser toe deformity, acquired
flat-foot, to include arthrodesis, osteotomy and soft-
tissue reconstruction
Knowledge of common amputations through foot
and ankle
Knowledge of common reconstructive surgical
procedures for degenerative and inflammatory
disorders of ankle and foot including arthrodesis,
arthroplasty, excision arthroplasty procedures to
first ray both proximal and distally for
management of hallux valgus and rigidus
13
Curriculum
6. HIP JOINT
6A. Anatomy:
6B. Basic knowledge Development of the hip joint
of the regional Relationship of bony elements
anatomy of the Blood supply of the femoral head
hip including: Anatomical course of all major regional vessels and
nerves
The capsule, labrum and related ligaments
An understanding of the action, anatomy and
innervation of the regional musculature
Detailed knowledge of the applied anatomy of
common surgical approaches to the hip (medial,
anterior, lateral and posterior)
6C. Biomechanics: An understanding of the lever arms, muscles and body
weight forces that produce the joint reaction force in
both normal and abnormal hips
An understanding of the application of these principles to
the rationale of both pelvic and femoral osteotomies, and
replacement arthroplasty
Knowledge of the tribological properties of materials

used for articulating surfaces
Knowledge of the biocompatibility and mechanical
properties of materials in common use in total hip
arthroplasty
6D. Pathology: Basic knowledge of the pathology of pyogenic and
non-pyogenic arthritis, slipped upper femoral epiphysis
[SUFE], Perthes' disease and hip dysplasia
Mechanism and pattern of common fractures and
fracture dislocations around the hip (intracapsular,
extracapsular, acetabular and periacetabular, femoral
head, etc)
Knowledge of the pathology of osteoarthritis,
rheumatoid arthritis and the seronegative arthritides at
the hip and of osteonecrosis of the femoral head
Familiarity with current theories of the
aetiopathogenesis of osteoarthritis
An understanding of the microbiological rationale for
the prevention of sepsis in total hip arthroplasty
6E. Clinical A sound knowledge of clinical assessment of the hip,
Assessment: lumbosacral spine and knee. Particular reference
should be paid to the gait, the Trendelenberg sign, limb
length, loss of movement and deformity at the joint
14
Curriculum
6E. The trainee needs to be well informed of current opinion regarding
aetiopathogenesis, clinical presentation and appropriate investigation of:
Proximal femoral fractures (intracapsular, extracapsular)
and simple fracture dislocations of the hip
Osteoarthritis and the inflammatory arthropathies
Perthes' disease
Slipped upper femoral epiphysis
Septic arthritis
Osteonecrosis
Soft tissue conditions around the hip (snapping hip,
gluteus medius tendonitis, etc)
A working knowledge of the clinical presentations and investigations of:
The sequelae of CDH and hip dysplasia
The sequelae of SUFE
Juvenile chronic arthritis
Non pyogenic arthritis
The painful total hip replacement
6F. Investigation: A working knowledge of the interpretation of plain
radiographs, dynamic arthrography, CT, bone
scintigraphy and MRI of the hip region
A working classification of proximal femoral and
periacetabular fractures. Also, mechanisms and classification
of failure of joint replacement and of periprosthetic fractures
6G. Treatment: Non-operative
An understanding of the principles of traction, bracing and
spica immobilisation
An understanding of the non operative aspects of the
management of hip pathology
Operative
A thorough knowledge of soft tissue surgery, osteotomy,
arthrodesis and arthroplasty (excision and replacement). A
sound knowledge of anterior, anterolateral, lateral and
posterior approaches to the hip and of the complications
associated with each
A sound knowledge of: internal fixation of proximal femoral
fractures, hemiarthroplasty for intracapsular fractures,
primary total hip replacement for OA and inflammatory
arthropathies in the elderly, simple proximal femoral
osteotomies. Familiarity with potential complications (i.e.
thromboembolism, sepsis, dislocation, etc) and be aware of
current opinion on the prevention and management of these
complications
A knowledge of the indications for, and principles of,
complex proximal femoral osteotomies, hip arthroscopy,
reconstruction of the hip in young adults (JCA and hip
dysplasia, etc), complex hip revision surgery
15
Curriculum
6G. Treatment (Cont.) An appreciation of complex acetabular and pelvic
fractures, complex periacetabular osteotomies
An understanding of the place of modern technologies
such as, joint resurfacing procedures minimally
invasive hip replacements and computer assisted
implantation in the management of hip pathology and
the attendant risks and complications
7. THE SPINE
7A. Anatomy: Development of the spine, spinal cord and nerve
roots
Surgical anatomy of the cervical, dorsal and
lumbosacral spine
Anterior and posterior surgical approaches to the
spine at each level
7B. Biomechanics: Basic knowledge of the biomechanics of the
cervical and lumbosacral spines
An understanding of the biomechanics of spinal
instability as applied to trauma, tumour, infection and
spondylolysis/listhesis
Biomechanics of spinal deformity
A knowledge of the basic mechanics of spinal
instrumentation
7C. Pathology: Pathophysiology of the ageing spine and
degenerative disc disease
Acute and chronic infections of the spine
Pathology of spinal deformity
Pathology of the acutely prolapsed cervical and
lumbar disc
Recognition of patterns of spinal injury and
associated cord and nerve root damage
Tumours of the spine
7D. Clinical A thorough knowledge of general and orthopaedic
Assessment: history-taking and examination
A knowledge of the assessment of spinal deformity
An understanding of the assessment of thoracic pain
A sound knowledge of clinical assessment of the spine
for low back pain, sciatica, spinal claudication, neck
pain, radiating arm pain, spinal injury and incipient
myelopathy
A knowledge of the assessment of spinal tumour
A basic knowledge of the assessment of a patient
after failed spinal surgery
16
Curriculum
7E. Investigation: A thorough knowledge of the basic investigations
required in spinal surgery, specifically: blood tests,
plain radiographs, bone scintigraphy, discography,
electrophysiological studies [including cord
monitoring], CT scanning, MRI scanning
A thorough knowledge of how each of these
investigations contributes to the diagnosis and
management of each of the major areas of spinal
disease
7F. Treatment:
Non-operative A knowledge of the non-surgical methods available for
the treatment of low back pain, sciatica, claudication,
neck pain, spinal deformity, instability, tumour,
infection and fracture to include:
Analgesics and NSAIDs, physiotherapeutic regimes,
pain clinic techniques, bracing, use of radiotherapy and
chemotherapy, non-operative management of spinal
injuries
Operative A sound knowledge of the indications for and
operative surgical management of the acute prolapsed
lumbar intervertebral disc, spinal stenosis, lumbar
spinal instability due to spondylolysis/listheses
A knowledge of the indications for, and operative
surgical management of the acutely
prolapsed cervical disc, cervical stenosis, spinal injury
and the surgery of spinal infection
A basic knowledge of the surgery of spinal deformity
and tumours of the spine
8. TRAUMA
8A. Anatomy: Applied to diagnosis and surgical treatment of
common bone, joint and soft tissue injuries
Knowledge of those anatomical structures particularly
at risk from common injuries or in surgical approaches
Physeal anatomy and its application to injury
8B. Biomechanics: Application to open reduction and internal fixation of
fractures and external skeletal fixation
Applied to fracture formation and fracture treatment
both operative and non-operative
Biomechanics of implants and fracture fixation
systems, including their material properties
Epidemiology and Research Methods:
Research and audit methods including the design of
clinical trials
17
Curriculum
8C. Pathophysiology Applied to fracture and soft tissue healing, including
& Pathology: skin, muscle, tendon and neurological structures
Classification systems for fractures and dislocations
Pathology of non-union of fractures
Response of the body, and local musculoskeletal
tissues to infection
Systemic response of body to major injury
Mechanisms underlying Acute Respiratory Distress
Syndrome and similar life threatening conditions
Science of fluid replacement therapy in the acutely injured
including application to the treatment of burns
Science of treatment of compartment syndrome
Response of infants, children and the elderly to injury
8D. Clinical Initial clinical assessment of the patient with severe
Assessment: injury, including spinal cord injury, soft tissue injury,
burns and head injury
Assessment of all types of fracture and dislocation,
their complications, early and late
Identification of life threatening/ limb threatening
injuries. Understanding priorities of treatment
8E. Investigations: Knowledge of the principles, application and side effects
of commonly used investigations, including radiographs,
CT and MRI scans, radio-isotope imaging, ultrasound
scans and electrophysiological investigations
8F. Management: Knowledge of different treatment options for
musculoskeletal injury, both non-operative and operative.
Ability to analyse the pros and cons for each method
Ability to manage the overall care of the severely injured
Ability to undertake the complete treatment of all types of
common fracture and dislocation including the bone and
soft tissue treatment of open fractures and the treatment of
pathological fractures
Where common injuries are normally treated by a sub
specialist (e.g. spinal injury, arterial injury or intra cranial
haemorrhage) there should be ability to manage the initial
treatment of the patient and know the principles of the
specialist treatment
Principles of reconstructive surgery for the injured,
including treatment of non-union and malunion of
fractures, bone defects, chronic post-traumatic
osteomyelitis and delayed treatment of nerve injury;
principles of soft tissue reconstruction
The principles of amputation in the injured and the
rehabilitation of such patients
18
Curriculum
9. PAEDIATRIC ORTHOPAEDIC
9A Basic Science: Detailed knowledge of the growth of bones, physeal
anatomy and its application to fracture types and
pathological processes and infection in particular
Knowledge of the anatomy of bones and joints in the
growing child and its application to growth and
deformity
Knowledge of the neurological processes involved in the
production of deformity e.g. spina bifida, cerebral palsy
and muscular dystrophy
9B Clinical Core knowledge should be at least that of a general
Assessment: orthopaedic textbook
'Expert' knowledge, i.e. the level of the speciality
journal is required for those wishing to pursue a career
in children's orthopaedics
The trainee must be able to clinically examine a child
competently and to relate effectively with the family
The trainee must be able to make proper management
decisions in paediatric practice and to refer
appropriately for treatment
9C Investigations: Knowledge of the indications for plain x-ray,
arthrogram, CT, MRI and the ability to interpret the
images
Knowledge of the indications for the use of ultrasound
and nuclear imaging
Awareness of the limitations of certain investigations
in paediatric practice
9D Treatment: A sound knowledge of normal variants, e.g. knock
knees, bow legs and flat feet
A detailed knowledge of the treatment for:
o Fractures (including non-accidental injury) and
growth plate injuries and recognise the sequelae
o Bone and joint infection
o Common childhood orthopaedic conditions, e.g.
irritable hip, anterior knee pain
A working knowledge of the treatment for:
o Slipped epiphysis
o Perthes' disease
o Developmental dysplasia of the hip
o Talipes
o Scoliosis
o Simple foot deformities (e.g. hallux valgus,
metatarsus varus)
19
Curriculum
9D Treatment (Cont.): o Simple congenital hand abnormalities (e.g. trigger
thumb)
o Osteogenesis imperfecta
o Skeletal dysplasias
o Tarsal coalitions
o Torticollis
o Leg length discrepancy
9E A knowledge of: Screening services for congenital abnormalities
Assessment of physical disability
10. SHOULDER & ELBOW
10A. Anatomy:
Basic knowledge of the regional anatomy of the shoulder including:
Detailed anatomy of the sternoclavicular,
acromioclavicular, glenohumeral and elbow joints to
include the connecting bones, muscles and tendons acting
across them, neurovascular supply, bursae and
relationships to local structures
Surgical approaches: deltopectoral and posterior
approaches to glenohumeral joint; superior (McKenzie)
approach to rotator cuff; and surgical approaches to the
acromioclavicular and sternoclavicular joints
Structure and function of the above joints; a clear
understanding of the static and dynamic stabilisers of the
glenohumeral and elbow joints
10B. Biomechanics: Biomechanics of the shoulder and elbow to the level of the
currently published specialist journals
Knowledge of the various types of shoulder and elbow
prostheses including the factors influencing design, wear
and loosening to the level of the currently published
specialist journals
10C. Pathology: Sound knowledge of all commonly encountered benign
and malignant conditions affecting the shoulder girdle,
elbow and surrounding soft tissues
A basic understanding of the pathology of:
Impingement and rotator cuff disorders
Instability of the shoulder and the elbow
Inflammatory and degenerative conditions affecting the
articular cartilage and synovium
Infection
Adhesive capsulitis of the shoulder
The pathology of the stiff elbow
Disorders such as ulnar neuritis and tennis or golfers
elbow
20
Curriculum
10D. Clinical Detailed history and examination of the painful, stiff or
Assessment: unstable shoulder or elbow
Knowledge of clinical tests used specifically to assess
instability of the shoulder and elbow, rotator cuff
disorders, the stiff shoulder or elbow and the use of
local anaesthetic in assessment. Examples are the
apprehension tests for shoulder instability,
impingement signs and tests, Gerbers lift off test,
Napoleon's sign, elbow instability tests, ulnar nerve
assessment
Knowledge of conditions causing referred symptoms to
the shoulder and elbow (e.g. cervical spine diseases,
entrapment neuropathies and thoracic outlet disorders)
Knowledge to the level of a basic specialist shoulder
textbook of common conditions affecting the shoulder
including instability, impingement, rotator cuff tears,
adhesive capsulitis, osteoarthritis, rheumatoid disease,
avascular necrosis, biceps tendon disorders, fractures
of the proximal humerus and clavicle, and disorders of
the acromioclavicular and sternoclavicular joints and
scapula
Knowledge to the level of a basic specialist elbow
textbook of common conditions affecting the elbow
including instability, osteoarthritis, rheumatoid
arthritis, causes of stiffness, soft tissue problems such
as medial and lateral epicondylitis, neuropathies and
fractures around the elbow
10E. Investigation: Knowledge of plain radiographs as used to assess
shoulder and elbow disorders. This should include a
knowledge of those special views (e.g. Modified axial,
Stryker notch, Supraspinatus Neer outlet and cubital
tunnel views) required to assess adequately the
conditions which commonly affect the shoulder and
elbow. The ability to recognise correctly normal and
abnormal abnormalities on plain radiographs
Knowledge of the value of ultrasound, arthrography, CT
and MRI as used to assess the shoulder and elbow. An
ability to identify straightforward abnormalities on CT and
MRI (e.g. full thickness and partial thickness rotator cuff
tears on MRI and the pathological anatomy of fractures
around the shoulder and elbow using CT)
Knowledge of the use and abuse of arthroscopy of the
shoulder and elbow including a knowledge of normal and
abnormal arthroscopic findings
21
Curriculum
10F. Treatment:
1) Non-operative An ability to supervise the non-operative management
of fractures, dislocations and soft tissue injuries around
the shoulder and elbow
An in-depth knowledge of the management of
straightforward fractures and dislocations of the shoulder
girdle and elbow. Knowledge of the treatment options for
more complex fractures with an understanding that these
might more appropriately be referred to someone with a
special interest; examples of these might include four part
fractures of the proximal humerus and complex
intraarticular fractures of the distal humerus. An ability to
recognise upper limb injuries involving injuries to the
brachial plexus and refer on as appropriate
A knowledge of injection techniques for both the shoulder
and the elbow
Knowledge of both the non-operative and operative
treatment of common disorders such as recurrent anterior
traumatic instability of the shoulder, rotator cuff
impingement and small rotator cuff tears, adhesive
capsulitis, acromioclavicular joint pain
2) Operative A knowledge of the management of soft tissue elbow
disorders such as lateral and medial epicondylitis and
ulnar neuropathy
Knowledge of the indications, options and complications for
prosthetic replacement of the shoulder and elbow. A detailed
knowledge of the surgical techniques is not required
2) Operative (cont.) Knowledge of the indications and benefits of arthroscopy of
the shoulder and elbow. An ability to perform an arthroscopic
assessment of the shoulder is expected but a knowledge of the
techniques of arthroscopic surgery procedures is not required
Understanding the principles of management of tumours
around the shoulder and elbow
11. ORTHOPEDIC ONCOLOGY

11A Basic Knowledge of the presentation, radiological features,
pathological features, treatment and outcome for common
benign and malignant bone tumours
Knowledge of the presenting features, management and
outcome of soft tissue swellings, including sarcomas
benign and malignant
Understanding of the principles of management of patients
with metastatic bone disease in terms of investigation,
prophylactic and definitive fixation of pathological
fractures and oncological management
22
Curriculum
11B Classification benign/malignant
Tissue of origin
11C Staging Investigations
Enneking Classification
Biopsy techniques
Basic Histopathologal Interpreatation
11D Treatment Principles surgical treatment
Incisional Excision
Marginal Excision
Wide Excision
Radical Excision
Radiotherapy
Chemotherapy-principles of action
Treatment of pathological fracturres
Palliative treatment
11E Specific Tumours
Bone Primary
Osteoid Osteoma
Osteoblastoma
Osteosarcoma
Ewing sarcoma
Giant cell sarcoma
Chondrosarcoma
MFH
Fibrosarcoma
Multiple myeloma
Metastases General Features
Soft Tissues Tumor General features
12. SPORT INJURY

12A Arthroscopy Principles of Arthroscopy
Common indication of arthroscopy
Standard and additional portals for knee, shoulder
arthroscopy
Complication of arthroscopy
12B Pathoanatomy of ACL/PCL injuries and their
management
Pathoanatomy of MCL/LCL injueris and their
management
Pathoanatomy of meniscal injuries and management
Patella-femoral disorder and various causes of anterior
knee pain
Causes and management of PF maltracking/ Instability
23
Curriculum
12B Cont.: Types and synovials plicae and treatment
Management of knee dislocation and multiple
ligaments injury
12C Shoulder Pathoanatomy of recurrent shoulder dislocation
and management
Types of shoulder impingement syndrome and ita
management
Rotator cuff arthropathy
Types of AC joint dislocation
12D Ankle Acute and chronic ankle ligaments injury
Impingement syndrome and meniscoid lesion
Tendon archilles rupture
24
2.2. Bidang Psikomotor (Applied Clinical Procedures Syllabus)
NO. TOPIC PROCEDURE

1. TRAUMA
1A Trauma Free flap
General Full thickness skin graft
Muscle flap
Nerve repair
Pedicle flap
Removal external fixator or frame
Removal foreign body from skin / subcutaneous
tissue
Removal K wires or skeletal traction
Split skin graft
Transpositional flap
Wound closure, delayed primary or secondary
Wound Debridement
Internal Fixation of Long Bone
Internal fixation of complex fracture
External fixation
Periarticuler fracture
Tendon repair
Vascular repair
Casting and splinting
1B Axial Sceleton
1) Cervical Spine Anterior fixation fracture / dislocation cervical spine
Application halo / tong traction cervical spine
MUA fracture / dislocation cervical spine
Posterior fixation fracture / dislocation cervical spine
2) Thoraco-lumbal Posterior decompression / fixation thoracic spine
Spine Lumbar Spine
Anterior decompression / fixation lumbar spine
Posterior decompression / fixation lumbar spine
3) Pelvis Simple acetabular fracture ORIF
Complex acetabular fracture ORIF
Pelvic fracture:
Pelvic fracture external fixator application
Simple pelvic fracture ORIF
Complex pelvic fracture ORIF
25
NO. TOPIC PROCEDURE
1C Upper Limb
1) Brachial Plexus Exploration / repair / grafting brachial plexus
2) Clavicle ORIF clavicle fracture
ORIF non-union clavicle fracture
3) Shoulder Joint Anterior dislocation shoulder
Anterior dislocation shoulder closed reduction
Anterior dislocation shoulder open reduction +/- fixation
Acromioclavicular joint dislocation acute ORIF
Fracture proximal humerus ORIF
Glenoid fracture ORIF
Posterior dislocation shoulder closed reduction
4) Humerus Fracture diaphysis humerus non-op:
Non-union ORIF +/- bone grafting
Fracture diaphysis humerus IM nailing
Fracture diaphysis humerus MUA +/- POP
Fracture diaphysis humerus ORIF plating
5) Elbow Joint Dislocated elbow +/- fracture:
Dislocated elbow +/- fracture closed reduction
Dislocated elbow +/- fracture open reduction +/- fixation
Intraarticular distal humerus fracture ORIF
Lateral condyle fracture ORIF
Medial condyle / epicondyle fracture MUA / K wire / ORIF
Olecranon fracture ORIF
Dislocated elbow +/- fracture:
Radial head / neck fracture MUA +/- K wire
Radial head / neck fracture ORIF
Radial head replacement for fracture
Supracondylar fracture:
Supracondylar fracture MUA +/- K wires
Supracondylar fracture ORIF
6) Forearm Fasciotomy for compartment syndrome
Fracture distal radius:
Fracture distal radius closed non-op
Fracture distal radius external fixation
Fracture distal radius MUA & percutaneous wires
Fracture distal radius MUA & POP
Fracture distal radius ORIF
Fracture shaft radius / ulna:
Fracture shaft radius / ulna IM nailing
Fracture shaft radius / ulna MUA & percutaneous wires
Fracture shaft radius / ulna MUA & POP
Fracture shaft radius / ulna ORIF
26
NO. TOPIC PROCEDURE
7) Wrist Carpal fracture / dislocation:
Carpal fracture / dislocation MUA & percutaneous
wires
Carpal fracture / dislocation MUA & POP
Carpal fracture / dislocation ORIF
Scaphoid fracture non-op
Scaphoid fracture ORIF
Scaphoid fracture MUA & percutaneous wires
Scaphoid fracture non-union ORIF +/- graft
8) Hand: Carpal fracture / dislocation:
5th metacarpal fracture / dislocation non-op
5th metacarpal fracture / dislocation MUA &
percutaneous wires
5th metacarpal fracture / dislocation MUA & POP
5th metacarpal fracture / dislocation ORIF
Finger tip reconstruction
Infection:
Infection hand drainage (not tendon sheath)
Infection tendon sheath drainage
IPJ fracture / dislocation:
IPJ fracture / dislocation MUA & percutaneous wires
IPJ fracture / dislocation MUA +/- POP
IPJ fracture / dislocation ORIF
Ligament repair hand
Metacarpal fracture (not 1st or 5th) non-op
Metacarpal fracture (not 1st or 5th) MUA &
Percutaneous wires
Metacarpal fracture (not 1st or 5th) MUA +/- POP
Metacarpal fracture (not 1st or 5th) ORIF
Phalangeal fracture non-op
Phalangeal fracture MUA & percutaneous wires
Phalangeal fracture MUA +/- POP
Phalangeal fracture ORIF
9) Tendon repair: Tendon repair extensor
Tendon repair flexor
MCPJ fracture / dislocation:
MCPJ fracture / dislocation MUA & Percutaneous
wires
MCPJ fracture / dislocation MUA +/- POP
MCPJ fracture / dislocation ORIF
27
NO. TOPIC PROCEDURE
1D Lower Limb
1) Hip joint
1a) Dislocated hip: Dislocated hip closed reduction
Acute dislocated hip open reduction +/- fixation
Neglected dislocated hip open reduction +/-
fixation
1b) Extracapsular Extracapsular fracture CHS / DHS
fracture: Extracapsular fracture intramedullary fixation
Extracapsular fracture other fixation
Intracapsular fracture:
Intracapsular fracture hemiarthroplasty
Intracapsular fracture internal fixation
Intracapsular fracture intracapsular fracture THR
2) Femur
2a) Diaphyseal Diaphyseal fracture traction or spica in child
fracture closed: Diaphyseal fracture intramedullary nailing
Diaphyseal fracture plate/screw fixation
Fasciotomy for compartment syndrome
2b) Subtrochanteric Subtrochanteric fracture intramedullary fixation
fracture: Subtrochanteric fracture plate/screw fixation
2c) Supracondylar Supracondylar fracture (not intraarticular) DCS /
fracture (not blade plate etc
intraarticular): Supracondylar fracture (not intraarticular)
intramedullary fixation
3) Knee Joint
Acute haemarthrosis arthroscopy
Acute ligament repair
Intraarticular fracture distal femur ORIF
Patella dislocation closed reduction +/- open repair
Patella fracture ORIF
Patella tendon repair
Quadriceps tendon repair
Simple tibial plateau fracture
Complex tibial plateau fracture
Tibial plateau fracture arthroscopically assisted fixation
Tibial plateau fracture ORIF with plates & screws
Tibial plateau fracture treatment with circular frame
28
NO. TOPIC PROCEDURE
4) Tibia & Fibula
Diaphyseal tibial fracture external fixation
(including frame)
Diaphyseal tibial fracture intramedullary nailing
Diaphyseal tibial fracture MUA & POP
Tibial shaft plating
Fasciotomy for compartment syndrome
Tibial non- Tibial non-union circular frame management
union: Tibial non-union intramedullary nailing +/- bone
grafting
5) Ankle
Ankle fracture / Ankle fracture / dislocation MUA & POP
dislocation: Ankle fracture / dislocation ORIF
Pilon fracture: Simple pilon fracture ORIF
Complex pilon fracture ORIF
Pilon fracture with circular frame
Tendoachilles repair
6) Foot
Amputation toe / ray for trauma
Simple calcaneal fracture ORIF
Complex calcaneal fracture ORIF
Metatarsal fracture ORIF
Phalangeal fracture MUA +/- K wire +/- ORIF
Talar, subtalar or midtarsal fracture / disloc:
Talar, subtalar or midtarsal fracture / dislocation MUA
+/-POP +/- K wires
Talar, subtalar or midtarsal fracture / dislocation ORIF
Achilles Tendon Repair
2. ELECTIVE (NON TRAUMA)
2A Non Specific Site
Aspiration / injection joint
Benign tumour excision (not exostoses)
Biopsy bone - needle
Biopsy bone - open
Bursa excision
Cyst bone curettage +/- bone graft
Epiphysiodesis
Malignant tumour excision
29
NO. TOPIC PROCEDURE
2B Axial Sceleton
1) Cervical Spine Anterior decompression +/- fixation / fusion (C2-C7)
Atlantoaxial fixation +/- fusion
Biopsy cervical spine
1) Cervical Spine Excision cervical / 1st rib
(cont) Nerve root / facet joint injection cervical spine
Occipito-cervical fusion +/- fixation
Posterior decompression +/- fixation / fusion (C20C7)
2) Thoracic Spine Anterior decompression +/- fixation / fusion
Biopsy thoracic spine
Posterior decompression +/- fixation / fusion
Scoliosis correction - anterior release +/- instrumentation
Scoliosis correction - posterior fusion +/- instrumentation
3) Lumbar Spine Caudal epidural injection
Decompression lumbar spine with fusion +/- fixation
Decompression lumbar spine without fusion (not
disectomy alone)
Discectomy open / micro
Nerve root / facet joint injection lumbar spine
4) Pelvis Salter Innominate Osteotomy
Reconstruction Acetabulum
Excision Sacrum
5) Brachial Plexus Exploration / repair / grafting brachial plexus
Neurolysis
2C Upper Limb
1) Shoulder Acromioclavicular joint excison - arthroscopic / open
/ lateral clavicle
Acromioclavicular joint reconstruction (e.g. Weaver
Dunn)
Acromioplasty open
Anterior repair for instability arthroscopic
Anterior repair for instability open including capsular
shift
Arthroscopic subacromial decompression
Arthroscopy diagnostic
Rotator cuff repair (open or arthroscopic) +/-
acromioplasty
Total shoulder replacement
30
NO. TOPIC PROCEDURE
2) Elbow Arthrolysis elbow (open/arthroscopic)
Arthroscopy elbow diagnostic
Arthoscopy elbow therapeutic
Arthrotomy elbow
Excision radial head +/- synovectomy
Radial head replacement
Tennis / golfer elbow release
Total elbow replacement
Ulnar nerve decompression / transposition
3) Wrist Arthrodesis wrist (includes partial arthrodesis)
Arthroscopy wrist
Carpal tunnel decompression
De Quervain's decompression
Excision distal ulna
Ganglion excision at wrist
Ulna shortening
Ulnar nerve decompression at wrist
4) Hand Dupuytrens contracture operation
Excision synovial cyst
Fusion of MCPJ or IPJ
MCPJ replacement
Soft tissue reconstruction hand
Tendon transfer hand
Trapezium excision or replacement
Trigger finger release
Trigger thumb release
2D Lower Limb
1) Hip Joint Arthrodesis hip
Arthrogram hip
Arthroscopy hip diagnostic
Arthroscopy hip therapeutic
Arthrotomy hip
Excision arthroplasty hip (e.g. Girdlestone)
Open reduction for DDH
Osteotomy hip pelvic for DDH
Osteotomy hip proximal femoral for DDH
Osteotomy pelvis not for DDH
Slipped upper Slipped upper femoral epiphysis open reduction
femoral Slipped upper femoral epiphysis pinning
epiphysis:
31
NO. TOPIC PROCEDURE
Total Hip THR cemented
Replacement: THR hybrid
THR surface replacement
THR uncemented
Revision THR acetabular component
Revision Total Hip Replacement
Revision THR both components
Revision THR femoral component
2) Femur Amputation above knee
Femoral lengthening
Osteotomy corrective (not for DDH)
3) Knee Joint Open ACL reconstruction
Injection & aspiration Joint
Arthroscopy ACL reconstruction
Arthroscopic lateral release
Arthroscopic partial meniscectomy
Arthroscopic removal loose bodies knee
Arthroscopic synovectomy
Arthroscopic knee diagnostic
Osteotomy distal femoral
Osteotomy proximal tibial
Patella realignment
Patella resurfacing alone
Revision TKR
TKR
Unicompartmental knee replacement
4) Tibia & Fibula Amputation below knee
Tibial lengthening
Harvesting Fibular Graft
5) Ankle Joint: Arthrodesis ankle
Arthroplasty ankle
Arthroscopy ankle diagnostic
Arthroscopy ankle therapeutic
Arthrotomy ankle
Decompression tendons at ankle
Tendoachilles lengthening
32
NO. TOPIC PROCEDURE
6) Foot Amputation toe / ray
Calcaneal osteotomy
CTEV correction
Fifth toe soft tissue correction
First metatarsal osteotomy
First MTPJ arthrodesis
First MTPJ excision arthroplasty
First MTPJ soft tissue correction
Hindfoot arthrodesis
Ingrowing toenail operation
Lesser metatarsal osteotomy
Lesser toe arthrodesis
Lesser toe excision part/all phalanx
Lesser toe tenotomy
Tendon decompression or repair
Tendon transfer foot
Wedge tarsectomy
33
2.3. Bidang Afektif (Professional & Management and Good
Clinical Practice)
1. Professional Behaviour
The Objective
1 To achieve an excellent level of care for the individual patient
a. to elicit a relevant focused history
b. to perform focused, relevant and accurate clinical examination
c. to formulate a diagnostic and therapeutic plan for a patient based upon
the clinic findings
d. to prioritise the diagnostic and therapeutic plan
e. to communicate a diagnostic and therapeutic plan appropriately
2 To produce timely, complete and legible clinical records to include case-note
records, handover notes, and operation notes.
3 To prescribe, review and monitor appropriate therapeutic interventions
relevant to clinical practice including non medication based therapeutic and
preventative indications.
4 To prioritise and organise clinical and clerical duties in order to optimise
patient care.
5 To make appropriate clinical and clerical decisions in order to optimise the
effectiveness of the clinical team resource.
6 To prioritise the patients agenda ncompassing their beliefs, concerns
expectations and needs
7 To prioritise and maximise patient safety.
8 To understand that patient safety depends on;
a. The effective and efficient organization of care
b. Health care staff working well together
c. Safe systems, individual competency and safe practice
9 To understand the risks of treatments and to discuss these honestly and
openly with patients
10 To systematic ways of assessing and minimizing risk
11 To ensure that all staff are aware of risks and work together to minimise risk
12 To manage and control infection in patients, Including;
a. Controlling the risk of cross-infection
b. Appropriately managing infection in individual patients
c. Working appropriately within the wider community to manage the risk
posed by communicable diseases
Examples and Descriptors
Patient assessment
a. Introducing self clearly to patients and indicates own place in team
b. Checks that patients comfortable and willing to be seen
c. Informs patients about elements of examination and any procedures that the
patient will undergo
34
Examples and Descriptors(Cont.)
Clinical reasoning
a. In a straightforward clinical case develops a provisional diagnosis and a differential
diagnosis on the basis of the clinical evidence, institutes an appropriate investigative
and therapeutic plan, seeks appropriate support from others and takes account of the
patients Wishes
Record keeping
a. Is able to format notes in a logical way and writes legibly
b. Able to write timely, comprehensive, informative letters to patients and to GPs
Time management
a. Works systematically through tasks and attempts to prioritise
b. Discusses the relative importance of tasks with more senior colleagues.
c. Understands importance of communicating progress with other team members
Patient safety
a. Participates in clinical governance processes
b. Respects and follows local protocols and guidelines
c. Takes direction from the team members on patient safety
d. Discusses risks of treatments with patients and is able to help patients make decisions
about their treatment
e. Ensures the safe use of equipment
f. Acts promptly when patient condition deteriorates
g. Always escalates concerns promptly
Infection control
a. Performs simple clinical procedures whilst maintaining full aseptic precautions
b. Follows local infection control protocols
c. Explains infection control protocols to students and to patients and their relatives
b. Aware of the risks of nosocomial infections.
2. Being A Good Communicator

The objective
1 Communication with patients
a. To establish a doctor/patient relationship characterised by understanding,
trust, respect, empathy and confidentiality
b. To communicate effectively by listening to patients, asking for and
respecting their views about their health and responding to their concerns and
preferences
c. To cooperate effectively with healthcare professionals involved in patient
care
d. To provide appropriate and timely information to patients and their families
2 Breaking bad news
a. To deliver bad news according to the needs of individual patients
35
3 Communication with Colleagues
a. To recognise and accept the responsibilities and role of the doctor in
relation to other healthcare professionals.
b. To communicate succinctly and effectively with other professionals as
appropriate
c. To present a clinical case in a clear, succinct and systematic manner

a. Conducts a simple consultation with due empathy and sensitivity and writes
accurate records thereof
b. Recognises when bad news must be imparted.
c. Able to break bad news in planned settings following preparatory discussion
with seniors
d. Accepts his/her role in the healthcare team and communicates appropriately
with all relevant members thereof
3. Teaching and Training

The objective
1 To teach to a variety of different audiences in a variety of different ways
2 To assess the quality of the teaching
3 To train a variety of different trainees in a variety of different ways
4 To plan and deliver a training programme with appropriate assessments

a. Prepares appropriate materials to support teaching episodes
b. Seeks and interprets simple feedback following teaching
c. Supervises a medical student, nurse or colleague through a simple procedure
d. Plans, develops and delivers small group teaching to medical students, nurses
or colleagues
4. Keeping Up to Date
The Objective
1 To understand the results of research as they relate to medical practice
2 To participate in medical research
3 To use current best evidence in making decisions about the care of patients
4 To construct evidence based guidelines and protocols
5 To complete an audit of clinical practice
6 At actively seek opportunities for personal development
7 To participate in continuous professional development activities
36
a. Defines ethical research and demonstrates awareness of GMC
guidelines
b. Differentiates audit and research and understands the different types of
research approach e.g. qualitative and quantitative
c. Knows how to use literature databases
d. Demonstrates good presentation and writing skills
e. Participates in departmental or other local journal club
f. Critically reviews an article to identify the level of evidence
g. Attends departmental audit meetings
h. Contributes data to a local or national audit
i. Identifies a problem and develops standards for a local audit
j. Describes the audit cycle and take an audit through the first steps
k. Seeks feedback on performance from clinical supervisor / mentor /
patients / careers / service users
5. Good Manager
The Objective
Self awareness and self management
1
a. To recognise and articulate ones own values and principles,
appreciating how these may
b. differ from those of others
c. To identify ones own, limitations and the impact of their
behaviour
d. To identify their own emotions and prejudices and understand how
these can affect their judgment and behaviour
e. To obtain, value and act on feedback from a variety of sources
f. To manage the impact of emotions on behaviour and actions
g. To be reliable in fulfilling responsibilities and commitments to a
consistently high standard
h. To ensure that plans and actions are flexible, and take into account
the needs and requirements of others
i. To plan workload and activities to fulfill work requirements and
commitments with regard to their own personal health
2 Team working
a. To identify opportunities where working with others can bring added
benefits
b. To work well in a variety of different teams and team settings by
listening to others, sharing information, seeking the views of others,
empathising with others, communicating well, gaining trust, respecting
roles and expertise of others, encouraging others,managing differences
of opinion, adopting a team approach
37
3 Leadership
a. To develop the leadership skills necessary to lead teams effectively. These
include:
b. Identification of contexts for change
c. Application of knowledge and evidence toproduce an evidence based
challenge to systems and processes
d. Making decision by integrating values with evidence
e. Evaluating impact of change and taking corrective action where necessary
4 Principles of quality and safety improvement
a. To recognise the desirability of monitoring performance, learning from
mistakes and adopting no blame culture in order to ensure high standards
of care and optimise patient safety
b. To critically evaluate services
c. To identify where services can be improved
d. To support and facilitate innovative service
e. Improvement
5 Management and NHS culture
a. To organise a task where several competing priorities may be involved
b. To actively contribute to plans which achieve service goals
b. To manage resources effectively and safely
c. To manage people effectively and safely
d. To manage performance of themselves and others
e. To understand the structure of the NHS and the management of local
healthcare systems in order to be able to participate fully in managing
healthcare provision

1. Self awareness and self management
a. Obtains 360 feedback as part of an assessment
b. Participates in peer learning and explores leadership styles and preferences
c. Timely completion of written clinical notes
d. Through feedback discusses and reflects on how a personally emotional
situation affected
e. communication with another person
f. Learns from a session on time management
2. Team working
a. Works well within the multidisciplinary team and recognises when
assistance is required from the relevant team member
b. Invites and encourages feedback from patients
c. Demonstrates awareness of own contribution to patient safety within a team
and is able to outline the roles of other team members.
d. Keeps records up-to-date and legible and relevant to the safe progress of the
patient.
e. Hands over care in a precise, timely and effective manner
f. Supervises the process of finalising and submitting operating lists to the
theatre suite
38
3. Leadership
a. Complies with clinical governance requirements of organisation
b. Presents information to clinical and service managers (e.g. audit)
c. Contributes to discussions relating to relevant issues e.g. workload, cover
arrangements using clear and concise evidence and information
4. Quality and safety improvement

a. Understands that clinical governance is the over-arching framework that
unites a range of quality improvement activities
b. Participates in local governance processes
c. Maintains personal portfolio
d. Engages in clinical audit
e. Questions current systems and processes
5. Management and NHS Structures

a. Participates in audit to improve a clinical service
b. Works within corporate governance structures
c. Demonstrates ability to manage others by teaching and mentoring juniors,
medical students and others, delegating work effectively,
d. Highlights areas of potential waste
6. Promoting Good Health

The Objective
1 To demonstrate an understanding of the determinants of health and
public policy in relation to individual patients
2 To promote supporting people with long term conditions to self-care
3 To develop the ability to work with individuals and communities to
reduce levels of ill health and to remove inequalities in healthcare
provision
Examples and descriptors

1. Understands that quality of life is an important goal of care and that this may
have different meanings for each patient
2. Promotes patient self care and independence
3. Helps the patient to develop an active understanding of their condition and how
they can be involved in self management
4. Discusses with patients those factors which could influence their health
5. Understands that quality of life is an important goal of care and that this may
have different meanings for each patient
7. Helps the patient to develop an active understanding of their condition and how
they can be involved in self management
8. Discusses with patients those factors which could influence their health
39
7. Probity and Ethics
The Objective
1 To uphold personal, professional ethics and values, taking into account the
values of the organisation and the culture and beliefs of individuals
2 To communicate openly, honestly and inclusively
3 To act as a positive role model in all aspects of communication
4 To take appropriate action where ethics and values are compromised
5 To recognise and respond the causes of medical error
6 To respond appropriately to complaints
7 To know, understand and apply appropriately the principles, guidance and
laws regarding medical ethics and confidentiality as they apply to surgery
8 To understand the necessity of obtaining valid consent from the patient and
how to obtain
9 To understand the legal framework within which healthcare is provided
10 To recognise, analyse and know how to deal with unprofessional behaviours
in clinical practice, taking into account local and national regulations
11 To understand ethical obligations to patients and colleagues
12 To appreciate an obligation to be aware of personal good health
Examples and descriptors

a. Reports and rectifies an error if it occurs
b. Participates in significant event audits
c. Participates in ethics discussions and forums
d. Apologises to patient for any failure as soon as an error is recognised
e. Understands and describes the local complaints procedure
f. Recognises need for honesty in management of complaints
g. Learns from errors
h. Respect patients confidentiality and their autonomy
i. Understand the Data Protection Act and Freedom of Information Act
j. Consult appropriately, including the patient, before sharing patient
information
k. Participate in decisions about resuscitation status, withholding or
withdrawing treatment
l. Obtains consent for interventions that he/she is competent to undertake
m. Knows the limits of their own professional capabilities
40
BAB III
TINGKAT KOMPETENSI
DAN LINGKUP BAHASAN
3.1. Tingkat Kompetensi

Menurut Standar Pendidikan Dokter Indonesia, Pendidikan
Dokter harus mempunyai 7 Standar Kompetensi Dokter yaitu:
1. Mempunyai keterampilan berkomunikasi secara efektif
2. Memiliki Keterampilan Klinik Dasar dan Lanjut
3. Mampu menerapkan Ilmu Kedokteran Dasar dalam praktek
Kedokteran
4. Mampu mengelola masalah kesehatan individu dan keluarga dalam
konteks pelayanan kesehatan paripurna.
5. Mampu memanfaatkan, mengelola Teknologi Informasi
6. Mawasdiri dan mampu mengembangkan diri dengan belajar sepanjang
hayat
7. Mampu mempertimbangkan moral dan etika dalam praktek
Kedokteran
Sebelum mencapai Kompetensi sebagai Spesialis Orthopedi &

Traumtologi (SpOT) secara lengkap, para Peserta Didik dalam proses
Pendidikan harus melalui Tahapan Kompetensi sesuai kategori sebagai
berikut,
1. Kompetensi tingkat Ilmu Dasar Bedah (IDB)
2. Kompetensi tingkat Orthopedi Dasar (OD)
3. Kompetensi tingkat Orthopaedi Lanjut 1 dan 2 (OL1 & OL2)
4. Kompetensi tingkat Chief Residen (CR)
3.1.1. Kompetensi Spesialis Orthopaedi dan Traumatologi Dasar,

mencakup:
1) Mampu memberikan penyuluhan, pelayanan dan perawatan pasca

tindakan terhadap penyakit yang tergolong harus dikuasai sampai
tingkat pemula.
41
2) Mampu mendiagnosis dan melakukan tindakan Orthopaedi dan
Traumatologi terhadap penyakit di bidang Orthopaedi dan
Traumatogi pada tingkat Kompetensi B2, C1
3) Mampu merencanakan dan melaksanakan kerjasana antar Disiplin
4) Siap mengantisipasi kemajuan dalam bidang Orthopaedi &
Traumatologi
3.1.2. Kompetensi Spesialis Orthopaedi dan Traumatologi Lanjut

1 dan 2 mencakup:

tingkat magang dalam proses Pendidikan Dokter Spesialis
Orthopaedi dan Traumatologi (tingkat Kompetensi KKI :
A3,B3,C2)
2) Siap mengembangkan Kompetensi terhadap penyakit yang
penguasaan dalam proses Pendidikan Spesialis Orthopaedi dan
Traumatologi tergolong hanya sampai Tingkat Mandiri sesuai
dengan tahap Kurikulumnya.
4) Mampu mengadakan penelitian dalam bidang Orthopaedi dan
Traumatologi
5) Mampu merencanakan dan melaksanakan kerjasama antar Disiplin
6) Dapat menjadi Pendidik/Fasilitator Ilmu Orhopaedi dan
Traumatologi di Program S1
3.1.3. Kompetensi Spesialis Orthopaedi dan Traumatologi Chief

Residen, mencakup:
Tingkat Mandiri dalam proses Pendidikan Dokter Spesialis
Orthopaedi dan Traumatologi (tingkat Kompetensi KKI :
A3,B4,C3)
42
2) Siap mengembangkan Kompetensi terhadap penyakit yang
penguasaan dalam proses Pendidikan Spesialis Orthopaedi dan
Traumatologi tergolong hanya sampai Tingkat Mandiri sesuai
dengan tahap Kurikulumnya.
4) Mampu mengadakan penelitian dalam bidang Orthopaedi dan
Traumatologi
5) Mampu merencanakan dan melaksanakan kerjasama antar Disiplin
6) Dapat menjadi Pendidik/Fasilitator Ilmu Orhopaedi dan
Traumatologi di Program S1
7) Siap mengantisipasi kemajuan dalam bidang Orthopaedi dan
Traumatologi, baik teknik operasi maupun diagnostik canggih
8) Siap meningkatkan profesionalisme dalam sikap dan perilaku
3.2. Tahapan Pencapaian Kompetensi
Tahapan Pendidikan Orthopaedi dan Traumatologi dilakukan dalam

beberapa tahap yaitu:
1. Tahap Pra Ilmu Dasar Bedah

2. Tahap Ilmu Dasar Bedah
3. Tahap Orthopaedi Dasar
4. Tahap Orthopaedi Lanjut 1 dan 2
5. Tahap Chief Residen
Dari Core Kurikulum yang telah disebutkan diatas dijabarkan lagi

sesuai dengan tahapan Pendidikan sebagai berikut.
3.2.1. Tahap Pra Ilmu Dasar Bedah
Tahap Pra Bedah Dasar diselenggarakan bersama dengan

Peserta Didik dari Program Studi Bedah lainnya selama 3 sampai 6
bulan, dengan mengikuti beberapa modul sebagai berikut dibawah
ini dan isi modul secara lengkap dapat dilihat pada lampiran 4
43
Module 1 : Basic Science
Module 2 : Common Surgical Conditions
Module 3 : Basic Surgical Skill
Module 4 : The Assesment & Management Of The
Surgical Patient
Module 5 : Peri operative Care
The Assesment & Management Of patients
Module 6 :
with Trauma (Including the Multiply Injured
Patient)
Module 7 : Surgical Care of The Paediatric Patient
Module 8 : Management of The Dying Patient
Module 9 : Organ & Tissue Transplantation
3.2.2. Tahap Ilmu Dasar Bedah

(semester I-II)
Tahap Ilmu Dasar Bedah dilakukan selama sembilan
bulan, merupakan kegiatan stase magang di beberapa divisi atau
subbagian yang berada di Departemen Bedah Umum, yaitu;
A. Bedah Plastik
B. Bedah Urologi
C. Bedah Thorax/Vaskuler
D. Bedah Digestif
E. Bedah Anak
F. Intensive Care Unit
3.2.3.Tahap Orthopaedi & Traumatologi Dasar

(semester III-IV)
Tahap Orthopaedi dan Traumatologi Dasar dilaksanakan
di Program Studi Orthopaedi dan Traumatologi pada semester ke-3
dan 4, dengan topik bahasan sebagai berikut;
1) Biologi selular dan molecular musculoskeletal
2) Pembentukan, Pertumbuhan dan Dasar Genetik Kelainan
Muskuloskeletal
3) Surgical Anatomy and Approach
4) Biomekanik Muskuloskeletal dan Biomaterial
5) Inflamasi, Degenerasi dan Neoplasma Muskuloskeletal
6) Imaging Orthopaedi
44
7) Dasar Traumatologi Muskuloskeletal
8) Komplikasi Trauma Muskuloskeletal
9) Dasar Osteosintesa
10) Orthopaedic research (Methodology and statistic).
Lingkup bahasan dan tingkat Kompetensi secara terperinci seperti

tercantum dalam lampiran 1 untuk Kognitif, lampiran 2 untuk
Psikomotor, dan lampiran 3 untuk Afektif.
3.2.4.Tahap Orthopaedi & Traumatologi Lanjut 1 dan 2

( semester V-VIII)
Lingkup bahasan dalam Kompetensi Kognitif pada tahap

Orthopaedi dan Traumatologi Lanjut 1 dan 2 adalah seperti yang
tercantum dalam lampiran 1, dengan level Kompetensi yang harus
dicapai sesuai tingkat sebagai berikut;
A1: Dapat mengetahui dan mengingat materi

A2: Dapat memahami dan mengerti materi
A3: Dapat menerapkan, menganalisa, mengevaluasi dan me-
rumuskan
B1: Mampu mendiagnosis dan merujuk
B2: Mampu mendiagnosis dan memberi terapi sementara dan
merujuk
B3: Mampu mendiagnosis dan memberi terapi paripurna
B4: Mampu mendiagnosis, terapi dan rawat bersama
Lingkup bahasan dalam Kompetensi Psikomotor pada tahap

Orthopaedi dan Traumatologi Lanjut 1 dan 2 adalah seperti yang
tercantum dalam lampiran 2, dengan level Kompetensi yang harus
dicapai sesuai tingkat sebagai berikut;
C1 : Melihat dan asimilasi

C2 : Mengerjakan dengan bimbingan
C3 : Mengerjakan mandiri dengan pengawasan
45
Lingkup bahasan dalam Kompetensi Afektif pada tahap
Orthopaedi dan Traumatologi Lanjut 1 & 2 adalah seperti yang
tercantum dalam lampiran 3.
3.2.5. Tahap Chief Residen (Semester IX)
Lingkup bahasan dalam Kompetensi Kognitif pada tahap

Orthopaedi dan Traumatologi Chief Residen adalah seperti yang
tercantum dalam lampiran 1, dan Lingkup bahasan dalam
Kompetensi Psikomotor pada tahap Orthopaedi dan Traumatologi
Chief Residen adalah seperti yang tercantum dalam lampiran 2,
Kompetensi Afektif seperti tercantum pada lampiran 3.
3.2.6. Tahap Penyelesaian Akhir
Semua Peserta Didik melakukan rotasi Nasional,

mempresentasikan Thesis/Penelitian Akhir, dan melaksanakan
Ujian Institusi dan Ujian Nasional Board.
46
BAB IV
PELAKSANAAN KURIKULUM
4.1. Cara Pelaksanaan
Kurikulum dilaksanakan dengan pendekatan/strategi SPICES

(Student-centred, Problem-based, Integrated, Community-based, Elective/
Early clinical Exposure Systematic). Dengan cara belajar mengajar sbb.:
1. Lectures
2. Standard textbook reading
3. Journal reading
4. Journal review
5. Symphosia and seminar
6. COE (Continuing Orthopaedic Education)
7. Clinical ward work
8. Bed side teaching /PBL
9. Out patient department work
10. Out patient clinic
11. Operation theatre
12. Rehabilitation
13. Whorkshop/Courses
4.2. Modul tambahan Kursus
Untuk memenuhi Kompentensinya setiap Peserta Didik diperlukan

pelatihan dalam bentuk kursus yang telah diakui dan ditetapkan oleh
Kolegium di setiap Tahapan Pendidikan dan harus dibuktikan dengan
dilampirkanya sertifikat. Kursus tersebut adalah;
1. Kursus di Tahap Bedah Dasar

- Basic Surgical Skill (BSS) (optional)
2. Kursus di Tahap Orthopaedic Dasar
- Basic Orthopaedic Skill (BOS)
- Perioperative Course
3. Kursus di Tahap Orthopaedic Lanjut
- Basic Osteosynthesis Course (BOC)
47
4.3. Karya Ilmiah Wajib/Thesis (Penelitian Akhir)
Setiap Peserta Didik diwajibkan untuk menyusun Karya Ilmiah

yang dipublikasikan dalam forum Ilmiah tingkat Nasional, penyusunan
Karya Ilmiah tersebut harus diketahui oleh Ketua Program Studi dan
dibimbing oleh sekurang-kurangnya dua Staf Pendidik dengan level
penilai atau pendidik.
Tata cara penyusunan Karya Ilmiah harus mengikuti Buku

Pedoman Penulisan Karya Ilmiah yang diterbitkan oleh Kolegium. Karya
Ilmiah tersebut terbagi dalam dua bentuk yaitu,
1. Laporan Serial Kasus

2. Penelitian bidang Orthopaedi dan Traumatologi (Thesis/Penelitian
Akhir)
4.4. Pelaksanaan dalam Stase
Pada pelaksanaan pencapaian Kompetensi setiap Tahapnya dapat

dilakukan dalam bentuk stase di Departemen atau Divisi (Sub-Bagian)
sesuai dengan Time Table Proses Belajar Mengajar Terintegrasi sebagai
berikut;
Tahun 1 Semester 1 Semester 2

Pra Bedah Dasar Tahap Bedah Dasar
Stase magang di :
Kuliah Magister 1. Plastik
(Combined Degree) 2. Urologi
3. Digestive
4. Thorax
5. Bedah Anak
6. Anestesi/ICU
Tahap Orthopaedi Tahap Orthopaedi dasar
Dasar (Stase divisi) :
(Tutorial 10 topik) 1. Trauma 1
2. Hand 1
3. Onco 1
4. Spine 1
5. Pediatric
6. Hip knee / recons 1
48
Tahap Orthopaedi dan Tahap Orthopaedi dan
Traumatologi lanjut 1 Traumatologi lanjut 1
1. Trauma 2 1. Trauma 3
2. Hand 2 2. Hand 3
3. Onco 2 3. Onco 3
4. Spine 2 4. Spine 3
5. Pediatric 2 5. Pediatric 3
6. Hip knee/recons 2 6. Hip knee / recons
Tahap Orthopaedi dan Tahap Orthopaedi dan
Traumatologi lanjut 2 Traumatologi lanjut 2
1. Trauma 4 1. Trauma 5
2. Hand 4 2. Hand 5
3. Onco 4 3. Onco 5
4. Spine 4 4. Spine 5
5. Pediatric 4 5. Pediatric 5
6. Hip knee/recons 4 6. Hip knee/recons 5
Chief Resident Rotasi Nasional
1. Trauma 6 Karya akhir

2. Hand 6
3. Onco 6 Ujian Institusi
4. Spine 6
5. Pediatric 6 Ujian Nasional Board
6. Hip knee/recons 6
Catatan :
Kurikulum integrated learning baik horizontal maupun vertical

adalah proses pembelajaran dengan menyatukan Ilmu-ilmu Dasar
Orthopaedi dan Ilmu Orthopaedi Klinik yang kedalamannya sesuai
dengan tingkat semester. Masing masing pengampu Seksi/Divisi di PS
menyesuaikan dengan hubungan antara Pokok Bahasan,Tahapan
Pendidikan dan Tingkat Kompetensi Kognitif dan Afektif.
49
4.5. Monitor dan Evaluasi:
Monitor dan evaluasi pencapaian Kompetensi Kognitif,
Psikomotor dan Afektif Peserta Didik dilakukan secara berkala sesuai
dengan Tahap Pendidik dengan mengikuti prinsip umum assement,
yaitu valid, objektif, dan reliable. Assessment, meliputi penilaian
formative, berkelanjutan, dan summative (final) dilaksanakan dalam
bentuk teori dan juga dalam bentuk praktik/klinik.
Evaluasi Karya Ilmiah dan Thesis (Penelitian akhir) akan dinilai
secara terpisah.
4.5.1. Formative Assessment

Formative assessment dilakukan secara berkelanjutan
sesuai dengan tahapan tingkat Kompetensi. Penilaian dilakukan
berdasarkan feedback dari Senior Residen dan Konsulen.
Asessment dilakukan pada setiap akhir semester. Formative
assessment tidak menentukan apakah seorang kandidat
lulus/tidak lulus, tetapi dapat digunakan untuk memberikan
feedback terhadap kandidat yang bersangkutan, untuk lebih
maju.
4.5.2. Internal Assessment

Performa dari kandidat selama masa Pendidikan harus
dimonitor sepanjang Pendidikan dan dicatat dalam suatu
Logbook sebagai bukti untuk kemampuan dan pekerjaan yang
telah dilakukan sehari-hari. dengan komposisi sebagai berikut:
1. Personal Attributes
2. Clinical Work (Operative dan Non-Operative Logbook)
3. Academic Activities ( Logbook )
4. End of Term theory examination (MCQ, OSCE, Essay) baik
UTS maupun UAS
5. End of Term practical examination
Logbook (Clinical work) yang sudah disetujui oleh Ketua

50
Program Studi harus diserahkan sebelum Ujian Akhir, Logbook harus
berisi informasi :
Nama dan Medical Record
Diagnosis yang relevan
Tanggal, prosedur tindakan, dan peranan sebagai asisten, operator
bimbingan, atau mandiri
Catatan :
Passing level dipergunakan nilai 70 setiap kenaikan semester. Bila
tidak lulus dilakukan remedy 1 kali.
4.5.3. Penghentian Pendidikan
Bila 2 kali berturutturut tidak naik dalam jenjang yang sama

dilakukan ujian ke-3 untuk menentukan ybs bisa
lanjut/diberhentikan dari proses Pendidikan.
Bila masa studi melebihi 1 kali masa studi normal, juga akan
dilakukan penghentian masa studi.
Penghentian Pendidikan dapat dilakukan bila ybs tersangkut
masalah atitude dan etika.
4.5.4. Summative
Evaluasi akhir pencapaian Kompetensi Peserta Didik

dilaksanakan dalam dua tahap, yaitu;
Ujian Institusi diselenggarakan oleh Program Studi dengan
pengawasan dari Kolegium
Ujian Board Nasional diselengarakan oleh Kolegium
Evaluasi akhir pencapaian (Summative) ini dilaksanakan dalam dua sesi,

Sesi I merupakan Ujian Tulis, sesi II Ujian Long Case untuk
kasusTrauma dan Non Trauma (Elective), dan VIVA short case untuk
masing-masing Divisi yaitu, Hand, Spine, Paediatric Orthopaedic,
Oncology Orthopaedic, Adult Reconstruction.
Passing level dipergunakan nilai 70.
4.6. Buku dan Jurnal Acuan Wajib
51
Buku bacaan yang dijadikan bahan acuan dalam pendidikan program
ini adalah:
1. Louis Solomon, David Warwick, Sevadurai Nayagam. Apleys System

of Orthopaedics & Fractures, 9th Ed. Hodder Arnold, UK, 2010.
2. W. C. Campbell, S. Terry Canale, James H. Beaty. Campbells
Operative Orthopaedics 11th Ed. Mosby/Elsevier, California, 2008.
3. Stanley Hoppenfeld, Piet deBoer, Richard Buckley. Surgical
Exposures in Orthopaedics: The Anatomic Approach, 4 th Ed.
Lippincott Williams & Wilkins, Philadelphia, 2009.
4. Ronald McRae. Clinical Orthopaedic Examination 5th Ed. Churchill
Livingstone, Michigan, 2004.
5. Hamilton Bailey, John Stuart Penton Lumley. Hamilton Baileys
Physical Signs: Demonstration of Physical Signs in Clinical Surgery,
18th Ed. Butterworth Heinemann, Boston, 1997.
6. Richard S. Snell. Clinical Anatomy by Regions 9th Ed. Lippincott
Willians & Wilkins, Philadelphia, 2011.
7. R. B. Duthie. Mercers Orthopaedic Surgery. Hodder General
Publishing Division, UK, 1996.
8. Anonymus. Pyes Surgical Handicraft. Biblio Bazaar, Llc, 2010.
9. Stewart L. McCurdy. Manual of Orthopaedic Surgery: Atreatise on
Deformities and Diseases of Joints and Bones. Nabu Press, 2011.
10. Robert W. Bucholz, James D. Heckman, Paul Tornetta. Rockwood and
Greens Fractures in Adults, 7th Ed. Lippincott Williams & Wilkins,
Philadelphia, 2009.
11. James H. Beaty, Charles A. Rockwood. Rockwood and Wilkins
Fractures in Children, 7th Ed. Lippincott Williams & Wilkins,
Philadelphia, 2009.
12. Michael W. Chapman. Chapmans Orthopaedic Surgery, 3rd Ed.
Lippincott Williams & Wilkins, Philadelphia, 2001.
13. Stuart L. Weinstein, Joseph A. Buckwalter. Tureks Ortho-paedics:
Principles and Their Application. Lippincott Williams & Wilkins,
Philadelphia, 2005.
14. Ronald McRae, Max Esser. Practical Fracture Management, 4th Ed.
Churchill Livingstone, Michigan University, 2002.
15. John W. Insall, W. Norman Scott. Insall and Scott Surgery of The
52
Knee, 4th Ed. Churchill Livingstone/Elsevier, North-western
University, 2006.
16. Mark D. Miller, Brian J. Cole. Textbook of Arthroscopy, vol . 355.
Elsevier Health Serviced, USA, 2004.
17. John A. Herring, Mihran O. Tachdjian. Tachdjians Pediatric
Orthopaedics 4th Ed. Saunders/Elsevier, Minnesota, 2008.
Dalam pelaksanaan proses pendidikan peserta didik diwajibkan

untuk menyusun karya tulis ilmiah berupa laporan kasus atau penelitian
yang mana diperlukan tambahan bahan acuan untuk itu yang lebih up
todate, sehingga diperlukan jurnal dibidang ini.
Jurnal yang dijadikan bahan acuan dasar adalah:

1. Journal Bone and Joint Surgery, edisi Amerika dan British
2. Majalah Orthopaedi Indonesia
3. Cllinical Orthopaedic and Related Research
4. International Orthopedics
5. Journal of Orthopaedic Trauma
6. Orthopedics
7. Journal AAOS
8. Orthopaedic clinics of north America
9. Acta orthopaedica scandinavica
KEPUSTAKAAN
1. Standar Pendidikan Dokter Indonesia
2. Standar Kompetensi Dokter Indonesia
3. Kolegium Orthopaedi & Traumatologi Indonesia, Kurikulum
Orthopaedi Dan Traumatologi Indonesia 2008
4. Buku Standar Pendidikan Profesi Dokter Spesialis Orthopaedi dan
Traumatologi Indonesia 2008
5. A Practical Guide For Medical Teacher
6. Specialist Training in Trauma and Orthopaedic ( British Orthopaedic
Association) 2009
7. Curriculum MS orthopaedics (India )
8. Guidesline for Competency Base Post graduates Training Programme
for diploma in orthopaedic (Amerika )
9. Guidelines to the Masters of Orthopaedic Surgery Programme
University of Malaya
53
LAMPIRAN 1
Tingkat Kompetensi Kognitif Peserta Didik
Berdasarkan Topik dan Tahapan Pendidikan
A1: Dapat mengetahui dan mengingat materi

A2: Dapat memahami dan mengerti materi
A3: Dapat menerapkan, menganalisa, mengevaluasi dan merumuskan
B1: Mampu mendiagnosis dan merujuk

B2: Mampu mendiagnosis dan memberi terapi sementara dan merujuk
B3: Mampu mendiagnosis dan memberi terapi paripurna
B4: Mampu mendiagnosis, terapi dan rawat bersama
Keterangan :
OD : Tahap Orthopaedi dan TraumatologiDasar
OL1: TahapOrthopaedi dan Traumatologi Lanjut 1
OL2: Tahap Orthopaedi dan Traumatologi Lanjut 2
CR : Tahap Chief Residen
54
Tingkat Kompetensi Kognitif Peserta Didik
TOPIC OD OTL1 OTL2 CR

1. BASIC SCIENCE
1.1. Anatomy:
Clinical and functional anatomy with patho-
A2B3 A2B2 A2B3 A3B4
logical and operative relevance
Anatomy (and embryology) of nervous and
A2B3 A2B2 A2B3 A3B4
vascular systems
Surgical approaches to the limbs and axial
A2B2 A2B2 A2B3 A3B4
skeleton
Anatomy (and embryology) of musculo-skeletal
A2B3 A2B2 A2B3 A3B4
system
1.2. Tissues:
Bone - Structure & Function A2B3 A2B2 A2B3 A3B4
Cartilage - articular, meniscal - Structure &
A2B3 A2B2 A2B3 A3B4
Function
Muscle and tendon - Structure & Function A2B3 A2B2 A2B3 A3B4
Synovium - Structure & Function A2B3 A2B2 A2B3 A3B4
Ligament - Structure & Function A2B3 A2B2 A2B3 A3B4
Nerve - Structure & Function A2B3 A2B2 A2B3 A3B4
Intervertebral disc - Structure & Function A2B2 A2B2 A2B3 A2B3
1.3. Physiology, Biochemistry & Genetics:
Structure and function of connective tissues A2B2 A2B2 A2B3 A2B3
Application/relevance of modern genetics to
A2B2 A2B2 A2B3 A2B3
orthopaedic disease and treatment
Shock - types, physiology, recognition and
A2B3 A2B2 A2B3 A3B4
treatment
Metabolism and hormonal regulation A2B3 A2B2 A2B3 A3B4
Metabolic and immunological response to
A2B3 A2B2 A2B3 A3B4
trauma
Blood loss in trauma/surgery, fluid balance and
A3B4 A2B2 A2B3 A3B4
blood transfusion
Bone grafts, bone banking and tissue
A2B3 A2B2 A2B3 A3B4
transplantation
1.4. Biomechanics & Bioengineering:
Biomechanics of musculoskeletal tissues A2B2 A2B2 A2B3 A2B3
Biomechanics of fracture fixation A2B3 A2B2 A2B3 A3B4
Tribology of natural and artificial joints A2B1 A2B2 A2B3 A2B3
Design of implants and factors associated with
A2B1 A2B2 A2B3 A3B4
implant failure (wear, loosening)
Kinematics and gait analysis A2B1 A2B2 A2B3 A2B3
Biomaterials A2B1 A2B3
55
2. BONE & JOINT DISEASE
2.1. Orthopaedic Oncology:
Knowledge of the presentation, radiological features,
pathological features, treatment and outcome for A2B2 A2B2 A2B3 A3B4
common benign and malignant bone tumours
Knowledge of the presenting features, mana-gement
and outcome of soft tissue swellings, including A2B1 A2B2 A2B3 A3B4
sarcomas benign and malignant
Understanding of the principles of management of
patients with metastatic bone disease in terms of
A2B2 A2B2 A2B3 A3B4
investigation, prophylactic and definitive fixation of
pathological fractures and onco-logical management
2.2. General:
Osteoarthritis A2B2 A2B2 A2B3 A3B4
Osteoporosis A2B2 A2B2 A2B3 A3B4
Metabolic bone disease A2B2 A2B2 A2B3 A3B4
Rheumatoid arthritis and other arthro-pathies
A2B2 A2B2 A2B3 A3B4
(inflammatory, crystal, etc)
Haemophilia A2B1 A2B2 A2B3 A3B4
Inherited musculoskeletal disorders A2B1 A2B2 A2B3 A3B4
Neuromuscular disorders - inherited and acquired A2B1 A2B2 A2B3 A2B3
Osteonecrosis A2B2 A2B2 A2B3 A3B4
Osteochondritides A2B2 A2B2 A2B3 A2B3
Heterotopic ossification A2B2 A2B2 A2B3 A2B3
2.3. Investigations:
Blood tests A2B3 A2B2 A2B3 A3B4
Musculoskeletal imaging: x-ray, contrast studies A2B2 A3B4
(myelography, arthrography), CT, MR, A2B2 A2B3
ultrasound, radioisotope studies
Effects of radiation A3B4 A2B2 A2B3 A3B4
Bone densitometry A2B2 A2B2 A2B3 A2B3
Electrophysiological investigations A2B2 A2B2 A2B3 A2B3
2.4. Operative Topics:
Tourniquets A2B3 A2B2 A2B3 A3B4
Design of theatres A2B2 A2B2 A2B3 A2B3
Anaesthesia - principles and practice of local and
regional anaesthesia and principles of general A2B2 A2B2 A2B3 A2B2
anaesthesia
2.5. Principle treatment of musculoskeletal tumor
2.6. Infection, Thromboembolism & Pain:
Infection of bone, joint, soft tissue, including
A2B2 A2B2 A2B3 A3B4
tuberculosis, and their prophylaxis
Sterilisation A2B2 A2B2 A2B3 A2B3
Thromboembolism and prophylaxis A2B2 A2B2 A2B3 A3B4
56
Behavioural dysfunction and somatization A2B2 A2B2 A2B3 A2B3
AIDS and surgery in high-risk patients A2B2 A2B2 A2B3 A3B4
Pain and pain relief A2B3 A2B2 A2B3 A2B3
Skin preparation A3B4 A2B2 A2B3 A3B4
Complex regional pain syndromes e.g. Reflex
A2B2 A2B2 A2B3 A2B3
Sympathetic Dystrophy and Causalgia
2.7. Prosthetics & Orthotics:
Principles of design A2B1 A2B2 A2B3 A2B3
Prescription and fitting of standard prostheses A2B1 A2B2 A2B3 A2B3
Principles of orthotic bracing for control of disease,
A2B1 A2B2 A2B3 A2B3
deformity and instability
2.8. Research & Audit:
Design and conduct of clinical trials A2B1 A2B2 A2B3 A2B3
Data analysis and statistics - principles and
A2B1 A2B2 A2B3 A2B2
applications
Principles of Epidemiology A2B1 A2B2 A2B3 A2B2
Audit A2B3 A2B2 A2B3 A3B4
2.9. Medical Ethics:
Duties of care A2B3 A2B2 A2B3 A3B4
Informed consent A2B3 A2B2 A2B3 A3B4
Medical negligence A2B3 A2B2 A2B3 A3B4
3. HAND & MICRORECONSRUCTION SURGERY
3.1. BASIC SCIENCE
Anatomy of:
The wrist/MCP/PIP/DIP joints and CMC joint of the
A2B3 A2B2 A2B3 A3B4
thumb
The flexor and extensor mechanism of the fingers
including interaction between extrinsic and intrinsic A2B3 A2B2 A2B3 A3B4
mechanism
The posture of the thumb in pinch, power and key
A2B3 A2B2 A2B3 A3B4
grip
The nerve supply to the hand A2B3 A2B2 A2B3 A3B4
The closed compartments of forearm and hand A2B2 A2B2 A2B3 A3B4
3.2. Pathology:
An understanding of the special circum-stances
associated with swelling and the effects of rising
A2B3 A2B2 A2B3 A3B4
pressure in a closed com-partment secondary to
infection and injury
An understanding of the special circum-stances in
which oedema causes fibrosis and permanent A2B3 A2B2 A2B3 A3B4
stiffness
Tendon injury and healing A2B3 A2B2 A2B3 A3B4
Nerve injury and healing A3B4 A2B2 A2B3 A3B4
An appreciation of the imbalances and deformities
A2B1 A2B2 A2B3 A3B4
associated with inflammatory arthritis
57
3.2. Pathology: (Cont.)
A classification system for congenital hand
n/a A2B2 A2B3 A3B4
disorders
Langers lines A2B3 A2B2 A2B3 A3B4
Hand tumours (e.g. ganglion/enchondroma) A2B1 A2B2 A2B3 A3B4
Dupuytren's disease A2B1 A2B2 A2B3 A3B4
3.3. Clinical Assessment:
History of examination of hand and wrist in the
assessment of tendons, distal radioulnar and A2B3 A2B2 A2B3 A3B4
radiocarpal joints
Ability to elicit median, ulnar and radial nerve
A2B3 A2B2 A2B3 A3B4
function and disorders
Recognition of patterns of presentation of common
A3B4 A2B2 A2B3 A3B4
compressive neuropathies and brachial neuralgia
Assessment of intrinsic and extrinsic motors in
digits and recognition of common deformities and A2B2 A2B2 A2B3 A3B4
deficiencies
Awareness of presentation of work-related hand
A2B2 A2B2 A2B3 A3B4
disorders
Ability to examine and assess common rheu-matoid
hand deformities, e.g.: inferior radio-ulnar
subluxation and carpal translocation; MCP
A2B1 A2B2 A2B3 A3B4
subluxation and ulnar drift; digital Bou-tonniere and
swan neck; thumb Boutonniere deformity and CMC
disease
Ability to recognise and assess focal hand swellings A2B2 A2B2 A2B3 A3B4
Investigations: A2B2 A2B3
Interpretation of plain and stress x-rays of wrist. A
A2B2 A2B2 A2B3 A3B4
knowledge of other views
Awareness of role of MRI/bone scan/arthro-
A2B1 A2B2 A2B3 A3B4
graphy/arthroscopy
Place and interpretation of nerve conduction studies A2B1 A2B2 A2B3 A3B4
3.4. Treatment:
Knowledge of a strategy of management for the osteo arthritic rheumatoid hand.
Understanding of the place of soft tissue
reconstruction, joint fusion, interposition and
A2B1 A2B2 A2B3 A3B4
excision arthroplasty in the treatment of the
arthritic hand and wrist.
Knowledge of the management of stenosing
A2B1 A2B2 A2B3 A3B4
tenovaginitis
Knowledge of the principles of treatment for
common flexor and extensor tendon injuries and
A2B3 A2B2 A2B3 A3B4
of the common surgical approaches to the digital
flexor and extensor compartments
58
3.4. Treatment (cont.):
Fractures of metacarpals and phalanges A2B3 A2B2 A2B3 A3B4
Familiarity with the surgical treatment of
A2B1 A2B2 A2B3 A3B4
Dupuytrens disease
Awareness of the principles of tendon transfer for
the reconstruction of mediun, ulnar and radial nerve
A2B1 A2B2 A2B3 A3B4
palsy and familiarity with simple transfers, e.g.
indicis to EPL
Knowledge of splinting techniques and rehabi-
A2B3 A2B2 A2B3 A3B4
litation principles
Ability to plan management for finger tip injuries
A2B3 A2B2 A2B3 A3B4
and undertake closed management
Knowledge of surgical approach to digits with
particular regard to the restoration of function and A2B3 A2B2 A2B3 A3B4
prevention of stiffness
Knowledge of the levels for digital amputation A2B3 A2B2 A2B3 A3B4
Injuries of ulnar collateral ligament of thumb A2B3 A2B2 A2B3 A3B4
Dislocations of carpus and carpal instability A2B1 A2B2 A2B3 A3B4
Knowledge of closed and operative options of
treatment for fractures of distal radius and common A3B4 A2B2 A2B3 A3B4
carpal injuries including scaphoid non union.
Familiarity with the surgical treatment of common
A2B3 A2B2 A2B3 A3B4
compressive neuropathy
Ability to manage common hand infections A2B3 A2B2 A2B3 A3B4
4. KNEE
4.1. BASIC SCIENCE
Anatomy:
Knowledge of regional anatomy of the knee, including: A2B3 A2B2 A2B3 A3B4
Surface anatomy A2B3 A2B2 A2B3 A3B4
particular reference to standard anterior and posterior A2B3 A2B2 A2B3 A3B4
surgical approaches
Bones and joints A2B3 A2B2 A2B3 A3B4
Functional anatomy of ligaments and supporting
A2B3 A2B2 A2B3 A3B4
muscles
Innervation of the knee including controlling
A2B3 A2B2 A2B3 A3B4
musculature
The extent and function of the synovium and bursae of
A2B3 A2B2 A2B3 A3B4
the knee
The structure and function of the menisci, and articular
A2B3 A2B2 A2B3 A3B4
cartilage
4.2. Biomechanics:
The mechanics of the patello-femoral mechanism A2B1 A2B2 A2B3 A3B4
The medial and lateral weight-bearing joints and their
A2B2 A2B2 A2B3 A3B4
inter-relationship
59
4.2. Biomechanics: (Cont.)
The cruciate and collateral ligaments and other
A2B1 A2B2 A2B3 A3B4
ligamentous and muscular supports
Menisci and articular cartilage A2B3 A2B2 A2B3 A3B4
4.3. Pathology:
The mechanism of ligamentous, bony and
combined trauma to the knee and healing A2B3 A2B2 A2B3 A3B4
potential
A complete knowledge of arthritides, including
degenerate wear, ageing changes and traumatic A2B2 A2B2 A2B3 A3B4
damage
Pathology of inflammatory disease and infection
A2B2 A2B2 A2B3 A3B4
affecting the knee
The response of synovium to debris A2B2 A2B2 A2B3 A3B4
Benign and malignant conditions in the knee and
surrounding structures including recognised A2B2 A2B2 A2B3 A3B4
classification where appropriate
A sound knowledge and understanding of: A2B2 A2B3
History and examination of the knee to include
A2B3 A2B2 A2B3 A3B4
relevant surrounding structures
The standard clinical signs of the knee and
relevant adjacent structures and competent skill in A2B3 A2B2 A2B3 A3B4
describing these
A critical understanding of rating and outcome
A2B1 A2B2 A2B3 A3B4
measures in common use
4.5. Investigations:
Indications for and interpretations of: A2B2 A2B3
Radiographs standard and specialised A2B1 A2B2 A2B3 A3B4
Blood investigation A2B1 A2B2 A2B3 A3B4
Aspiration A2B3 A2B2 A2B3 A3B4
Special investigations including CT, MRI and
A2B3 A2B2 A2B3 A3B4
radioisotope scanning
Arthroscopy A2B2 A2B2 A2B3 A3B4
Biomechanical testing A2B1 A2B2 A2B3 A3B4
4.6. Treatment:
A sound knowledge of conservative and surgical management, including the indications
for referral to a specialist of:
Paediatric disorders, including deformity,
dislocations, epiphyseal disorders, osteochondritis A2B2 A2B2 A2B3 A3B4
and discoid meniscus
Adolescent disorders including patello femoral and
A2B2 A2B2 A2B3 A3B4
meniscal dysfunction, osteochondritis dissecans
60
4.6. Treatment: (Cont.)
Young adult disorders including patello femoral and
meniscal injuries, instability and ligament
A2B2 A2B2 A2B3 A3B4
deficiency, synovial disorders, benign and malignant
tumours
Degenerative and inflammatory arthritis, including a
balanced understanding of conservative and surgical
A2B2 A2B2 A2B3 A3B4
options, including osteotomy, arthrodesis and
arthroplasty
Traumatic disorders including skin and soft tissue
injuries, fractures and dislocations of patella, tibia
and femoral components, ligament ruptures and
internal derangement of the knee. Conservative and A2B3 A2B2 A2B3 A3B4
surgical indications and detailed methods of
treatment. Outcomes of conservative and operative
management
Infections, particularly infections and inflammations
of the bursae, intra-articular sepsis, prevention and A2B3 A2B2 A2B3 A3B4
management of sepsis in implant surgery
A sound working knowledge of the range of
arthroplasties for primary and revision surgery for
patello femoral, unicompartmental and total
replacement of the knee with particular reference to
A2B2 A2B2 A2B3 A3B4
secure bone anchorage, alignment, ligament stability
and optimising range of movement; a good
knowledge of post-operative complications, their
prophylaxis and management
A knowledge of the indications and techniques of
revision surgery particularly for aseptic and septic n/a A2B2 A2B3 A3B4
loosening
A knowledge of simple arthroscopic surgery
A2B2 A2B2 A2B3 A3B4
including meniscectomy, trimming and shaving
An appreciation of complex arthroscopic procedures A2B1 A2B2 A2B3 A3B4
An appreciation of medical and surgical techniques
A2B1 A2B2 A2B3 A3B4
available to repair and replace articular cartilage
5. ANKLE & FOOT SURGERY

5.1. BASIC SCIENCE
Anatomy:
Bones and articulations A2B3 A2B2 A2B3 A3B4
Ligamentous structures-ankle/hindfoot/ midfoot A2B3 A2B2 A2B3 A3B4
Plantar fascia and MTP anatomy A2B3 A2B2 A2B3 A3B4
Surface markings of neural and vascular structures A2B3 A2B2 A2B3 A3B4
Tendon anatomy A2B3 A2B2 A2B3 A3B4
Muscle compartments of the foot A3B4 A2B2 A2B3 A3B4
61
5.2. Biomechanics:
Function of the lower limb and foot in gait A2B2 A2B2 A2B3 A3B4
Ankle and subtalar joint A2B2 A2B2 A2B3 A3B4
Plantar fascia mechanisms A2B2 A2B2 A2B3 A3B4
Tendon function A2B2 A2B2 A2B3 A3B4
Orthoses and footwear A2B2 A2B2 A2B3 A3B4
5.3. Pathology:
Arthrities A2B2 A2B3
Degenerative joint disease A2B2 A2B2 A2B3 A3B4
Rheumatoid foot disease A2B1 A2B2 A2B3 A3B4
Neuropathy A2B2 A2B3
Neuropathic joint and skin changes A2B1 A2B2 A2B3 A3B4
Tumours
E.g. osteoid osteoma and plantar fibroma A2B1 A2B2 A2B3 A3B4
History and clinical examination of the foot and
ankle in order to assess pain, joint function, A2B3 A2B2 A2B3 A3B4
deformity, nerve, muscle and tendon function
Ability to recognise and assess the following diseases of the ankle and foot:
Neurological disorders:
Charcot joint A2B1 A2B2 A2B3 A3B4
Morton's neuroma A2B2 A2B2 A2B3 A3B4
Nerve entrapment A2B2 A2B2 A2B3 A3B4
Neurological foot deformity A2B2 A2B2 A2B3 A3B4
Trauma:
Evaluation of skin and soft tissue injury A3B4 A2B2 A2B3 A3B4
Compartment syndrome A3B4 A2B2 A2B3 A3B4
Recognition of all fractures and dislocations A2B3 A2B2 A2B3 A3B4
Ankle and hindfoot disorder:
Hindfoot pain A2B1 A2B2 A2B3 A3B4
Ankle instability A2B1 A2B2 A2B3 A3B4
Heel pain A2B1 A2B2 A2B3 A3B4
Degenerative disease of the ankle A2B1 A2B2 A2B3 A3B4
Rheumatoid arthritis A2B1 A2B2 A2B3 A3B4
Osteochondritis dissecans of talus A2B2 A2B2 A2B3 A3B4
Forefoot disorders:
Hallux valgus A2B1 A2B2 A2B3 A3B4
Hallux rigidus A2B1 A2B2 A2B3 A3B4
Lesser toe deformities A2B1 A2B2 A2B3 A3B4
Metatarsalgia A2B1 A2B2 A2B3 A3B4
Inflammatory arthritis A2B2 A2B2 A2B3 A3B4
62
Tumours:
Ability to recognise and assess local foot
A2B1 A2B2 A2B3 A3B4
swellings
Diabetic foot: A2B2 A2B2 A2B3 A3B4
Complex foot deformity A2B2 A2B3
Flatfoot deformity - mobile and rigid A2B1 A2B2 A2B3 A3B4
Cavus deformity A2B1 A2B2 A2B3 A3B4
Residual congenital foot deformity A2B1 A2B2 A2B3 A3B4
Investigations:
Radiograph:
Standard foot and ankle views A3B4 A2B2 A2B3 A3B4
CT, MRI and Scintigraphy:
Knowledge of role of these ancillary
investigations in certain specific conditions e.g.
A2B2 A2B2 A2B3 A3B4
infection, tumour, tibialis posterior rupture,
osteonecrosis
EMG:
Relevance to foot and ankle disorders A2B1 A2B2 A2B3 A3B4
5.5. Treatment:
Non-operative:
Knowledge of rational basis for the use of
footwear modifications, orthoses and total contact A2B1 A2B2 A2B3 A3B4
casting
Operative:
Detailed knowledge of closed and operative
methods for management of fractures and
dislocations of ankle, hindfoot and forefoot,
including knowledge of common reconstructive
A2B3 A2B2 A2B3 A3B4
surgical procedures for foot deformity including
hallux valgus, lesser toe deformity, acquired flat-
foot, to include arthrodesis, osteotomy and soft-
tissue reconstruction
Knowledge of common amputations through foot
A2B3 A2B2 A2B3 A3B4
and ankle
Knowledge of common reconstructive surgical
procedures for degenerative and inflammatory
disorders of ankle and foot including arthrodesis,
A2B1 A2B2 A2B3 A3B4
arthroplasty, excision arthroplasty procedures to
first ray both proximal and distally for
management of hallux valgus and rigidus
63
6. HIP
6.1. BASIC SCIENCE
Anatomy:
Basic knowledge of the regional anatomy of the hip
A2B3 A2B2 A2B3 A3B4
including:
Development of the hip joint A2B3 A2B2 A2B3 A3B4
Relationship of bony elements A2B3 A2B2 A2B3 A3B4
Blood supply of the femoral head A2B3 A2B2 A2B3 A3B4
Anatomical course of all major regional vessels and
A2B3 A2B2 A2B3 A3B4
nerves
The capsule, labrum and related ligaments A2B3 A2B2 A2B3 A3B4
An understanding of the action, anatomy and
A2B3 A2B2 A2B3 A3B4
innervation of the regional musculature
Detailed knowledge of the applied anatomy of
common surgical approaches to the hip (medial, A2B3 A2B2 A2B3 A3B4
anterior, lateral and posterior)
6.2. Biomechanics:
An understanding of the lever arms, muscles and
body weight forces that produce the joint reaction A2B2 A2B2 A2B3 A3B4
force in both normal and abnormal hips
An understanding of the application of these
principles to the rationale of both pelvic and femoral A2B1 A2B2 A2B3 A3B4
osteotomies, and replacement arthroplasty
Knowledge of the tribological properties of
A2B1 A2B2 A2B3 A3B4
materials used for articulating surfaces
Knowledge of the biocompatibility and mechanical
properties of materials in common use in total hip A2B1 A2B2 A2B3 A3B4
arthroplasty
6.3. Pathology:
Basic knowledge of the pathology of pyogenic and
non-pyogenic arthritis, slipped upper femoral A2B2 A2B2 A2B3 A3B4
epiphysis [SUFE], Perthes' disease and hip dysplasia
Mechanism and pattern of common fractures and
fracture dislocations around the hip (intracapsular,
A2B3 A2B2 A2B3 A3B4
extracapsular, acetabular and periacetabular, femoral
head, etc)
Knowledge of the pathology of osteoarthritis,
rheumatoid arthritis and the seronegative arthritides A2B2 A2B2 A2B3 A3B4
at the hip and of osteonecrosis of the femoral head
Familiarity with current theories of the
A2B1 A2B2 A2B3 A3B4
aetiopathogenesis of osteoarthritis
An understanding of the microbiological rationale
A2B3 A2B2 A2B3 A3B4
for the prevention of sepsis in total hip arthroplasty
64
A sound knowledge of clinical assessment of
the hip, lumbosacral spine and knee. Particular
reference should be paid to the gait, the A2B3 A2B2 A2B3 A3B4
Trendelenberg sign, limb length, loss of
movement and deformity at the joint
The trainee needs to be well informed of current
opinion regarding aetiopathogenesis, clinical A2B2 A2B2 A2B3 A3B4
presentation and appropriate investigation of:
Proximal femoral fractures (intracapsular,
extracapsular) and simple fracture dislocations of A3B4 A2B2 A2B3 A3B4
the hip
Osteoarthritis and the inflammatory arthropathies A2B2 A2B2 A2B3 A3B4
Perthes' disease A2B2 A2B2 A2B3 A3B4
Slipped upper femoral epiphysis A2B2 A2B2 A2B3 A3B4
Septic arthritis A2B3 A2B2 A2B3 A3B4
Osteonecrosis A2B3 A2B2 A2B3 A3B4
Soft tissue conditions around the hip (snapping
A2B2 A2B2 A2B3 A3B4
hip, gluteus medius tendonitis, etc)
A working knowledge of the clinical presentations and investigations of:
The sequelae of CDH and hip dysplasia A2B1 A2B2 A2B3 A3B4
The sequelae of SUFE A2B3 A2B2 A2B3 A3B4
Juvenile chronic arthritis A2B1 A2B2 A2B3 A3B4
Non pyogenic arthritis A2B2 A2B2 A2B3 A3B4
The painful total hip replacement A2B1 A2B2 A2B3 A3B4
Investigation:
A working knowledge of the interpretation of
plain radiographs, dynamic arthrography, CT, A2B2 A2B2 A2B3 A3B4
bone scintigraphy and MRI of the hip region
A working classification of proximal femoral
and periacetabular fractures. Also, mechanisms
A2B3 A2B2 A2B3 A3B4
and classification of failure of joint
replacement and of periprosthetic fractures
6.5. Treatment:
Non-operative
An understanding of the principles of traction,
A2B3 A2B2 A2B3 A3B4
bracing and spica immobilisation
An understanding of the non operative aspects
A2B3 A2B2 A2B3 A3B4
of the management of hip pathology
65
Operative
A thorough knowledge of soft tissue surgery,
osteotomy, arthrodesis and arthroplasty
(excision and replacement). A sound
A2B3 A2B2 A2B3 A3B4
knowledge of anterior, anterolateral, lateral
and posterior approaches to the hip and of the
complications associated with each
A sound knowledge of: internal fixation of
proximal femoral fractures, hemiarthroplasty
for intracapsular fractures, primary total hip
replacement for OA and inflammatory
arthropathies in the elderly, simple proximal
A2B3 A2B2 A2B3 A3B4
femoral osteotomies. Familiarity with poten-
tial complications (i.e. thromboembo-lism,
sepsis, dislocation, etc) and be aware of current
opinion on the prevention and management of
these complications
A knowledge of the indications for, and
principles of, complex proximal femoral
osteotomies, hip arthroscopy, reconstruction of A2B1 A2B2 A2B3 A3B4
the hip in young adults (JCA and hip dysplasia,
etc), complex hip revision surgery
An appreciation of complex acetabular and pelvic
A2B3 A2B2 A2B3 A3B4
fractures, complex periacetabular osteotomies
An understanding of the place of modern
technologies such as, joint resurfacing procedures
minimally invasive hip replace-ments and
A2B2 A2B2 A2B3 A3B4
computer assisted implantation in the
management of hip pathology and the attendant
risks and complications
7. THE SPINE
7.1. BASIC SCIENCE
Anatomy:
Development of the spine, spinal cord and nerve
A2B3 A2B2 A2B3 A3B4
roots
Surgical anatomy of the cervical, dorsal and
A2B3 A2B2 A2B3 A3B4
lumbosacral spine
Anterior and posterior surgical approaches to the
A2B3 A2B2 A2B3 A3B4
spine at each level
66
Biomechanics:
Basic knowledge of the biomechanics of the
A2B2 A2B2 A2B3 A3B4
cervical and lumbosacral spines
An understanding of the biomechanics of spinal
instability as applied to trauma, tumour, infection A2B1 A2B2 A2B3 A3B4
and spondylolysis/listhesis
7.2. Biomechanics
Biomechanics of spinal deformity A2B1 A2B2 A2B3 A3B4
A knowledge of the basic mechanics of spinal
A2B1 A2B2 A2B3 A3B4
instrumentation
7.3. Pathology:
Pathophysiology of the ageing spine and
A2B3 A2B2 A2B3 A3B4
degenerative disc disease
Acute and chronic infections of the spine A2B1 A2B2 A2B3 A3B4
Pathology of spinal deformity A2B1 A2B2 A2B3 A3B4
Pathology of the acutely prolapsed cervical and
A2B2 A2B2 A2B3 A3B4
lumbar disc
Recognition of patterns of spinal injury and
A2B3 A2B2 A2B3 A3B4
associated cord and nerve root damage
Tumours of the spine A2B1 A2B2 A2B3 A3B4
A thorough knowledge of general and orthopaedic
A2B3 A2B2 A2B3 A3B4
history-taking and examination
A knowledge of the assessment of spinal deformity A2B1 A2B2 A2B3 A3B4
An understanding of the assessment of thoracic pain A2B1 A2B2 A2B3 A3B4
A sound knowledge of clinical assessment of the
spine for low back pain, sciatica, spinal claudication,
A2B2 A2B2 A2B3 A3B4
neck pain, radiating arm pain, spinal injury and
incipient myelopathy
A knowledge of the assessment of spinal tumour A2B2 A2B2 A2B3 A3B4
A basic knowledge of the assessment of a patient after
A2B1 A2B2 A2B3 A3B4
failed spinal surgery
Investigation:
A thorough knowledge of the basic investigations
required in spinal surgery, specifically: blood
tests, plain radiographs, bone scintigraphy,
A2B2 A2B2 A2B3 A3B4
discography, electrophysiological studies
[including cord monitoring], CT scanning, MRI
scanning
A thorough knowledge of how each of these
investigations contributes to the diagnosis and
A2B2 A2B2 A2B3 A3B4
management of each of the major areas of spinal
disease
67
7.5. Treatment:
Non-operative
A knowledge of the non-surgical methods available for
the treatment of low back pain, sciatica, claudication,
A2B2 A2B2 A2B3 A3B4
neck pain, spinal deformity, instability, tumour,
infection and fracture to include:
Analgesics and NSAIDs, physiotherapeutic regimes,
pain clinic techniques, bracing, use of radiotherapy and
A2B1 A2B2 A2B3 A3B4
chemotherapy, non-operative management of spinal
injuries
Operative
A sound knowledge of the indications for and
operative surgical management of the acute
prolapsed lumbar intervertebral disc, spinal stenosis, A2B2 A2B2 A2B3 A3B4
lumbar spinal instability due to
spondylolysis/listheses
A knowledge of the indications for, and operative
surgical management of the acutely
prolapsed cervical disc, cervical stenosis, spinal
A2B2 A2B2 A2B3 A3B4
injury and the surgery of spinal infection
A basic knowledge of the surgery of spinal
A2B1 A2B2 A2B3 A3B4
deformity and tumours of the spine
TRAUMA
8.1. BASIC SCIENCE
Anatomy:
Applied to diagnosis and surgical treatment of
A3B4 A2B2 A2B3 A3B4
common bone, joint and soft tissue injuries
Knowledge of those anatomical structures
particularly at risk from common injuries or in A3B4 A2B2 A2B3 A3B4
surgical approaches
Physeal anatomy and its application to injury A2B3 A2B2 A2B3 A3B4
8.2. Biomechanics:
Application to open reduction and internal
A2B3 A2B2 A2B3 A3B4
fixation of fractures and external skeletal fixation
Applied to fracture formation and fracture
A2B3 A2B2 A2B3 A3B4
treatment both operative and non-operative
Biomechanics of implants and fracture fixation
A2B3 A2B2 A2B3 A3B4
systems, including their material properties
8.3. Epidemiology and Research Methods:
Research and audit methods including the design
A2B2 A2B2 A2B3 A2B3
of clinical trials
68
8.4. Pathology:
A knowledge of the non-surgical methods
available for the treatment of low back pain,
sciatica, claudication, neck pain, spinal A2B2 A2B2 A2B3 A3B4
deformity, instability, tumour, infection and
fracture to include:
Applied to fracture and soft tissue healing,
including skin, muscle, tendon and neurological A3B4 A2B2 A2B3 A3B4
structures
Classification systems for fractures and dislo-
A2B3 A2B2 A2B3 A3B4
cations
Pathology of non-union of fractures A3B4 A2B2 A2B3 A3B4
Response of the body, and local muscu-loskeletal
A3B4 A2B2 A2B3 A3B4
tissues to infection
Systemic response of body to major injury A3B4 A2B2 A2B3 A3B4
Mechanisms underlying Acute Respiratory
Distress Syndrome and similar life threatening A3B4 A2B2 A2B3 A3B4
conditions
Science of fluid replacement therapy in the
acutely injured including application to the A3B4 A2B2 A2B3 A3B4
treatment of burns
Science of treatment of compartment syndrome A3B4 A2B2 A2B3 A3B4
Response of infants, children and the elderly to injury A3B4 A2B2 A2B3 A3B4
Initial clinical assessment of the patient with severe
injury, including spinal cord injury, soft tissue A3B4 A2B2 A2B3 A3B4
injury, burns and head injury
Assessment of all types of fracture and dislocation,
A3B4 A2B2 A2B3 A3B4
their complications, early and late
Identification of life threatening/limb threatening
A3B4 A2B2 A2B3 A3B4
injuries. Understanding priorities of treatment
Investigations:
Knowledge of the principles, application and side
effects of commonly used investigations, including
radiographs, CT and MRI scans, radio-isotope A2B3 A2B2 A2B3 A3B4
imaging, ultrasound scans and electrophysiological
investigations
Treatment:
Knowledge of different treatment options for
musculoskeletal injury, both non-operative and
A2B3 A2B2 A2B3 A3B4
operative. Ability to analyse the pros and cons for
each method
Ability to manage the overall care of the severely
A2B3 A2B2 A2B3 A3B4
injured
69
Treatment (Cont.):
Ability to undertake the complete treatment of all
types of common fracture and dislocation including
A2B3 A2B2 A2B3 A3B4
the bone and soft tissue treatment of open fractures
and the treatment of pathological fractures
Where common injuries are normally treated by a
sub specialist (e.g. spinal injury, arterial injury or
intra cranial haemorrhage) there should be ability A2B3 A2B2 A2B3 A3B4
to manage the initial treatment of the patient and
know the principles of the specialist treatment
Principles of reconstructive surgery for the injured,
including treatment of non-union and malunion of
fractures, bone defects, chronic post-traumatic A2B3 A2B2 A2B3 A3B4
osteomyelitis and delayed treatment of nerve injury;
principles of soft tissue reconstruction
The principles of amputation in the injured and
A2B3 A2B2 A2B3 A3B4
the rehabilitation of such patients
9. PAEDIATRIC ORTHOPAEDIC SURGERY

9.1. BASIC SCIENCE
Detailed knowledge of the growth of bones,
physeal anatomy and its application to fracture
A2B2 A2B2 A2B3 A3B4
types and pathological processes and infection in
particular
Knowledge of the anatomy of bones and joints in
the growing child and its application to growth A2B2 A2B2 A2B3 A3B4
and deformity
Knowledge of the neurological processes
involved in the production of deformity e.g. spina A2B2 A2B2 A2B3 A3B4
bifida, cerebral palsy and muscular dystrophy
Core knowledge should be at least that of a
A2B2 A2B2 A2B3 A3B4
general orthopaedic textbook
'Expert' knowledge, i.e. the level of the speciality
journal is required for those wishing to pursue a A2B2 A2B2 A2B3 A3B4
career in children's orthopaedics
The trainee must be able to clinically examine a
child competently and to relate effectively with A2B2 A2B2 A2B3 A3B4
the family
The trainee must be able to make proper
management decisions in paediatric practice and A2B2 A2B2 A2B3 A3B4
to refer appropriately for treatment
70
Investigations:
Knowledge of the indications for plain x-
ray, arthrogram, CT, MRI and the ability to A2B1 A2B2 A2B3 A3B4
interpret the images
Knowledge of the indications for the use of
A2B1 A2B2 A2B3 A3B4
ultrasound and nuclear imaging
Awareness of the limitations of certain
A2B1 A2B2 A2B3 A3B4
investigations in paediatric practice
9.3. Treatment:
A sound knowledge of normal variants, e.g.
A2B1 A2B2 A2B3 A3B4
knock knees, bow legs and flat feet
A detailed knowledge of the treatment for:
Fractures (including non-accidental injury)
and growth plate injuries and recognise the A2B3 A2B2 A2B3 A3B4
sequelae
Bone and joint infection A2B3 A2B2 A2B3 A3B4
Common childhood orthopaedic conditions,
A2B1 A2B2 A2B3 A3B4
e.g. irritable hip, anterior knee pain
A working knowledge of the treatment for:
Slipped epiphysis A2B2 A2B2 A2B3 A3B4
Perthes' disease A2B1 A2B2 A2B3 A3B4
Developmental dysplasia of the hip A2B1 A2B2 A2B3 A3B4
Talipes A2B1 A2B2 A2B3 A3B4
Scoliosis A2B1 A2B2 A2B3 A3B4
Simple foot deformities (e.g. hallux valgus,
A2B1 A2B2 A2B3 A3B4
metatarsus varus)
Simple congenital hand abnormalities (e.g.
A2B1 A2B2 A2B3 A3B4
trigger thumb)
Osteogenesis imperfecta A2B2 A2B2 A2B3 A3B4
Skeletal dysplasias A2B1 A2B2 A2B3 A3B4
Tarsal coalitions A2B1 A2B2 A2B3 A3B4
Torticollis A2B1 A2B2 A2B3 A3B4
Leg length discrepancy A2B1 A2B2 A2B3 A3B4
A knowledge of:
Screening services for congenital
A2B1 A2B2 A2B3 A3B4
abnormalities
Assessment of physical disability A2B1 A2B2 A2B3 A3B4
71
10. SHOULDER & ELBOW
10.1. BASIC SCIENCE
Anatomy:
Basic knowledge of the regional anatomy of the shoulder including:
Detailed anatomy of the sternoclavicular,
acromioclavicular, glenohumeral and elbow
joints to include the connecting bones, muscles
A2B3 A2B2 A2B3 A3B4
and tendons acting across them, neurovascular
supply, bursae and relationships to local
structures
Basic knowledge of the regional anatomy of the shoulder including (cont.):
Surgical approaches: deltopectoral and posterior
approaches to glenohumeral joint; superior (McKenzie)
A2B3 A2B2 A2B3 A3B4
approach to rotator cuff; and surgical approaches to the
acromioclavicular and sternoclavicular joints
Structure and function of the above joints; a clear
understanding of the static and dynamic stabilisers of A2B3 A2B2 A2B3 A3B4
the glenohumeral and elbow joints
10.2. Biomechanics:
Biomechanics of the shoulder and elbow to the
A2B2 A2B2 A2B3 A3B4
level of the currently published specialist journals
Knowledge of the various types of shoulder and
elbow prostheses including the factors
A2B1 A2B2 A2B3 A3B4
influencing design, wear and loosening to the
level of the currently published specialist journals
10.3. Pathology:
Sound knowledge of all commonly encountered
benign and malignant conditions affecting the
A2B1 A2B2 A2B3 A3B4
shoulder girdle, elbow and surrounding soft
tissues
A basic understanding of the pathology of:
Impingement and rotator cuff disorders A2B2 A2B2 A2B3 A3B4
Instability of the shoulder and the elbow A2B2 A2B2 A2B3 A3B4
Inflammatory and degenerative conditions
A2B2 A2B2 A2B3 A3B4
affecting the articular cartilage and synovium
Infection A2B2 A2B2 A2B3 A3B4
Adhesive capsulitis of the shoulder A2B2 A2B2 A2B3 A3B4
The pathology of the stiff elbow A2B2 A2B2 A2B3 A3B4
Disorders such as ulnar neuritis and tennis or
A2B2 A2B2 A2B3 A3B4
golfers elbow
72
10.4.Clinical Assessment:
Detailed history and examination of the painful, stiff
A2B3 A2B2 A2B3 A3B4
or unstable shoulder or elbow
Knowledge of clinical tests used specifically to
assess instability of the shoulder and elbow, rotator
cuff disorders, the stiff shoulder or elbow and the
use of local anaesthetic in assessment. Examples are
A2B2 A2B2 A2B3 A3B4
the apprehension tests for shoulder instability,
impingement signs and tests, Gerbers lift off test,
Napoleon's sign, elbow instability tests, ulnar nerve
assessment
Knowledge of conditions causing referred symptoms
to the shoulder and elbow (e.g. cervical spine
A2B3 A2B2 A2B3 A3B4
diseases, entrapment neuropathies and thoracic
outlet disorders)
Knowledge to the level of a basic specialist shoulder
textbook of common conditions affecting the
shoulder including instability, impingement, rotator
cuff tears, adhesive capsulitis, osteoarthritis,
A2B3 A2B2 A2B3 A3B4
rheumatoid disease, avascular necrosis, biceps
tendon disorders, fractures of the proximal humerus
and clavicle, and disorders of the acromioclavicular
and sternoclavicular joints and scapula
Knowledge to the level of a basic specialist elbow
textbook of common conditions affecting the elbow
including instability, osteoarthritis, rheumatoid
A2B3 A2B2 A2B3 A3B4
arthritis, causes of stiffness, soft tissue problems
such as medial and lateral epicondylitis,
neuropathies and fractures around the elbow
Investigation:
Knowledge of plain radiographs as used to assess
shoulder and elbow disorders. This should include a
knowledge of those special views (e.g. Modified axial,
Stryker notch, Supraspinatus Neer outlet and cubital
A2B3 A2B2 A2B3 A3B4
tunnel views) required to assess adequately the
conditions which commonly affect the shoulder and
elbow. The ability to recognise correctly normal and
abnormal abnormalities on plain radiographs
Knowledge of the value of ultrasound, arthrography,
CT and MRI as used to assess the shoulder and
elbow. An ability to identify straightforward
abnormalities on CT and MRI (e.g. full thickness A2B3 A2B2 A2B3 A3B4
and partial thickness rotator cuff tears on MRI and
the pathological anatomy of fractures around the
shoulder and elbow using CT)
Knowledge of the use and abuse of arthroscopy of
the shoulder and elbow including a knowledge of A2B2 A2B2 A2B3 A3B4
normal and abnormal arthroscopic findings
73
LAMPIRAN 2
10.5. Treatment:
Non-operative
An ability to supervise the non-operative management
of fractures, dislocations and soft tissue injuries around A2B3 A2B2 A2B3 A3B4
the shoulder and elbow
An in-depth knowledge of the management of
straightforward fractures and dislocations of the
shoulder girdle and elbow. Knowledge of the treatment
options for more complex fractures with an
understanding that these might more appropriately be
referred to someone with a special interest; examples of A2B3 A2B2 A2B3 A3B4
these might include four part fractures of the proximal
humerus and complex intraarticular fractures of the
distal humerus. An ability to recognise upper limb
injuries involving injuries to the brachial plexus and
refer on as appropriate
A knowledge of injection techniques for both the
A2B2 A2B2 A2B3 A3B4
shoulder and the elbow
Knowledge of both the non-operative and operative
treatment of common disorders such as recurrent
anterior traumatic instability of the shoulder, rotator A2B2 A2B2 A2B3 A3B4
cuff impingement and small rotator cuff tears,
adhesive capsulitis, acromioclavicular joint pain
Operative
A knowledge of the management of soft tissue
elbow disorders such as lateral and medial A2B2 A2B2 A2B3 A3B4
epicondylitis and ulnar neuropathy
Knowledge of the indications, options and
complications for prosthetic replacement of the
A2B2 A2B2 A2B3 A3B4
shoulder and elbow. A detailed knowledge of the
surgical techniques is not required
Knowledge of the indications and benefits of
arthroscopy of the shoulder and elbow. An ability
to perform an arthroscopic assessment of the
A2B1 A2B2 A2B3 A3B4
shoulder is expected but a knowledge of the
techniques of arthroscopic surgery procedures is
not required
Understanding the principles of management of
A2B1 A2B2 A2B3 A3B4
tumours around the shoulder and elbow
74
LAMPIRAN 2
Tingkat Kompetensi Psikomotor Peserta Didik
Berdasarkan Topik dan Tahapan
Tingkat Kompetensi
C1 : Melihat dan asimilasi
C2 : Mengerjakan dengan bimbingan
C3 : Mengerjakan mandiri dengan pengawasan
OL1
TOPIC OD CR
OL 2
TRAUMA
TRAUMA GENERAL
Free flap C1 C1 C1
Full thickness skin graft C1 C2 C3
Muscle flap C1 C1 C3
Nerve repair C1 C2 C3
Pedicle flap C1 C1 C3
Removal external fixator or frame C2 C3 C3
Removal foreign body from skin / subcutaneous tissue C2 C3 C3
Removal K wires or skeletal traction C3 C3 C3
Split skin graft C1 C2 C3
Transpositional flap C1 C1 C3
Wound closure, delayed primary or secondary C3 C3 C3
Wound Debridement C2 C3 C3
Internal Fixation of Long Bone C2 C3 C3
Internal fixation of complex fracture C2 C3 C3
External fixation C2 C3 C3
Periarticuler fracture C1 C2 C3
Tendon repair C2 C3 C3
Vascular repair C1 C2 C3
Casting and splinting C2 C3 C3
AXIAL SKELETON:
Cervical Spine
Anterior fixation fracture/dislocation cervical spine C1 C1 C2
Application halo / tong traction cervical spine C1 C2 C2
MUA fracture / dislocation cervical spine C1 C2 C2
Posterior fixation fracture/dislocation cervical spine C1 C2 C2
TOPIC OD OL1 CR
75
OL 2
Thoracic Spine
Anterior decompression / fixation thoracic spine C1 C2 C3
Posterior decompression / fixation thoracic spine C1 C2 C3
Lumbar Spine
Anterior decompression / fixation lumbar spine C1 C2 C3
Posterior decompression / fixation lumbar spine C1 C2 C3
Pelvis
Simple acetabular fracture ORIF C1 C2 C3
Complex acetabular fracture ORIF C1 C2 C2
Pelvic fracture:
Pelvic fracture external fixator application C1 C2 C3
Simple pelvic fracture ORIF C1 C2 C3
Complex pelvic fracture ORIF C1 C2 C2
UPPER LIMB:
Brachial Plexus
Exploration / repair / grafting brachial plexus C1 C1 C2
Clavicle
ORIF clavicle fracture C1 C2 C3
ORIF non-union clavicle fracture C1 C2 C3
Shoulder
Anterior dislocation shoulder
Anterior dislocation shoulder closed reduction C2 C3 C3
Anterior dislocation shoulder open reduction +/- fixation C1 C2 C3
Acromioclavicular joint dislocation acute ORIF C1 C2 C3
Fracture proximal humerus ORIF C2 C2 C3
Glenoid fracture ORIF C1 C2 C3
Posterior dislocation shoulder closed reduction C2 C3 C3
Humerus
Fracture diaphysis humerus non-op: C3 C3 C3
Non-union ORIF +/- bone grafting C1 C2 C3
Fracture diaphysis humerus IM nailing C1 C2 C3
Fracture diaphysis humerus MUA +/- POP C2 C3 C3
Fracture diaphysis humerus ORIF plating C2 C3 C3
Elbow
Dislocated elbow +/- fracture closed reduction C2 C3 C3
Dislocated elbow +/- fracture open reduction +/- fixation C2 C2 C3
Intraarticular distal humerus fracture ORIF C2 C2 C3
Lateral condyle fracture ORIF C2 C2 C3
Medial condyle / epicondyle fracture MUA / K wire / ORIF C2 C3 C3
Olecranon fracture ORIF C2 C3 C3
76
OL1
TOPIC OD CR
OL 2
Radial head / neck fracture MUA +/- K wire C2 C3 C3
Radial head / neck fracture ORIF C2 C3 C3
Radial head replacement for fracture C1 C2 C3
Supracondylar fracture:
Supracondylar fracture MUA +/- K wires C2 C2 C3
Supracondylar fracture ORIF C1 C2 C3
Forearm
Fasciotomy for compartment syndrome C1 C3 C3
Fracture distal radius:
Fracture distal radius closed non-op C1 C2 C3
Fracture distal radius external fixation C2 C2 C3
Fracture distal radius MUA & percutaneous wires C2 C2 C3
Fracture distal radius MUA & POP C2 C3 C3
Fracture distal radius ORIF C2 C2 C3
Fracture shaft radius / ulna:
Fracture shaft radius / ulna IM nailing C1 C2 C3
Fracture shaft radius / ulna MUA & percutaneous wires C2 C3 C3
Fracture shaft radius / ulna MUA & POP C2 C3 C3
Fracture shaft radius / ulna ORIF C2 C3 C3
Wrist
Carpal fracture / dislocation:
Carpal fracture / dislocation MUA & percutaneous wires C2 C2 C3
Carpal fracture / dislocation MUA & POP C2 C4 C3
Carpal fracture / dislocation ORIF C1 C2 C3
Scaphoid fracture non-op C2 C3 C3
Scaphoid fracture ORIF C1 C2 C3
Scaphoid fracture MUA & percutaneous wires C1 C2 C3
Scaphoid fracture non-union ORIF +/- graft C1 C2 C3
Hand
Carpal fracture / dislocation:
5th metacarpal fracture / dislocation non-op C2 C3 C3
5th metacarpal fracture / dislocation MUA & percu-taneous C2 C3 C3
wires
5th metacarpal fracture / dislocation MUA & POP C2 C3 C3
5th metacarpal fracture / dislocation ORIF C2 C3 C3
Finger tip reconstruction C2 C3 C3
Infection:
Infection hand drainage (not tendon sheath) C2 C3 C3
Infection tendon sheath drainage C2 C3 C3
77
OL1
TOPIC OD CR
OL 2
IPJ fracture / dislocation:
IPJ fracture / dislocation MUA & percutaneous wires C2 C3 C3
IPJ fracture / dislocation MUA +/- POP C2 C3 C3
IPJ fracture / dislocation ORIF C2 C3 C3
Ligament repair hand C2 C2 C3
Metacarpal fracture (not 1st or 5th) non-op C2 C3 C3
Metacarpal fracture (not 1st or 5th) MUA & Percutaneous C2 C3 C3
wires
Metacarpal fracture (not 1st or 5th) MUA +/- POP C2 C3 C3
Metacarpal fracture (not 1st or 5th) ORIF C2 C3 C3
Phalangeal fracture non-op C2 C3 C3
Phalangeal fracture MUA & percutaneous wires C2 C3 C3
Phalangeal fracture MUA +/- POP C2 C3 C3
Phalangeal fracture ORIF C2 C2 C3
Tendon repair:
Tendon repair extensor C2 C3 C3
Tendon repair flexor C2 C3 C3
CPJ fracture / dislocation:
MCPJ fracture / dislocation MUA & Percutaneous wires C2 C2 C3
MCPJ fracture / dislocation MUA +/- POP C2 C2 C3
MCPJ fracture / dislocation ORIF C2 C2 C3
LOWER LIMB:
Hip
Dislocated hip:
Dislocated hip closed reduction C2 C3 C3
Acute dislocated hip open reduction +/- fixation C1 C2 C3
Neglected dislocated hip open reduction +/- fixation C1 C2 C2
Extracapsular fracture:
Extracapsular fracture CHS / DHS C2 C3 C3
Extracapsular fracture intramedullary fixation C2 C3 C3
Extracapsular fracture other fixation C2 C3 C3
Intracapsular fracture:
Intracapsular fracture hemiarthroplasty C2 C3 C3
Intracapsular fracture internal fixation C2 C3 C3
Intracapsular fracture intracapsular fracture THR C2 C2 C3
Femur
Diaphyseal fracture closed:
Diaphyseal fracture traction or spica in child C1 C2 C3
Diaphyseal fracture intramedullary nailing C2 C3 C3
Diaphyseal fracture plate/screw fixation C2 C3 C3
78
OL1
TOPIC OD CR
OL 2
Subtrochanteric fracture:
Subtrochanteric fracture intramedullary fixation C2 C3 C3
Subtrochanteric fracture plate/screw fixation C2 C3 C3
Supracondylar fracture (not intraarticular):
Supracondylar fracture (not intraarticular) DCS / blade plate etc C2 C2 C3
Supracondylar fracture (not intraarticular) intra-medullary C2 C2 C3
fixation
Knee
Acute haemarthrosis arthroscopy C1 C2 C3
Acute ligament repair C1 C2 C3
Intraarticular fracture distal femur ORIF C1 C2 C3
Patella dislocation closed reduction +/- open repair C2 C3 C3
Patella fracture ORIF C2 C3 C3
Patella tendon repair C2 C3 C3
Quadriceps tendon repair C2 C3 C3
Simple tibial plateau fracture C1 C2 C3
Complex tibial plateau fracture C1 C2 C2
Tibial plateau fracture arthroscopically assisted fixation C1 C2 C3
Tibial plateau fracture ORIF with plates & screws C1 C2 C3
Tibial plateau fracture treatment with circular frame C1 C2 C3
Tibia & Fibula
Diaphyseal tibial fracture external fixation (including C2 C2 C3
frame)
Diaphyseal tibial fracture intramedullary nailing C2 C3 C3
Diaphyseal tibial fracture MUA & POP C2 C3 C3
Tibial shaft plating C2 C2 C3
Tibial non-union:
Tibial non-union circular frame management C1 C2 C3
Tibial non-union intramedullary nailing +/- bone grafting C1 C2 C3
Ankle
Ankle fracture / dislocation:
Ankle fracture / dislocation MUA & POP C2 C3 C3
Ankle fracture / dislocation ORIF C2 C3 C3
Pilon fracture:
Simple pilon fracture ORIF C1 C2 C3
Complex pilon fracture ORIF C1 C2 C2
Pilon fracture with circular frame C1 C2 C3
Tendoachilles repair C2 C3 C3
Foot
Amputation toe / ray for trauma C2 C3 C3
Simple calcaneal fracture ORIF C1 C2 C3
79
OL1
TOPIC OD CR
OL 2
Complex calcaneal fracture ORIF
Metatarsal fracture ORIF C1 C3 C3
Phalangeal fracture MUA +/- K wire +/- ORIF C2 C3 C3
Talar, subtalar or midtarsal fracture / disloc:
Talar, subtalar or midtarsal fracture / dislocation MUA +/- C1 C2 C3
POP +/- K wires
Talar, subtalar or midtarsal fracture / dislocation ORIF C1 C2 C3
Achilles Tendon Repair C1 C2 C3
ELECTIVE
ELECTIVE SITE NON SPECIFIC
Aspiration / injection joint C2 C3 C3
Benign tumour excision (not exostoses) C2 C3 C3
Biopsy bone - needle C1 C3 C3
Biopsy bone - open C1 C3 C3
Bursa excision C2 C3 C3
Cyst bone curettage +/- bone graft C1 C3 C3
Epiphysiodesis n/a C2 C3
Malignant tumour excision C1 C2 C2
AXIAL SKELETON:
Cervical Spine
Anterior decompression +/- fixation / fusion (C2-C7) n/a C1 C2
Atlantoaxial fixation +/- fusion n/a C1 C2
Biopsy cervical spine n/a C2 C3
Excision cervical / 1st rib n/a C1 C2
Nerve root / facet joint injection cervical spine n/a C1 C3
Occipito-cervical fusion +/- fixation n/a C1 C2
Posterior decompression +/- fixation / fusion (C20C7) n/a C1 C2
Thoracic Spine
Anterior decompression +/- fixation / fusion n/a C1 C2
Biopsy thoracic spine n/a C1 C2
Posterior decompression +/- fixation / fusion n/a C2 C3
Scoliosis correction - anterior release +/- instrumentation n/a C1 C2
Scoliosis correction - posterior fusion +/- instrumentation n/a C1 C2
Lumbar Spine
Caudal epidural injection n/a C2 C3
Decompression lumbar spine with fusion +/- fixation n/a C2 C3
Decompression lumbar spine without fusion (not disectomy n/a C2 C3
alone)
Discectomy open / micro C1 C2 C3
Nerve root / facet joint injection lumbar spine C1 C2 C3
80
OL1
TOPIC OD CR
OL 2
Brachial Plexus
Exploration / repair / grafting brachial plexus C1 C1 C2
UPPER LIMB:
Shoulder
Acromioclavicular joint excison - arthroscopic /open/lateral clavicle n/a C2 C3
Acromioclavicular joint reconstruction (e.g. Weaver Dunn) n/a C2 C3
Acromioplasty open n/a C2 C3
Anterior repair for instability arthroscopic n/a C2 C3
Anterior repair for instability open including capsular shift n/a C3 C3
Arthroscopic subacromial decompression n/a C2 C3
Arthroscopy diagnostic C1 C3 C3
Rotator cuff repair (open or arthroscopic) +/- acromioplasty n/a C2 C3
Total shoulder replacement C1 C2 C3
UPPER ARM:
Elbow
Arthrolysis elbow (open/arthroscopic) n/a C2 C3
Arthroscopy elbow diagnostic n/a C2 C3
Arthoscopy elbow therapeutic C1 C2 C3
Arthrotomy elbow C2 C3 C3
Excision radial head +/- synovectomy C1 C2 C3
Radial head replacement C1 C2 C3
Tennis / golfer elbow release C1 C2 C3
Total elbow replacement C1 C2 C3
Ulnar nerve decompression / transposition C1 C3 C3
FOREARM:
Wrist
Arthrodesis wrist (includes partial arthrodesis) n/a C2 C3
Arthroscopy wrist n/a C1 C2
Carpal tunnel decompression C1 C3 C3
De Quervain's decompression C1 C3 C3
Excision distal ulna C1 C2 C3
Ganglion excision at wrist C2 C3 C3
Ulna shortening C1 C2 C3
Ulnar nerve decompression at wrist C1 C3 C3
Hand
Dupuytrens contracture operation C1 C2 C3
Excision synovial cyst C1 C3 C3
Fusion of MCPJ or IPJ C1 C2 C3
MCPJ replacement n/a C2 C3
Soft tissue reconstruction hand C1 C2 C3
Tendon transfer hand C1 C2 C3
Trapezium excision or replacement n/a C2 C3
Trigger finger release C1 C3 C3
Trigger thumb release C1 C3 C3
81
OL1
TOPIC OD CR
OL 2
LOWER LIMB:
HIP
Arthrodesis hip n/a C1 C2
Arthrogram hip n/a C1 C3
Arthroscopy hip - diagnostic n/a C1 C3
Arthroscopy hip - therapeutic n/a C1 C3
Arthrotomy hip C2 C3 C3
Excision arthroplasty hip (e.g. Girdlestone) n/a C2 C3
Open reduction for DDH n/a C2 C3
Osteotomy hip - pelvic for DDH n/a C2 C3
Osteotomy hip - proximal femoral for DDH n/a C2 C3
Osteotomy pelvis - not for DDH n/a C2 C3
Revision Total Hip Replacement n/a C2 C3
Revision THR acetabular component n/a C2 C3
Revision THR both components n/a C2 C3
Revision THR femoral component n/a C2 C3
Slipped upper femoral epiphysis:
Slipped upper femoral epiphysis open reduction n/a C2 C2
Slipped upper femoral epiphysis pinning n/a C2 C2
Total Hip Replacement:
THR cemented C1 C3 C3
THR hybrid C1 C3 C3
THR surface replacement C1 C2 C3
THR uncemented C1 C2 C3
Femur
Amputation above knee C1 C3 C3
Femoral lengthening n/a C2 C3
Osteotomy corrective (not for DDH) n/a C2 C3
Knee
Open ACL reconstruction C1 C2 C3
Arthroscopy ACL reconstruction
Arthroscopic lateral release C1 C2 C3
Arthroscopic partial meniscectomy C1 C2 C3
Arthroscopic removal loose bodies knee C1 C2 C3
Arthroscopic synovectomy C1 C2 C3
Arthroscopic knee diagnostic C2 C3 C3
Osteotomy distal femoral n/a C2 C3
Osteotomy proximal tibial n/a C2 C3
Patella realignment n/a C2 C3
Patella resurfacing alone n/a C2 C3
Revision TKR n/a C2 C3
TKR n/a C3 C3
Unicompartmental knee replacement n/a C2 C3
82
OL1
TOPIC OD CR
OL 2
Tibia & Fibula
Amputation below knee C1 C3 C3
Tibial lengthening n/a C2 C3
Ankle
Arthrodesis ankle C1 C2 C3
Arthroplasty ankle n/a C2 C3
Arthroscopy ankle diagnostic n/a C2 C3
Arthroscopy ankle therapeutic n/a C2 C3
Arthrotomy ankle n/a C3 C3
Decompression tendons at ankle n/a C3 C3
Tendoachilles lengthening n/a C3 C3
Foot
Amputation toe / ray C1 C3 C3
Calcaneal osteotomy n/a C2 C3
CTEV correction n/a C2 C3
Fifth toe soft tissue correction n/a C2 C3
First metatarsal osteotomy n/a C3 C3
First MTPJ arthrodesis n/a C3 C3
First MTPJ excision arthroplasty n/a C3 C3
First MTPJ soft tissue correction n/a C3 C3
Hindfoot arthrodesis n/a C2 C3
Ingrowing toenail operation C2 C3 C3
Lesser metatarsal osteotomy n/a C2 C3
Lesser toe arthrodesis n/a C3 C3
Lesser toe excision part/all phalanx n/a C3 C3
Lesser toe tenotomy n/a C3 C3
Tendon decompression or repair n/a C3 C3
Tendon transfer foot n/a C2 C3
Wedge tarsectomy n/a C2 C3
83
LAMPIRAN 3
Tingkat Kompetensi Afektif Peserta Didik
OL
Profesionl Behaviour OD CR
1-2
1.Patient assessment
1. Obtains, records and presents accurate clinical history
and physical examination relevant to the clinical
presentation, including an indication of patients views
2. Uses and interprets findings adjuncts to basic
examination appropriately e.g. internal examination,
blood pressure measurement, pulse oximetry, peak
flow
3. Responds honestly and promptly to patient questions
4. Knows when to refer for senior help
5. Is respectful to patients by:
a. Introducing self clearly to patients and indicates own
place in team
b. Checks that patients comfortable and willing to be
seen
c. Informs patients about elements of examination and
any procedures that the patient will undergo
Clinical reasoning
1. In a straightforward clinical case develops a
provisional diagnosis and a differential diagnosis on
the basis of the clinical evidence, institutes an
appropriate investigative and therapeutic plan, seeks
appropriate support from others and takes account of
the patients Wishes
Record keeping
1. Is able to format notes in a logical way and writes
legibly
2. Able to write timely, comprehensive, informative
letters to patients and to GPs
Time management
1. Works systematically through tasks and attempts to
prioritise
2. Discusses the relative importance of tasks with more
senior colleagues.
3. Understands importance of communicating progress
with other team members
84
OL
1-2
Patient safety
1. Participates in clinical governance processes
2. Respects and follows local protocols and
guidelines
3. Takes direction from the team members on patient
safety
4. Discusses risks of treatments with patients and is
able to help patients make decisions about their
treatment
5. Ensures the safe use of equipment
6. Acts promptly when patient condition deteriorates
7. Always escalates concerns promptly
Infection control
1. Performs simple clinical procedures whilst
maintaining full aseptic precautions
2. Follows local infection control protocols
3. Explains infection control protocols to students
and to patients and their relatives
6. Aware of the risks of nosocomial infections.
2. Being a good communicator
Objective Communication with patients
1. To establish a doctor/patient relationship characterised
by understanding, trust, respect, empathy and
confidentiality
2. To communicate effectively by listening to patients,
asking for and respecting their views about their health
and responding to their concerns and preferences
3. To cooperate effectively with healthcare professionals
involved in patient care
4. To provide appropriate and timely information to
patients and their families
Breaking bad news
1. To deliver bad news according to the needs of
individual patients
Communication with Colleagues
1. To recognise and accept the responsibilities and
role of the doctor in relation to other healthcare
professionals.
2. To communicate succinctly and effectively with
other professionals as appropriate
3. To present a clinical case in a clear, succinct and
systematic manner
85
OL
1-2
1. Conducts a simple consultation with due empathy and
Descriptors sensitivity and writes accurate records thereof
2. Recognises when bad news must be imparted.
3. Able to break bad news in planned settings following
preparatory discussion with seniors
4. Accepts his/her role in the healthcare team and
communicates appropriately with all relevant
5. members thereof
3.Teaching and Training
Objectives 1. To teach to a variety of different audiences in a variety
of different ways
2. To assess the quality of the teaching
3. To train a variety of different trainees in a variety of
different ways
4. To plan and deliver a training programme with
appropriate assessments
Descriptors 1. Prepares appropriate materials to support teaching
episodes
2. Seeks and interprets simple feedback following
teaching
3. Supervises a medical student, nurse or colleague
through a simple procedure
4. Plans, develops and delivers small group teaching to
medical students, nurses or colleagues
4. Keeping up to date
Objective 1. To understand the results of research as they relate to
medical practise
2. To participate in medical research
3. To use current best evidence in making decisions about
the care of patients
4. To construct evidence based guidelines and protocols
5. To complete an audit of clinical practice
6. At actively seek opportunities for personal
development
7. To participate in continuous professional development
activities
8. To understand the results of research as they relate to
medical practise
9. To participate in medical research
10. To use current best evidence in making decisions
about the care of patients
11. To construct evidence based guidelines and protocols
12. To complete an audit of clinical practice
13. At actively seek opportunities for personal
development
14. To participate in continuous professional
development activities
86
OL
1-2
4. Keeping up to date
Descriptors 1. Defines ethical research and demonstrates awareness of
GMC guidelines
2. Differentiates audit and research and understands the
different types of research approach e.g. qualitative and
quantitative
3. Knows how to use literature databases
4. Demonstrates good presentation and writing skills
5. Participates in departmental or other local journal club
6. Critically reviews an article to identify the level of
evidence
7. Attends departmental audit meetings
8. Contributes data to a local or national audit
9. Identifies a problem and develops standards for a local audit
10. Describes the audit cycle and take an audit through the
first steps
11. Seeks feedback on performance from clinical supervisor
/ patients / careers / service users
5. Manager
Objective Self awareness and self management
1. To recognise and articulate ones own values and
principles, appreciating how these may differ from those of
others
2. To identify ones own strengths, limitations and the impact
of their behaviour
3. To identify their own emotions and prejudices and
understand how these can affect their judgment and
behavior
4. To obtain, value and act on feedback from a variety of
sources
5. To manage the impact of emotions on behaviour and
actions
6. To be reliable in fulfilling responsibilities and
commitments to a consistently high standard
7. To ensure that plans and actions are flexible, and take into
account the needs and requirements of others
8. To plan workload and activities to fulfill work
requirements and commitments with regard to their own
personal health
Team working
1. To identify opportunities where working with others can
bring added benefits
2. To work well in a variety of different teams and team
settings by listening to others, sharing information, seeking
the views of others,
3. empathising with others, communicating well, gaining
trust, respecting roles and expertise of
4. others, encouraging others, managing differences of
opinion, adopting a team approach
87
OL
1-2
Objective Leadership
(cont.) 1. To develop the leadership skills necessary to lead
teams effectively. These include:
2. Identification of contexts for change
3. Application of knowledge and evidence toproduce
an evidence based challenge to systems and
processes
4. Making decision by integrating values withevidence
5. Evaluating impact of change and taking corrective
action where necessary
Principles of quality and safety improvement

1. To recognise the desirability of monitoring
performance, learning from mistakes and adopting
no blame culture in order to ensure high standards
of care and optimise patient safety
2. To critically evaluate services
3. To identify where services can be improved
4. To support and facilitate innovative service
improvement
Management and NHS culture

1. To organise a task where several competing
priorities may be involved
2. To actively contribute to plans which achieve
service goals
3. To manage resources effectively and safely
4. To manage people effectively and safely
5. To manage performance of themselves and others
6. To understand the structure of the NHS and the
management of local healthcare systems in order to
be able to participate fully in managing healthcare
provision.
Descriptors Self awareness and self management

1. Obtains 360 feedback as part of an assessment
2. Participates in peer learning and explores leadership
styles and preferences
3. Timely completion of written clinical notes
4. Through feedback discusses and reflects on how a
personally emotional situation affected
communication with another person
5. Learns from a session on time management
88
OL
1-2
Descriptors Team working
(Cont.) 1. Works well within the multidisciplinary team and
recognises when assistance is required from the
relevant team member
2. Invites and encourages feedback from patients
3. Demonstrates awareness of own contribution to
patient safety within a team and is able to outline the
roles of other team members.
4. Keeps records up-to-date and legible and relevant to
the safe progress of the patient.
5. Hands over care in a precise, timely and effective
manner
6. Supervises the process of finalising and submitting
operating lists to the theatre suite
Leadership
1. Complies with clinical governance
requirements of organisation
2. Presents information to clinical and service managers
(e.g. audit).
3. Contributes to discussions relating to relevant issues
e.g. workload, cover arrangements using clear and
concise evidence and information
Quality and safety improvement

1. Understands that clinical governance is the over-
arching framework that unites a range of quality
improvement activities
2. Participates in local governance processes
3. Maintains personal portfolio
4. Engages in clinical audit
5. Questions current systems and processes
Management and NHS Structures

1. Participates in audit to improve a clinical service
2. Works within corporate governance structures
3. Demonstrates ability to manage others by teaching and
mentoring juniors, medical students and others,
delegating work effectively
4. Highlights areas of potential waste
6. Promoting good health
Objectives 1. To demonstrate an understanding of the determinants
of health and public policy in relation to individual
patients
2. To promote supporting people with long term
conditions to self-care
89
OL
1-2
Descriptors 1. Understands that quality of life is an important goal of
care and that this may have different meanings for each
patient
3. Helps the patient to develop an active understanding of
their condition and how they can be involved in self
management
4. Discusses with patients those factors which could
influence their health
7.Probity and Ethics
Objective 1. To uphold personal, professional ethics and values, taking into
account the values of the organisation and the culture and
beliefs of individuals
2. To communicate openly, honestly and inclusively
3. To act as a positive role model in all aspects of communication
4. To take appropriate action where ethics and values are
compromised
5. To recognise and respond the causes of medical error
6. To respond appropriately to complaints
7. To know, understand and apply appropriately the principles,
guidance and laws regarding medical ethics and confidentiality
as they apply to surgery
8. To understand the necessity of obtaining valid consent from
the patient and how to obtain
9. To understand the legal framework within which healthcare is
provided
10. To recognise, analyse and know how to deal with
unprofessional behaviours in clinical practice, taking into
account local and national regulations
11. Understand ethical obligations to patients and colleagues
12. To appreciate an obligation to be aware of personal good
health
Descriptors 1. Reports and rectifies an error if it occurs
2. Participates in significant event audits
3. Participates in ethics discussions and forums
4. Apologises to patient for any failure as soon as an error is
recognised
5. Understands and describes the local complaints procedure
6. Recognises need for honesty in management of complaints
7. Learns from errors
8. Respect patients confidentiality and their autonomy
9. Understand the Data Protection Act andFreedom of
Information Act
10. Consult appropriately, including the patient, before
sharing patient information
11. Participate in decisions about resuscitation status,
withholding or withdrawing treatment
12. Obtains consent for interventions that he/she is
competent to undertake
13. Knows the limits of their own professional capabilities
90
LAMPIRAN 4
MODUL-MODUL
MODUL 1: BASIC SCIENCE

1. Objective
To acquire and demonstrate underpinning basic science knowledge appropriate for

the practice of surgery, including:
o Applied anatomy: Knowledge of anatomy appropriate for surgery
o Physiology: Knowledge of physiology relevant to surgical practice
o Pharmacology: Knowledge of pharmacology relevant to surgical practice
centred around safe prescribing of common drugs
o Pathology: Knowledge of pathological principles underlying system specific
pathology
o Microbiology: Knowledge of microbiology relevant to surgical practice
Imaging:
o Knowledge of the principles, strengths and weaknesses of various diagnostic
and interventional imaging methods
1. Knowledge
Applied anatomy:
o Development and embryology
o Gross and microscopic anatomy of the organs and other structures
o Surface anatomy
o Imaging anatomy
This will include anatomy of thorax, abdomen, pelvis, perineum, limbs, spine,
head and neck as appropriate for surgical operations that the trainee will be
involved with during coretraining (see Module 2).
Physiology:
o General physiological principles including:
Homeostasis
Thermoregulation
Metabolic pathways and abnormalities
Blood loss and hypovolaemic shock
Sepsis and septic shock
Fluid balance and fluid replacement therapy
Acid base balance
Bleeding and coagulation
Nutrition
91
o This will include the physiology of specific organ systems relevant to surgical
care including the cardiovascular, respiratory, gastrointestinal, urinary,
endocrine and neurological systems.
Pharmacology:
o The pharmacology and safe prescribing of drugs used in the treatment of
surgical diseases including analgesics, antibiotics, cardiovascular drugs,
antiepileptic, anticoagulants, respiratory drugs, renal drugs, drugs used for the
management of endocrine disorders (including diabetes) and local
anaesthetics.
o The principles of general anaesthesia
o The principles of drugs used in the treatment of common malignancies
Pathology:
o General pathological principles including:
Inflammation
Wound healing
Cellular injury
Tissue death including necrosis and apoptosis
Vascular disorders
Disorders of growth, differentiation and morphogenesis
Surgical immunology
Surgical haematology
Surgical biochemistry
Pathology of neoplasia
Classification of tumours
Tumour development and growth including metastasis
Principles of staging and grading of cancers
Principles of cancer therapy including surgery, radiotherapy,
chemotherapy,
immunotherapy and hormone therapy
Principles of cancer registration
Principles of cancer screening
The pathology of specific organ systems relevant to surgical care including

cardiovascular pathology, respiratory pathology, gastrointestinal pathology,
genitourinary disease, breast, exocrine and endocrine pathology, central and
peripheral, neurological systems, skin, lymphoreticular and musculoskeletal
systems
Microbiology:
o Surgically important micro organisms including blood borne viruses
o Soft tissue infections including cellulitis, abscesses, necrotising fasciitis,
gangrene
o Sources of infection
o Sepsis and septic shock
92
Microbiology: (Cont.)
o Asepsis and antisepsis
o Principles of disinfection and sterilisation
o Antibiotics including prophylaxis and resistance
o Principles of high risk patient management
o Hospital acquired infections
Imaging:
o Principles of diagnostic and interventional imaging including x-rays,
ultrasound, CT, MRI. PET, radiounucleotide scanning
MODULE 2 : COMMON SURGICAL CONDITIONS

This section assumes that candidates have general medical competencies consistent
with a doctor leaving Foundation in the UK. It also assumes an ongoing commitment to
keeping these skills and knowledge up to date as laid out in GMP. It is predicated on the
value that surgeons are doctors who carry our surgery and require competencies.
Objective
To demonstrate understanding of the relevant basic scientific principles for each of
these surgical conditions and to be able to provide the relevant clinical care as defined in
modules assessment and management as defined in Modules 1 and 4.
2. Knowledge
Presenting symptoms or syndromes

o Abdominal pain
o Gastrointestinal haemorrhage
o Rectal bleeding
o To include the following conditions
Appendicitis
Adhesions
Abdominal hernias
Peritonitis
Intestinal perforation
Presenting symptoms or syndromes
Peripheral vascular disease
Presenting symptoms or syndrome
o Chronic and acute limb ischaemia
o Transient ischaemic attacks
o Varicose veins
o Leg ulceration
Atherosclerotic arterial disease
Embolic and thrombotic arterial disease
93
o To include the following conditions (Cont.)
Venous insufficiency
Diabetic ulceration
Cardiovascular and pulmonary Disease
To include the following conditions
o Coronary heart disease
o Space occupying lesions of the chest
Genitourinary disease
o Haematuria
o Lower urinary tract symptoms
o Urinary retention
o Renal failure
o Scrotal swellings
Trauma and orthopaedics
o Traumatic limb and joint pain and deformity
o Chronic limb and joint pain and deformity
o Back pain
Simple fractures and joint dislocations
Fractures around the hip and ankle
Basic principles of Degenerative joint disease
Basic principles of inflammatory joint disease including bone and joint
infection
Spinal nerve root entrapment and spinal cord compression
Metastatic bone cancer
Common peripheral neuropathies and nerve injuries
MODULE 3 : BASIC SURGICAL SKILLS
1. Objective
Preparation of the surgeon for surgery
Safe administration of appropriate local anaesthetic agents
Acquisition of basic surgical skills in instrument and tissue handling.
Understanding of the formation and healing of surgical wounds
Incise superficial tissues accurately with suitable instruments.
Close superficial tissues accurately.
Tie secure knots.
Safely use surgical diathermy
Achieve haemostasis of superficial vessels.
Use suitable methods of retraction.
Knowledge of when to use a drain and which to choose.
Handle tissues gently with appropriate instruments.
Assist helpfully, even when the operation is not familiar.
94
1. Objective (Cont.)
Understand the principles of anastomosis

Understand the principles of endoscopy
2. Knowledge
Principles of safe surgery

Principles of hand washing, scrubbing and gowning
Immunisation protocols for surgeons and patients
Administration of local anaesthesia
Choice of anaesthetic agent
Safe practise
Surgical wounds
Classification of surgical wounds
Principles of wound management
Pathophysiology of wound healing
Scars and contractures
Incision of skin and subcutaneous tissue:
o Langers lines
o Choice of instrument
o Safe practice
Closure of skin and subcutaneous tissue:
o Options for closure
o Suture and needle choice
Safe practice
Knot tying
o Range and choice of material for suture and ligation
o Safe application of knots for surgical sutures and ligatures
Haemostasis:
o Surgical techniques
o Principles of diathermy
Tissue handling and retraction:
o Choice of instruments
Biopsy techniques including fine needle aspiration cytology
Use of drains:
o Indications
o Types
o Management/removal
Principles of anastomosis
Principles of surgical endoscopy
3. Clinical Skills
95
Effective and safe hand washing, gloving and gowning
Accurate and safe administration of local anaesthetic agent
Preparation of a patient for surgery

Creation of a sterile field
Antisepsis
Draping
4. Technical Skills and Procedures

Effective and safe hand washing, gloving and gowning
Accurate and safe administration of local anaesthetic agent
Incision of skin and subcutaneous tissue:
o Ability to use scalpel, diathermy and scissors
Closure of skin and subcutaneous tissue:
o Accurate and tension free apposition of wound edges
Knot tying:
o Single handed
o Double handed
o Instrument
o Superficial
o Deep
Haemostasis:
o Control of bleeding vessel (superficial)
o Diathermy
o Suture ligation
o Tie ligation
o Clip application
o Transfixion suture
Tissue retraction:
Tissue forceps
Placement of wound retractors
Use of drains:
o Insertion
o Fixation
o Removal
Tissue handling:
Appropriate application of instruments and respect for tissues
Biopsy techniques
Skill as assistant:
Anticipation of needs of surgeon when assisting
96
MODULE 4: THE ASSESSMENT AND MANAGEMENT OF THE
SURGICAL PATIENT MODULE 4
1. Objective
To demonstrate the relevant knowledge, skills and attitudes in assessing the

patient and manage the patient, and propose surgical or non-surgical management.
2. Knowledge
The knowledge relevant to this section will be variable from patient to patient
and is covered within the rest of the syllabus see common surgical conditions in
particular (Module 2).
As a trainee develops an interest in a particular speciality then the principles of

history taking and examination may be increasingly applied in that context.
3. Clinical Skills
Surgical history and examination (elective and emergency)

Construct a differential diagnosis
Plan investigations
Clinical decision making
Team working and planning
Case work up and evaluation; risk management
Active participation in clinical audit events
Appropriate prescribing
Taking consent for intermediate level intervention; emergency
and elective
Written clinical communication skills
Interactive clinical communication skills: patients
Interactive clinical communication skills: colleagues
MODULE 5 : PERI-OPERATIVE CARE

1. Objective
To assess and manage preoperative risk

To manage patient care in the peri-operative period
To conduct safe surgery in the operating theatre environment
To assess and manage bleeding including the use of blood products
To care for the patient in the post-operative period including the assessment of
common complications
To assess and plan perioperative nutritional management
97
2. Knowledge
Pre-operative assessment and management:

Cardiorespiratory physiology
Diabetes mellitus and other relevant endocrine disorders
Fluid balance and homeostasis
Renal failure
Pathophysiology of sepsis prevention and prophylaxis
Thromboprophylaxis
Laboratory testing and imaging
Risk factors for surgery and scoring systems
Pre-medication and other preoperative prescribing
Principles of day surgery
Intraoperative care:
Safety in theatre including patient positioning and avoidance of nerve
injuries
Sharps safety
Diathermy, laser use
Infection risks
Radiation use and risks
Tourniquet use including indications, effects and complications
Principles of local, regional and general anaesthesia
Principles of invasive and non-invasive monitoring
Prevention of venous thrombosis
Surgery in hepatitis and HIV carriers
Post-operative care:
Post-operative monitoring
Cardiorespiratory physiology
Diabetes mellitus and other relevant endocrine disorders
Renal failure
Pathophysiology of blood loss
Pathophysiology of sepsis including SIRS and shock
Multi-organ dysfunction syndrome
Post-operative complications in general
Methods of postoperative analgesia
To assess and plan nutritional management:

Post-operative nutrition
Effects of malnutrition, both excess and depletion
Metabolic response to injury
Methods of screening and assessment of nutritional status
Methods of enteral and parenteral nutrition
98
2. Knowledge (cont.)
Haemostasis and Blood Products:

Mechanism of haemostasis including the clotting cascade
Pathology of impaired haemostasis e.g. haemophilia, liver disease,
massive haemorrhage
Components of blood
Alternatives to use of blood products
Principles of administration of blood products
Patient safety with respect to blood products
Coagulation, deep vein thrombosis and embolism:

Clotting mechanism (Virchow Triad)
Effect of surgery and trauma on coagulation
Tests for thrombophilia and other disorders of coagulation
Methods of investigation for suspected thromboembolic disease
Principles of treatment of venous thrombosis and pulmonary embolism
including anticoagulation
Role of V/Q scanning, CTpulmonary angiography, D-dimer and
thrombolysis
Place of pulmonary embolectomy
Prophylaxis of thromboembolism:
Risk classification and management of DVT
Knowledge of methods of prevention of DVT, mechanical and
pharmacological
Antibiotics:
Common pathogens in surgical patients
Antibiotic sensitivities
Antibiotic side-effects
Principles of prophylaxis and treatment
Metabolic and endocrine disorders in relation perioperative management

Pathophysiology of thyroid hormone excess and deficiency and
associated risks from surgery
Causes and effects of hypercalcaemia and hypocalcaemia
Complications of corticosteroid therapy
Causes and consequences of Steroid insufficiency
Complications of diabetes mellitus
Causes and effects of hyponatraemia
Causes and effects of hyperkalaemia and hypokalaemia
3. Clinical Skills
Pre-operative assessment and management:

History and examination of a patient from a medical and surgical
standpoint
Interpretation of pre-operative investigations
99
3. Clinical Skills (cont.)
Management of co morbidity
Resuscitation
Appropriate preoperative prescribing including premedication
Intra-operative care:
Safe conduct of intraoperative care
Correct patient positioning
Avoidance of nerve injuries
Management of sharps injuries
Prevention of diathermy injury
Prevention of venous thrombosis
Post-operative care:
Writing of operation records
Assessment and monitoring of patients condition
Post-operative analgesia
Fluid and electrolyte management
Detection of impending organ failure
Initial management of organ failure
Principles and indications for Dialysis
Recognition, prevention and treatment of post-operative complications
Haemostasis and Blood Products:
Recognition of conditions likely to lead to the diathesis
Recognition of abnormal bleeding during surgery
Appropriate use of blood products
Management of the complications of blood product transfusion
Coagulation, deep vein thrombosis and embolism
Recognition of patients at risk
Awareness and diagnosis of pulmonary embolism and DVT
Role of duplex scanning, venography and d-dimer measurement
Initiate and monitor treatment of venous thrombosis and pulmonary
embolism
Initiation of prophylaxis
Antibiotics:
Appropriate prescription of antibiotics
Assess and plan preoperative nutritional management
Arrange access to suitable artificial nutritional support, preferably via a
nutrition team including Dietary supplements, Enteral nutrition and
Parenteral nutrition
Metabolic and endocrine disorders
History and examination in patients with endocrine and electrolyte
disorders
Investigation and management of thyrotoxicosis and hypothyroidism
Investigation and management of hypercalcaemia and hypocalcaemia
100
Peri-operative management of patients on steroid therapy

Peri-operative management of diabetic patients
Investigation and management of hyponatraemia
Investigation and management of hyperkalaemia and hypokalaemia
4. Technical Skills and Procedures
Central venous line insertion

Urethral catheterization
MODULE 6: ASSESSMENT AND MANAGEMENT OF PATIENTS

WITH TRAUMA (INCLUDING THE MULTIPLY
INJURED PATIENT)
1. Objective
Assess and initiate management of patients with chest trauma

who have sustained a head injury
who have sustained a spinal cord injury
who have sustained abdominal and urogenital trauma
who have sustained vascular trauma
who have sustained a single or multiple fractures or dislocations
who have sustained traumatic skin and soft tissue injury
who have sustained burns
Safely assess the multiply injured patient.
Contextualise any combination of the above
Be able to prioritise management in such situation as defined by ATLS,
APLS etc
2. Knowledge
General
Scoring systems for assessment of the injured patient
Major incident triage
Differences In children
Shock
Pathogenesis of shock
Shock and cardiovascular physiology
Metabolic response to injury
Adult respiratory distress syndrome
Indications for using uncross matched blood
101
Wounds and soft tissue injuries
Gunshot and blast injuries
Stab wounds
Human and animal bites
Nature and mechanism of soft tissue injury
Principles of management of soft tissue injuries
Principles of management of traumatic wounds
Burns
Classification of burns
Principle of management of burns
Fractures
Classification of fractures
Pathophysiology of fractures
Principles of management of fractures
Complications of fractures
Joint injuries
Organ specific trauma
Pathophysiology of thoracic trauma
Pneumothorax
Head injuries including traumatic intracranial haemorrhage and brain
injury
Spinal cord injury
Peripheral nerve injuries
Blunt and penetrating abdominal trauma
Including spleen
Vascular injury including iatrogenic injuries and intravascular drug abuse
Crush injury
Principles of management of skin loss including use of skin grafts and
skin flaps
3. Clinical Skills
General
History and examination
Investigation
Referral to appropriate surgical subspecialties
Resuscitation and early management of patient who has sustained
thoracic, head, spinal, abdominal or limb injury according to ATLS and
APLS guidelines
Resuscitation and early management of the multiply injured patient
102
Specific problems
Management of the unconscious patient
Initial management of skin loss
Initial management of burns
Prevention and early management of the compartment syndrome
4. Technical Skill and Procedures
Central venous line insertion

Chest drain insertion
Diagnostic peritoneal lavage
Urethral catheterisation
Suprapubic catheterization
MODULE 7: SURGICAL CARE OF THE PAEDIATRIC PATIENT

1. Objective
To assess and manage children with surgical problems, understanding the similarities
and differences from adult surgical patients
To understand the issues of child protection and to take action as appropriate
2. Knowledge
Physiological and metabolic response to injury and surgery

Fluid and electrolyte balance
Thermoregulation Safe prescribing in children
Principles of vascular access in children
Working knowledge of trust and Local Safeguarding Children Boards
(LSCBs) and Child Protection Procedures
Basic understanding of child protection law
Understanding of Children's rights
Working knowledge of types and categories of child maltreatment, pre-
sentations, signs and other features (primarily physical, emotional,
sexual, neglect, professional)
Understanding of one personal role, responsibilities and appropriate
referral patterns in child protection
Understanding of the challenges of working in partnership with children
and families
Recognise the possibility of abuse or maltreatment
Recognise limitations of own knowledge and experience and seek
appropriate expert advice
Urgently consult immediate senior in surgery to enable referral to
paediatricians
103
Keep appropriate written documentation relating to child protection

matters
Communicate effectively with those involved with child protection,
including children and their families
3. Clinical Skills
History and examination of the neonatal surgical patient

History and examination of paediatric surgical patient
Assessment of respiratory and cardiovascular status
Undertake consent for surgical procedures (appropriate to the level of
training) in paediatric patients
MODULE 8: MANAGEMENT OF DYING PATIENT

1. Objective :
Ability to manage the dying patient appropriately.
Palliative Care: Good management of the dying patient in consultation with the palliative
care team.
2. Knowledge
Palliative Care:
Care of the terminally ill
Appropriate use of analgesia, antiemetics and laxatives
Principles of organ donation:

Circumstances in which consideration of organ donation is appropriate
Principles of brain death
Understanding the role of the coroner and the certification of death
3. Clinical Skills
Palliative Care:
Symptom control in the terminally ill patient
Principles of organ donation:
Assessment of brain stem death
Certification of death
104
MODULE 9: ORGAN AND TISSUE TRANPLANTATION
1. Objective
To understand the principles of organ and tissue transplantation
2. Knowledge
Principles of transplant immunology including tissue typing, acute,

hyperactute and chronic rejection
Principles of immunosuppression
Tissue donation and procurement
Indications for whole organ transplantation
105

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KURIKULUM

PENDIDIKAN DOKTER SPESIALIS

KOLEGIUM ORTHOPAEDI DAN TRAUMATOLOGI INDONESIA

Penanggung Jawab : Prof. dr. Errol U Hutagalung, SpB, SpOT(K)

Editor : Prof. Dr. dr. Putu Astawa, MKes, SpOT(K)

Syukur Alhamdulillah kita panjatkan ke hadirat Allah SWT,

Dokter Spesialis Orthopaedi dan Traumatologi adalah dokter

Penerbitan Buku Kurikulum Pendidikan Dokter Spesialis

Buku kurikulum ini disusun oleh Kolegium dan menjadi paduan

Kami mengucapkan terima kasih dan penghargaan setinggi-tingginya

Semoga Allah Subhanahu Wataala memberikan bimbingan,

Jakarta, Juni 2012

Prof. dr. Errol Untung Hutagalung, SpB, SpOT(K)

Menimbang : 1. Bahwa untuk menjalankan kegiatan Pendidikan Dokter Spesialis

Buku ini terdiri atas 4 Bab.

Bab I, Pendahuluan mengambarkan filosofi yang mendasari

Bab III, Menjelaskan secara sistematika tahapan pencapaian

Bab IV, Dalam bab ini dijelaskan secara sistematis cara

Untuk memberikan perlindungan kepada pasien dan

Asosiasi Institusi Pendidikan Kedokteran berkoordinasi

Kurikulum merupakan seperangkat rencana dan pengaturan

1.2. Model Kurikulum

Isi Kurikulum meliputi prinsip-prinsip metode ilmiah,

Ilmu biomedik meliputi anatomi, biokimia, histologi,

Ilmu-ilmu humaniora meliputi ilmu perilaku, psikologi

Core Curriculum dapat disederhanakan menjadi General

Fostering conducive environment Curriculum renewal

Gambar 1.1. Skema Tujuan Komprehensif Kurikulum

Knowledge of the tribological properties of materials

11. ORTHOPEDIC ONCOLOGY

12. SPORT INJURY

NO. TOPIC PROCEDURE

Examples and Descriptors

2. Being A Good Communicator

Examples and Descriptors

3. Teaching and Training

Examples and Descriptors

Examples and Descriptors

4. Quality and safety improvement

5. Management and NHS Structures

6. Promoting Good Health

Examples and descriptors

Examples and descriptors

3.1. Tingkat Kompetensi

Sebelum mencapai Kompetensi sebagai Spesialis Orthopedi &

3.1.1. Kompetensi Spesialis Orthopaedi dan Traumatologi Dasar,

1) Mampu memberikan penyuluhan, pelayanan dan perawatan pasca

3.1.2. Kompetensi Spesialis Orthopaedi dan Traumatologi Lanjut

1) Mampu memberikan penyuluhan, pelayanan dan perawatan pasca

3.1.3. Kompetensi Spesialis Orthopaedi dan Traumatologi Chief

3.2. Tahapan Pencapaian Kompetensi

Tahapan Pendidikan Orthopaedi dan Traumatologi dilakukan dalam

1. Tahap Pra Ilmu Dasar Bedah

Dari Core Kurikulum yang telah disebutkan diatas dijabarkan lagi

3.2.1. Tahap Pra Ilmu Dasar Bedah

Tahap Pra Bedah Dasar diselenggarakan bersama dengan

3.2.2. Tahap Ilmu Dasar Bedah

3.2.3.Tahap Orthopaedi & Traumatologi Dasar

Lingkup bahasan dan tingkat Kompetensi secara terperinci seperti

3.2.4.Tahap Orthopaedi & Traumatologi Lanjut 1 dan 2

Lingkup bahasan dalam Kompetensi Kognitif pada tahap

A1: Dapat mengetahui dan mengingat materi

Lingkup bahasan dalam Kompetensi Psikomotor pada tahap

C1 : Melihat dan asimilasi