01 Sep 2009

Berita CSM September 2009

Vol . 17 / No. 2 / SEPTEMBER 2009

Table of Contents


Click here to Download Berita CSM in PDF Format (2.2MB)



Message from the President


The Advanced Trauma Life Support (ATLS) Course was conceived after a plane crash involving an orthopaedic surgeon in rural Nebraska in 1976. One member of the surgeon's family was killed and four others were badly injured. The care the surgeon and his family received was so sub-optimal that he concluded, “When I can provide better care in the field with limited resources than what my children and I received at the primary care facility – there is something wrong with the system and the system has to be changed”. With the assistance from a few like minded private doctors and charitable organisations, they worked to organise the first trauma course in 1978. The American College of Surgeons (ACS) adopted the course and its popularity spread rapidly throughout North America. Today ATLS is taught in more than 50 countries worldwide.

Trauma is the leading cause of deaths among people less than 44 years of age in Malaysia. It constitutes 6% of all deaths in Kementerian Kesihatan Malaysia (KKM) hospitals. It is the third leading cause of admissions in KKM hospitals, consisting of 9% of the hospital admissions. Despite its frequent occurrence, sadly, trauma care is one of the neglected areas of healthcare. In a position statement, the Royal College of Surgeons of England, in 1988, said:

  • One in three hospital deaths from trauma can be prevented
  • Often avoidable factors include simple management errors in the early stages (“golden hour”) rather than a failure of complex definitive treatment

Why is this the case? The key to improved trauma care lies with the initial doctor who sees the patient. He has the greatest opportunity to impact on the outcome. The problem with the initial doctor is that he often lacks sufficient knowledge and skills, is fearful, unable to establish priorities, has poor decision making skills and displays poor teamwork.

The ATLS course addresses these weakness. It teaches core knowledge and imparts essential skills. Using an acronym ABCDE, it ensures an organised approach for the evaluation and management of seriously injured patients. Resuscitation and stabilization is done according to priority and haphazard treatment is avoided. A safe decision making process is the result. At all times, optimal care is stressed. The ATLS course also helps decision making on whether a patient's need exceed a facilities’ capabilities so that arrangements for appropriate definitive care for the patient can be made early. ATLS methods are equally applicable in a large or a small rural hospital. Feedback from participants has repeatedly confirmed that course participants became more confident in managing trauma patients after the course.


The original intent of the ATLS course was for doctors who do not manage major trauma on a daily basis e.g. general practitioners. However, the course has proved so popular that it is now required training for emergency room doctors, surgical trainees, military doctors, search and rescue doctors, anaesthetists and GPs in many countries (e.g. Singapore).


The process of bringing the course to Malaysia has been long and this would not have happened without the strong trust and partnership that existed between the College of Surgeons, Academy of Medicine of Malaysia (CSAMM) and Kementerian Kesihatan Malaysia (KKM). In the long journey of Promulgation of the ATLS, I also acknowledge the tremendous help, encouragement, advice and support given to me by many overseas friends from The Royal Australasian College of Surgeons, American College of Surgeons (ACS), The Royal College of Surgeons of Thailand, College of Surgeons of Singapore, the National ATLS Committee of Singapore at the SAF Medical Training Institute and the ATLS team at Tan Tock Sing Hospital (TTSH), Singapore. Their encouragement, advice and support have been very useful and uplifting when the journey was difficult and their help made it possible for me to reduce the costs of promulgation significantly.

Council 2009 – 2010

Dr Lum Siew Kheong

Prof Yip Cheng Har

Dr Chew Loon Guan

Dr Rohan Malek

Assoc Prof Kwan Mun Keong
Prof Dato’ Lokman Saim
Dr Ashim Kumar Nandy
Dr Pall Singh
Dr Ramesh Gurunathan
Prof Rohaizak Muhammad
Assoc Prof Andrew Tan
Dr Peter Wong Toh Lee


The historic milestones are tabulated below:
14th February 2008 President CSAMM met with Director-General of Health
April 2008 President CSAMM sent Letter of Intent to ACS
September 2008 ACS approval for Promulgation of ATLS obtained
December 2008 Renovation of ATLS Centre in Sg Buloh Hospital commenced
8th – 9th January 2009 CSAMM sent two Council members for Student Course in TTSH, Singapore.
Three Coordinators sent by KKM for training in TTSH, Singapore.
Mid February 2009 Renovation of ATLS Centre in Sg Buloh Hospital completed
21st – 22nd April 2009 Site Visit to Sg Buloh Hospital by
Dr C R Kaufmann and Dr M Hollands.
President CSAMM signed MOU with
17th August 2009 President CSAMM signed Agreement
with KKM during Opening Ceremony
of 8th MOH-AMM Scientific Meeting.
3rd – 4th September 2009 Five doctors attended Instructor
Course at SAF Nee Soon Camp,
Singapore accompanied by Educator
and three Coordinators.
18th – 23rd January 2010 Inaugural ATLS Course


Dr Chng Kim-Im, Amanda
Dr Lum Siew Kheong
Dr Mohd Ismail Saiboon
Dr Muhammad Radhi Ahmad
Dr Rizal Imran
Dr Sabariah Faizah
Dr Shalizan Torman
Dr Zamyn Zuki
EDUCATOR Prof Moses Samuel Ed D
COORDINATORS Ms Nurul'ain bt Ahayalimudin
Ms Wan Marina bt Wan Ismail
Mr Yusof Said


8th – 9th January 2009
Prof David Choon (3rd from left), Dr Sabariah Faizah (4th from left),
Dr Lum Siew Kheong (6th from left), Dr Muhammad Radhi (7th from
left), Dr Ismail Mohd Saiboon (last on left)

21st - 22nd April 2009

21st - 22nd April 2009
Section of participants at lecture

21st - 22nd April 2009
Exchanging of MOU between CSAMM and ACS

3rd – 4th September 2009
Faculty members and the Malaysian team

3rd – 4th September 2009
(Seated from left to right):
Instructor candidates: Shalizan Torman, Andre Das, Lum Siew Kheong,
Sabariah, Zamyn Zuki
(Standing from left to right):
Educator: Moses Samuel
Coordinators: Yusof Said, Nurul'Ain, Wan Marina
ACS Reps: Lesley Dunstall (Nat Coordinator, Australia),
Michael Hollands (ATLS Region XV1 Chief )

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Annual Scientific Meeting of the College of Surgeons,
Academy of Medicine of Malaysia in 2009

Theme: “Teamwork in Surgery”
29th – 31st May 2009. Awana Porto Malai Langkawi, Kedah, Malaysia
Report by Prof Yip Cheng Har, Scientific Chair

The Annual Scientific Meeting of the College of Surgeons, Academy of Medicine of Malaysia was chaired by Dr Andrew Gunn, the Chief of Surgery in Johor, with Professor Yip Cheng Har as the Scientific Chair. In the organising committee were Professor David Choon, Dr Lim Lay Hooi, Datuk Dr Noor Hisham Abdullah, Dr Ramesh Gurunathan, Associate Professor Razman Jarmin and Dr Chew Loon Guan. Our President, Dr Lum Siew Kheong and Dr David Galloway were ex-officio members, with Dr Galloway coordinating the programme for the Royal College of Physicians and Surgeons of Glasgow.

This was one of the best attended annual scientific meeting of the College of Surgeons, Academy of Medicine of Malaysia in recent years, with a record registration of over 500 participants. Participation from the Royal College of Physicians and Surgeons of Glasgow, led by the Vice-President (Surgical) Dr David Galloway, and the inaugural John Hopkins Fellow, Dr John Cameron, coupled with an excellent scientific programme that appealed to a wide group of surgeons were responsible for the good turn-out.

There was a dramatic increase in the number of abstracts submitted for free papers and oral presentations, with a dozen submissions for the Ethicon Prize. Over 200 abstracts were accepted, giving a chance for our surgeons and trainees to showcase their work.

The conference started on 28th May at 2.00 pm with two precongress workshops:

  1. Trauma Surgery – An exciting new career prospect chaired by Professor David Choon and Dr Philip Iau
  2. Intercontinental Comparison of Surgical Subspecialty Training – chaired by Professor Yip Cheng Har and Professor Dato’ P Kandasami

Both these workshops were well attended.

The main conference was opened by the Master of the Academy, Professor Victor Lim, on 29th May 2009. The 36th AM Ismail Oration “The treatment of pancreatic cancer” was delivered by Dr John Cameron, a famous pancreatic surgeon, and the current president of the American College of Surgeons. This was then followed by the opening of the trade exhibiton. More than 30 booths were set up in the exhibition area next to the ballroom, and next to that were nearly 200 posters.

Despite fears that the H1N1 influenza outbreak might dampen the conference, all except one of the overseas speakers turned up. The only speaker who was unable to come was the Japanese surgeon, Dr Tai Omari, because his hospital was quarantined in view of the H1N1 flu.

There were seven plenaries and eight symposia, all of them carrying the theme of Teamwork in Surgery. For this conference, the topics were focussed on Trauma Surgery, Colorectal, Hepatobiliary, Upper GIT and Vascular Surgery. Together with the team from the RCPS Glasgow, there were lectures from the John Hopkins Travelling Fellow, Dr John Cameron, and the Royal Australasian College of Surgeons Traveling Fellow, Dr David Watson. The feedback from the delegates were that the lectures were excellent. A multidisciplinary team discussion on colorectal surgery, moderated by Dr Galloway and Dr April Roslani from the University Malaya Medical Centre, with an oncologist, a radiologist and a pathologist on the expert panel was also well received.

There were also four free paper sessions, and one Ethicon Prize session. All were well attended, even the free paper sessions. The Ethicon Prize was won by Dr Mahadevan D Tata, a final year Master of Surgery student with the University of Malaya for his paper, “A randomized double-blinded, placebo-controlled study of the effect of pre-emptive intraperitoneal local anaesthetic on immediate post-operative pain control and metabolic stress in laparoscopic appendicectomy”. All agreed that the standard of the Ethicon Prize submissions was very high this year.

Besides the scientific programme, there was also a Presidential Roundtable discussion on Friday afternoon attended by members of the Council of the College of Surgeons of Malaysia together with the overseas presidents of the Surgical Societies from Australia, USA, Philippines, Vietnam, Thailand, Pakistan and the Vice-President (Surgical) of the RCPS Glasgow. There was also a free afternoon on the 30th May 2009 where the overseas speakers and invited guests were treated to a boat trip to the nearby islands. The other delegates were also seen island-hopping or shopping in the duty-free shops.

The Congress Banquet on 30th May gave an opportunity for exchange of gifts, speeches and presentation of prizes. The Ethicon Prize winner, Dr Mahadevan Tata, was announced, and the SMA Alhady Gold Medal was presented to the top student in the Conjoint Master of Surgery Examination for 2008, Dr Michael Ng Keng Lim and for 2009, Dr Tham Teck Meng.

The session on the last session on Sunday morning were also very well attended, and the final few words of farewell were given by Dr Andrew Gunn, the Organising Chair for the 2009 Annual Scientific Meeting of the College of Surgeons, Academy of Medicine of Malaysia.

More interesting photos...

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Trauma Papers Competition for Surgical Trainees 2010

Malaysian doctors who are still surgical trainees as on March 2010 are invited to submit papers on any topic related to trauma to the President, College of Surgeons before noon on 31st December 2009. The author of the best paper will be sponsored by the College of Surgeons to present the paper at the ATLS Asia Pacific meeting in Jakarta, in April 2010.

A panel of judges will choose the best paper from Asia Pacific region at the Jakarta meeting.

The winner will be sponsored to attend the ATLS meeting at the Clinical Congress of the American College of Surgeons, USA, in October 2010.

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Upcoming Events

65th Annual Clinical Congress of the Philippine College of Surgeons
Theme: “New Frontiers in Surgical Oncology and Surgical Infections”
Date: 6th – 9th December 2009
Venue: SMX Convention Center, Seashell Drive,
Mall of Asia Complex, Pasay City,


Inaugural ATLS Course in Malaysia
Date: 18th – 23rd January 2010
18th – 20th January 2010 (Student Course)
21st January 2010 (Day off)
22nd – 23rd January 2010 (Instructor Course)


Royal Australasian College of Surgeons Annual Scientific Congress 2010
Date: 4th – 7th May 2010
Venue: Perth Convention & Exhibition Centre Australia

International Scholarships: Rowan Nicks Scholarship

Rowan Nicks, OBE, FRACS, is one of the oldest surviving Fellows of the Royal Australasian College of Surgeons (RACS) and has been a major benefactor of the RACS since 1987, when the Rowan Nicks Scholarship was established.

It is Rowan's wish that a scholarship should be offered annually to young surgeons from selected developing countries who have shown particular promise and are destined to be leaders in their own countries. The scholarship is tenable for up to a year in either Australia or New Zealand, in an institution where young surgeons would learn not just the craft of surgery, but where they would become involved in teaching, research and administration. Rowan sees these Scholarships as nurturing surgical leaders of the future.

Applications for 2011 will open in December 2009.

Applications may be mailed to:
Secretariat, Rowan Nicks Committee
Royal Australasian College of Surgeons
College of Surgeons' Gardens
250 - 290 Spring Street
East Melbourne VIC 3002

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