Knowledge:

At the end of fellowship, fellow should be able to

• Demonstrate Epidemiology of obesity
• Describe Pathophysiology of morbid obesity and the metabolic syndrome
• Demonstrate Therapeutic options for morbid obesity indications for weight loss and metabolic surgery
• Describe the principles of perioperative management of the obese patient
• Describe types of operations performed and mechanisms of action
• Diagnose complications of metabolic surgery and their management
• Explain what is revisional metabolic surgery
• Explain long term management of the bariatric patient following surgery
• Describe essential components of a bariatric service
  Judge psychology of the morbidly obese patient

Skills:

• Take History and examination of the obese patient, interpretation of investigations in the obese patient
• Should be able to do preoperative evaluation and optimization assessment of the post-operative bariatric patient, management decisions for early and late complications of bariatric surgery
• Should have Level 4 competency in gastric band or sleeve required
• Perform Laparoscopic access in the morbidly obese (level 4) Roux en Y gastric bypass (level 4)
• Able to do Repair of internal hernia after gastric bypass Insertion of laparoscopic gastric band (Level 2)
• Perform Aspiration of band port
• Perform Emergency release of band for slippage
• Perform repositioning of band after slip Sleeve gastrectomy (Level 2) Participate in revisional surgery for obesity (level 4).

Professional Attributes:

• Able to participate and present different cases at bariatric MDT meetings
• Able to participate in departmental morbidity and mortality audit
• Able to express knowledge of patient support group meetings
• Will show involvement in the debate and presentation of evidence-based surgery

• Program Director
• Associate Program Director
• Chief Resident
• Program Coordinator

One year program leading to fellowship in Bariatric and Metabolic.

Outline of Training:

A. Didactic Educational Sessions Required:

It is mandatory that all fellows and at least one mentor attend these sessions. The fellows must document that they participated in at least 80% of meetings.
Specially designated bariatric textbook review sessions, journal clubs, peer-review conferences, and resident teaching rounds. The following topics must be covered during the fellowship:

• Epidemiology of Obesity
• Pathophysiology of Morbid Obesity and metabolic syndrome
• Preoperative Evaluation of the Bariatric Patient
• Therapeutic options of morbid obesity
• History of bariatric surgery
• Indications of weight loss and metabolic surgery
• Types of bariatric procedure and their mechanism of action
• Restrictive versus mal absorptive procedure
• Long term management of bariatric patient following surgery
• Essential of bariatric program
• Psychology of the Morbidly Obese Patient
• Essentials of a Bariatric Program
• Postoperative Management of the Bariatric Patient
• Revisional Weight Loss Surgery
• Managing Postoperative Complications
• Nutritional Deficiencies
• Obesity in Childhood and Adolescence
• Outcomes of Bariatric Surgery
• Role of Endoscopy in Bariatric Surgery

B. Clinical Skills:

• History and examination of the obese patient
• Interpretation of investigations in obese patient
• Preoperative evaluation and optimization
• Assessment of post-operative bariatric patient
• Management decisions for early and late complications of bariatric surgery

C. Management Conference Requirements:

• Participation in quarterly morbidity and mortality (M&M)
• Documentation of participation

D. Research Requirements:

Fellows are expected to conduct research and are expected to complete at least one clinical / research project during the fellowship and submitted to Pakistan society of metabolic and bariatric in the journal to which it was submitted.

E. Multidisciplinary Conference Requirements:

• Fellows are expected to participate in regular bariatric multidisciplinary conferences.
• They also must attend at least one patient support group and one patient educational seminar.

F. Surgical Operation Requirements:

• Exposure to variety of procedures
• Participation in at least 50 weight loss surgeries
• Primary surgeon in 51% of cases (defined as having perform key components of operation)
• Exposure to endoscopy

G. Evaluation Requirements:

• Fellow must participate in 50 preoperative evaluations.
• 100 postoperative in patient management encounters
• 100 post-operative outpatient evaluations
• Documentation required

H. Performance Assessment Synopsis:

• The Program Director will be responsible for conducting fellow performance assessment (Minicex) interviews after every six months.

The programme is run by Programme Director. This in turn is supervised by the Postgraduate Medical Education Department of Shifa International Hospital. We aim to maintain Quality assurance through trainee questionnaires, supervisors’ feedback and regular PGME assessment.

Each fellow is expected to remain on-call in the hospital premises once in four nights. The reporting time of fellow is 8 am.

The fellows are evaluated three monthly with internal assessment. In addition, each fellow undertakes a MCQs exam by well-trained consultants in the end of year. ​

Must have completed the College of Physician and Surgeons of Pakistan [CPSP] training requirements in General Surgery, or equivalent must be eligible for medical licensure with the Pakistan Medical Dental Council.

Candidates are required to fill on-line application form. Please follow the steps mentioned below:
1. Register yourself by defining user name and password.
2. After your account is created, you will need to login to fill the Application Form. Programs offered will be displayed after registration.
3. A candidate can apply for only one program at a time.
4. Candidate may partially fill the form and save it on-line for resuming filling out the form later using login credentials.
5. Once the on-line application form is filled and submitted, candidate would be able to take a printout.
6. The hard copy of the on-line application form along with the required documents mentioned in the Application Form must be submitted to the PGME Office, Medical Staff Affairs either personally, through friends/relatives or through reliable courier service.

7. Check your junk emails (in case of email not received).

If there is still confusion, then follow these Steps

Step 1. Register yourself
Step 2. Check your email address and click on the received link
Step 3. Login
Step 4. Fill the Profile necessary information
Step 5. Submit
Step 6. Ok
Step 7. Online Application Form
Step 8. Select Program or Medical Officer
Step 9. Select specialty
Step 10. Submit
Step 11. Print application form.