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Bone and soft-tissue tumors in postgraduate education
J Orthop Sci (2001) 6:215–216
Editorial Bone and soft-tissue tumors in postgraduate education Koichi Saotome Department of Orthopaedic Surgery, Dokkyo University School of Medicine, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan
Key words Bone and soft-tissue tumors · Postgraduate education · Specialist
The 34th Annual Musculoskeletal Tumor Meeting of the Japanese Orthopaedic Association will be held July 19–20, this summer in Utsunomiya, Tochigi prefecture. Members participating in this meeting, orthopedic surgeons, radiologists, and pathologists who are interested in bone and soft-tissue tumors, have reported and will report on recent successful results of their studies. During the last 20 years of the twentieth century, the treatment of musculoskeletal tumors developed remarkably and led to surprisingly good results, in terms of survival rates and function of the extremities. These meetings have played an important role in the advances in the treatment of bone and softtissue tumors, and they are expected to contribute to further advances. It is gratifying that young orthopedic surgeons are interested in bone and soft-tissue tumors and attend this meeting every year. However, it is regrettable that most orthopedic surgeons in Japan are not interested in bone and softtissue tumors; there is a tendency toward less effort in studying this ailment and less active interest in the condition. In daily medical care, patients with tumorous mass of the extremities cannot visit orthopadists. When patients with a tumor seek consultation, their masses must be correctly diagnosed as benign or malignant, and suitable treatment must be sought to manage the tumorous mass. Therefore, it is vital that all orthopedic surgeons should have a fundamental understanding of bone and soft-tissue tumors. Actually, a patient with a recognized benign tumor does not need to be sent to a specialist in bone and soft-tissue tumors at all. A patient
Received: February 26, 2001
with a malignant tumor, however, should not be observed without caution over a long period. Several reasons have been thought to explain why orthopedic surgeons seem to dislike treating bone and soft-tissue tumors; for example, the treatment of such tumors troubles doctors; such patients are in the minority; and, as the treatment is troublesome, it is better to leave treatment to a specialist. Most medical doctors usually wish to undertake their postgraduate education at university hospitals and at popular, well known general hospitals. In these hospitals, there are specialists for subspecialties of orthopedics who can treat patients only according to their specialization. Therefore, the intention of young doctors to become such specialists is understandable, and, accordinly, it is understandable that they would want to undergo specific training from an early stage of postgraduate study. And yet I worry about this tendency, which has spread, and can hardly understand whether the young doctors misunderstand such specialists as fully trained doctors in orthopedics. I believe that an ideal orthopedic specialist should be a doctor with a fundamental knowledge of general areas of orthopedics, who is a prominent expert in one relevant field. In other words, young doctors should undergo training in all fields of orthopedics for at least their periods as residents. It has been recently indicated that orthopedic surgeons treat only patients with the diseases and trauma related to their speciality, but not other patients, and that this tendency has led doctors from other departments to encroach on some of the orthopedist’s areas expertise, thus increasingly narrowing the fields managed by orthopedic surgeons. Young orthopedic surgeons should master general and fundamental knowledge and skills of orthopedics during their period of training, and this should include knowledge of bone and soft-tissue tumors, as well as knowledge of diseases such as rheumatoid arthritis and osteoporosis.
216
K. Saotome: Bone and soft-tissue tumors in postgraduate education
In addition, educational hospitals should make an effort to offer a good environment for residents so that they work usefully and hard to become fully trained doctors. In this regard, it is necessary that educational hospital have the appropriate teaching staff and present a variety of patients to residents, including those with bone and soft-tissue tumors. However, under the present medical insurance system and medical administration system in Japan, various problems and difficulties are faced by educational hospitals in regard to teaching
the treatment of bone and soft-tissue tumors to residents. However, despite these problem, the institutes should still offer such training. If they cannot, residents should be advised to undergo training in other hospitals for a certain period. Finally, I hope for a more substantial postgraduate training system that will produce fully trained doctors, including those who are interested in bone and softtissue tumors.
Editorial Bone and soft-tissue tumors in postgraduate education Koichi Saotome Department of Orthopaedic Surgery, Dokkyo University School of Medicine, Mibu-machi, Shimotsuga-gun, Tochigi 321-0293, Japan
Key words Bone and soft-tissue tumors · Postgraduate education · Specialist
The 34th Annual Musculoskeletal Tumor Meeting of the Japanese Orthopaedic Association will be held July 19–20, this summer in Utsunomiya, Tochigi prefecture. Members participating in this meeting, orthopedic surgeons, radiologists, and pathologists who are interested in bone and soft-tissue tumors, have reported and will report on recent successful results of their studies. During the last 20 years of the twentieth century, the treatment of musculoskeletal tumors developed remarkably and led to surprisingly good results, in terms of survival rates and function of the extremities. These meetings have played an important role in the advances in the treatment of bone and softtissue tumors, and they are expected to contribute to further advances. It is gratifying that young orthopedic surgeons are interested in bone and soft-tissue tumors and attend this meeting every year. However, it is regrettable that most orthopedic surgeons in Japan are not interested in bone and softtissue tumors; there is a tendency toward less effort in studying this ailment and less active interest in the condition. In daily medical care, patients with tumorous mass of the extremities cannot visit orthopadists. When patients with a tumor seek consultation, their masses must be correctly diagnosed as benign or malignant, and suitable treatment must be sought to manage the tumorous mass. Therefore, it is vital that all orthopedic surgeons should have a fundamental understanding of bone and soft-tissue tumors. Actually, a patient with a recognized benign tumor does not need to be sent to a specialist in bone and soft-tissue tumors at all. A patient
Received: February 26, 2001
with a malignant tumor, however, should not be observed without caution over a long period. Several reasons have been thought to explain why orthopedic surgeons seem to dislike treating bone and soft-tissue tumors; for example, the treatment of such tumors troubles doctors; such patients are in the minority; and, as the treatment is troublesome, it is better to leave treatment to a specialist. Most medical doctors usually wish to undertake their postgraduate education at university hospitals and at popular, well known general hospitals. In these hospitals, there are specialists for subspecialties of orthopedics who can treat patients only according to their specialization. Therefore, the intention of young doctors to become such specialists is understandable, and, accordinly, it is understandable that they would want to undergo specific training from an early stage of postgraduate study. And yet I worry about this tendency, which has spread, and can hardly understand whether the young doctors misunderstand such specialists as fully trained doctors in orthopedics. I believe that an ideal orthopedic specialist should be a doctor with a fundamental knowledge of general areas of orthopedics, who is a prominent expert in one relevant field. In other words, young doctors should undergo training in all fields of orthopedics for at least their periods as residents. It has been recently indicated that orthopedic surgeons treat only patients with the diseases and trauma related to their speciality, but not other patients, and that this tendency has led doctors from other departments to encroach on some of the orthopedist’s areas expertise, thus increasingly narrowing the fields managed by orthopedic surgeons. Young orthopedic surgeons should master general and fundamental knowledge and skills of orthopedics during their period of training, and this should include knowledge of bone and soft-tissue tumors, as well as knowledge of diseases such as rheumatoid arthritis and osteoporosis.
216
K. Saotome: Bone and soft-tissue tumors in postgraduate education
In addition, educational hospitals should make an effort to offer a good environment for residents so that they work usefully and hard to become fully trained doctors. In this regard, it is necessary that educational hospital have the appropriate teaching staff and present a variety of patients to residents, including those with bone and soft-tissue tumors. However, under the present medical insurance system and medical administration system in Japan, various problems and difficulties are faced by educational hospitals in regard to teaching
the treatment of bone and soft-tissue tumors to residents. However, despite these problem, the institutes should still offer such training. If they cannot, residents should be advised to undergo training in other hospitals for a certain period. Finally, I hope for a more substantial postgraduate training system that will produce fully trained doctors, including those who are interested in bone and softtissue tumors.