MINISTRY OF HEALTH

DEPARTMENT OF HUMAN RESOURCES FOR HEALTH

UNIVERSITY OF MEDICINE -2, YANGON

CURRICULUM

[Link] (Cardiovascular Surgery)

2023

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2
Curriculum
1. Title of the Course
2. Preamble
3. Aim and Objectives
4. Duration of the Course
5. Training Program
5.1. Contents
5.2. Learning/ Teaching Methods
6. Assessment
6.1. Formative Assessment
6.2. Summative Assessment, Log Book
6.3. Research
7. Resources
7.1. Personnel
7.2. Training Areas
7.3. Libraries
7.4. Reference Books
8. Degree Conferred

Governance

1. Board of Study
2. Selection of Candidates
2.1. Criteria for Application
2.2. Selection Examination
2.3. Number of Candidates Intake
3. Career Ladder

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1. Title of the Course
The course shall be known as “Basic Specialist Training Course in Cardiovascular
Surgery”. The degree awarded will be “Master of Medical Science”, [[Link]] (Cardiovascular
Surgery).

2. Preamble

With the increasing population and progressive incidence of cardiovascular diseases in

Myanmar, more and more competent specialists in cardiovascular surgery are necessary to provide
the comprehensive cardiovascular surgical care to the needy patients. Therefore, it is essential to
produce qualified cardiovascular surgeons both quantitatively and qualitatively.

This course is meant to meet the demand of future cardiovascular surgical practice in this
country.

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3. Aim and Objectives
Aim
To develop qualified cardiovascular surgeons to deal with common cardiovascular
diseases in Myanmar, providing good surgical practice safely to patients, after a
defined period, in accordance with National Health Policy and National Health Plan

Objectives

(1) To provide postgraduate basic specialist training in cardiovascular surgery

(2) To upgrade the level of clinical competency to keep abreast with international level

4. Duration of the course

The duration of the course is 4 academic years.

4.1. Post [Link] training

o After being graduated, the candidate should be completed a period of training, not less than
one year in a department of cardiovascular surgery.
o Surgical log book shall be checked regularly by supervisors for assessment of competency.

5. Training Programme
The candidate shall acquire the given level of competence for the following clinical skills,
technical and operative skills based on Six Competency Domains.

1. Medical Knowledge
It relates to the acquisition, integrating and application of medical knowledge in the
provision of patient care.
2. Clinical skill and judgement
It involves making informed and timely decisions regarding assessment, diagnosis,
surgical management, follow-up, health maintenance and promotion.

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3. Technical and operative skill
It relates to safely and effectively performing surgical procedures conducted in the
unit in which they are training.
4. Management and leadership skill
All surgeons are required to be able to
- Communicate effectively with patients, families, carers, colleagues and other
staff.
- Able to collaborate effectively with members of an interdisciplinary team
where appropriate.
- Able to effectively use health resources to balance patient care and system.
5. Academic performance
Trainees are required to be able to recognize the value of knowledge and research and
its application to clinical practice and teach others effectively.
6. Professionalism and ethics
It involves demonstrating commitment to patients, the community and the profession
through the ethical practice of surgery.

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 The expected learning outcomes of the programme year by year are described with the level
of competence.

The level of competence should be defined as follow:

1. Observer status
2. Assistant status
3. Performed under supervision
4. Performed independently

A. KNOWLEDGE AND CLINICAL SKILLS

Level of Competence
Sr No. Procedure
Year 1 Year 2 Year 3 Year 4
1 Taking Patient History 3 3 4 4
2 Performing Physical Examination 3 3 4 4
3 Requesting appropriate 3 3 4 4
Investigation
4 Interpreting results of 3 3 4 4
investigation
5 Deciding and implementation of 3 3 4 4
appropriate treatment
6 Managing immediate 3 3 4 4
complications
7 Maintaining follow up 3 3 4 4
8 Arranging assessment by 3 3 4 4
Anesthetist
9 Pre-op preparation of patients 3 3 4 4

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 B. TECHNICAL SKILLS IN ICU PROCEDURES

[Link]. Procedure Level of competence

Year 1 Year 2 Year 3 Year 4

1 Airway maintenance and passing 2 2 3 4
of endotracheal tube

2 Assisted ventilation 2 2 3 4

3 Cardiac Massage 3 3 4 4

4 Control of Haemorrhage 3 3 4 4

5 Venous cut down 2 3 4 4

6 CVP line 2 2 3 4

7 Swan-Ganz’s catheter 2 2 3 4

8 Arterial line insertion procedure 2 2 3 4

9 Tracheostomy 2 2 3 4

10 Management of post-operative 2 3 3 4
Hypotension

11 Management of post-operative 2 3 3 4
Renal failure

12 Management of unconscious 2 3 3 4
patient

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 C. OPERATIVE SKILLS IN CARDIAC SURGERY

Sr. no. Procedure Level of competence

Year 1 Year 2 Year 3 Year 4
1 Midline sternotomy 1 2 3 4
2 Posterolateral thoracotomy 1 2 3 3/4
3 Anterolateral thoracotomy 1 2 3 3/4
4 Mitral valvotomy 1 2 2 3
5 Cannulation of Aorta/caval 1 2 3 3
6 Removal of sternal wires 1 2 3 4
7 Re-open for haemorrhage 1 2 3 3/4
8 Insertion of pacemaker 1 2 3 3
9 Pericardiostomy 1 2 3 4
10 Mitral valve annuloplasty 1 2 2 2
11 Mitral valve repair/ replacement 1 2 2 3
12 Aortic valve repair/ Replacement 1 2 2 3
13 Tricuspid valve annuloplasty/ 1 2 2 3
Replacement
14 Pulmonary valvotomy 1 2 2 2
15 Redo mitral valve replacement 1 1 2 2
16 Redo aortic valve replacement 1 1 2 2
17 CABG 1 2 2 2
18 Redo CABG 1 1 2 2
19 Combine valve + graft operation 1 1 2 2
20 Redo sternotomy 1 1 2 2
21 Multiple valve replacement/ Repair 1 2 2 2
22 ASD (O.S) 1 2 2 3
23 VSD 1 2 2 3
24 PDA 1 2 2 3
25 TOF 1 2 2 2
26 Removal of |Tumors of Heart 1 1 2 2
27 Ascending aorta replacement 1 1 2 2
28 Descending aorta replacement 1 1 2 2
29 Coarctation of Aorta 1 1 2 2

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 D. OPERATIVE SKILLS IN VASCULAR SURGERY

Level of competence
Sr. No. Procedure
Year 1 Year 2 Year 3 Year 4
Embolectomy (Femoral) 2 2 3 4
1
Embolectomy (Brachial) 2 2 3 4
2
Varicose Vein Surgery 2 2 3 4
3
Sympathetectomy (Cervical) 1 1 2 2
4
Sympathetectomy (Lumbar) 1 1 2 2
5
Harvesting Saphenous vein 2 2 3 4
6
Harvesting Radial artery 2 2 2 4
7
Harvesting LIMA 1 1 2 2/3
8
False aneurysm repair 2 2 2 3
9
Aortic iliac/ femoral grafting 2 2 2 3
10
Femoropoplitial bypass 2 2 2 3
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Creation of AVF 2 2 2 4
12
AAA repair 2 2 2 3
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5.1. Contents (Syllabus)
A. Applied Basic Science

1. Anatomy
 Development of the heart and great vessels
 Mediastinum , thoracic inlet
 Heart, pericardium, great vessels
 Coronary arterial venous anatomy
 Cardiac chambers and heart valves
 Conduction system
 Nerve supply of the heart
 Peripheral vascular system

2. Physiology
 Haemodynamics ;physiology and measurement
 Cardiac arrhythmia
 Haemostasis , thrombosis , bleeding
 Acid base balance
 Pulmonary physiology , ventilation and gas exchange
 Metabolic response to trauma and surgery
 GIT, renal and hepatic physiology
 Nutrition
 Temperature regulation
 Myocardial cellular physiology
 Electrophysiology, including conduction disorders
 Valve physiology & haemodynamics

3. Pathology
 Inflammation and wound healing
 Myocardial infarction and complications
 Endocarditis
 Pericarditis
 Systemic inflammatory response syndrome
 ARDS
 Pathophysiology of valve stenosis and incompetence
 AF & other arrhythmias

4. Pharmacology
 Drugs used in the treatment of hypertension, heart failure and angina
 Inotropes, vasodilators, vasoconstrictors
 Anti - arrhythmic drugs
 Haemostatic drugs
 Antiplatelet, anticoagulant and thrombolytic drugs
 Analgesia
 Antibiotics
 Anaesthetic agents, local and general

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B. General Surgery

1. Basic Science Knowledge relevant to surgical practice

 Applied anatomy appropriate for surgery

 Applied physiology relevant to surgical practice
 Pharmacology relevant to surgical practice centred around safe prescribing of common drugs
 Pathology , principles underlying systemic specific pathology
 Microbiology relevant to surgical practice
 Diagnostic and interventional radiology

2. Common Surgical Conditions

 Assess and initiate investigation and management of common surgical conditions which may
happen in any patients whilst under the care of surgeons, irrespective of speciality.
 To understand what, whom and when to refer in a way that an insightful discussion may take
place with colleagues whom will be involved in the management.

3. Basic Surgical Skills

 Prepare oneself for surgery.

 Administer appropriate local anaesthetic agents safely.
 Handle surgical instruments safely.
 Handle tissues safely.
 Incise and close superficial tissues accurately.
 Tie knots secure.
 Use surgical diathermy safely.
 Achieve haemostasis of superficial vessels.
 Use a suitable surgical drain appropriately.
 Assist helpfully, even when the surgery is not familiar.
 Understand the principles of anastomosis.
 Understand the principles of endoscopy in the aspects of diagnostic and therapeutic.
 Understand the principles of minimally invasive surgery.

4. The Principles of assessment and management of the surgical patient

 To assess the surgical patient.

 To elicit a history which is relevant, accurate and appropriate to the patient’s problem
 To produce timely, complete and legible clinical records.
 To assess the patient prior to surgery and manage any pre-operative problems appropriately.
 To propose and initiate surgical or non-surgical management as appropriate.
 To take informed consent for straightforward cases.

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5. Perioperative care of the surgical patient

 Assessment and management of pre-operative risks.

 Conduct of safe surgery in the operating theatre.
 Assessment and management of bleeding, including the use of blood and blood products.
 Post-operative care , including the assessment of common complications
 Assessment and management of post-operative fluid balance.
 Perioperative nutritional management

6. Assessment and early treatment of the patient with trauma

 To assess safely the multiple injured patients.

 To initiate the management of patients with chest trauma, vascular trauma and others like skin
and soft tissue injuries, fractures and dislocations , internal organ injuries and head and spine
injuries , burns

7. Surgical care of the paediatric patient

 Assess and manage children with surgical problems, understanding the similarities and
differences from adult surgical patients.
 Understand the common issue of child protection and to take action as appropriate.

8. Management of the dying patient

 To manage the dying patient appropriately.

 To understand consent and ethical issues in patients certified DNAR. (Do Not Attempt
Resuscitation).
 To manage the dying patient in consultation with the palliative care team.
9. Organ and Tissue transplantation

 To understand the principles of organ and tissue transplantation.

 To understand the assessment of brain stem death and its relevance to continued life support
and organ donation.

10. Professional behaviour

 To provide good clinical care.

 To be a good communicator
 To teach and to train
 To keep up to date and know how to analyse the data
 To understand and manage people and resources within the health environment
 To promote good health
 To understand the ethical and legal obligations of a surgeon

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C. Cardiac Surgery

1. Critical Care and Postoperative Management

o The management of cardiac surgical patients in the pre and post-operative periods ,including
critically ill patients

2. Cardiopulmonary Bypass, Myocardial Protection and Circulatory Support

o The management of a patient undergoing cardiopulmonary bypass
o The management of myocardial protection during cardiac surgery
o The management of a patient requiring circulatory support

3. Ischaemic Heart Disease

o The assessment and management of patients with coronary heart disease, including elective
and emergency presentations. To include competence in both primary and secondary
procedures and where appropriate to include off-pump and on-pump strategies and arterial
revascularisation.
o The preliminary assessment and initial management of patients with complications of
myocardial infarction, including mitral regurgitation, ventricular aneurysm and septal defects.
(To include operative management in appropriate situations.) Full competence in operative
management of complex cases to be developed in the post [Link] period.

4. Heart Valve Disease

o The assessment and management of patients with valvular heart disease, including both
isolated and combined aortic and mitral valve disease .
o The assessment and management of patients with combined coronary and valvular heart
disease, including operative management.
o Full competence in operative management of complex cases including mitral valve repair and
secondary procedures to be developed in post [Link] period

5. Aortovascular Disease
o The preliminary assessment and initial management of patients with acute dissection of the
ascending aorta.
o To include operative management in appropriate situations.
o Full competence in operative management of complex cases to be developed in post
[Link] period.

6. Disorders of the Pericardium

o The assessment and management of patients with disorders of the pericardium and pericardial
cavity; including surgical management if appropriate.

7. Cardiothoracic Trauma
o The assessment and management of patients with minor and major cardiothoracic trauma.
To include operative management in appropriate situations.
o Full competence in the operative management of complex cases including great vessel injury
to be developed in post [Link] period.

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8. Congenital Heart Disease
o The assessment and management of children and adults with common uncomplicated
congenital heart disease, including operative management.
o The assessment and management of more complex congenital conditions ; full competence
in operative management to be developed in the post [Link] period.

9. Intrathoracic Transplantation and Surgery for Heart Failure

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D. Vascular Surgery

1. Venous disease
o The assessment and management of patients with venous insufficiency.
o The assessment and management of patients with deep vein thrombosis.
o The assessment and management of patients with varicose veins.

2. Peripheral arterial disease

o Assessment, resuscitation and management of patients with acute ischaemic limbs. ( upper &
lower limb )
o Recognition of critical ischaemia and claudication in patients with peripheral vascular disease
and knowledge of treatment options including angioplasty, stent and bypass procedure.
o Recognition and management of patients with vasospastic and arteritic conditions of the upper
and lower limbs.
o Assessment and management of patients with diabetic foot.

3. Carotid artery disease

o Diagnosis and management of Carotid artery disease including endovascular techniques.

4. Arterial aneurysm
o Principles of assessment and management of peripheral arterial aneurysm ( true & false )
o Assessment and management of thoracic aortic aneurysm , including open surgery and
endovascular repair
o Assessment and management (open and endovascular repair ) of abdominal aortic aneurysm ,
including rupture .

5. Vascular infection
o Recognition and management of vascular infections , involving native vessels and synthetic
grafts

6. Vascular injury
o Safely assess the multiply injured patients.
o Identify and manage traumatic and iatrogenic vascular injuries.

7. Arteriovenous malformations
o Assessment and management of patients with AV malformations

8. Vascular access and Renovascular surgery

o Assessment and management of patients who require vascular access, including operative
techniques and procedures.
o Principles and techniques of renovascular surgical intervention

9. Thoracic outlet syndrome

o Diagnosis and management of patients with thoracic outlet syndrome.

10. Hyperhidrosis
o Assessment and management of patients with hyperhidrosis.

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 11. Lymphoedema
o Diagnosis and treatment of patients with lymphoedema

(E) Index procedures

Cardiac Surgery

1. Critical care and postoperative management

o Arterial line insertion , radial, brachial, femoral artery
o Central venous catheter insertion
o Pulmonary artery catheter insertion
o Vascath insertion for haemofiltration
o Chest drain insertion
o Emergency re-opening of sternotomy
o Conduct of CPR

2. Cardiopulmonary Bypass, Myocardial protection and circulatory support

o Sternotomy
o Closure of sternotomy
o Cannulation for CPB
o De-cannulation of CPB
o Placement of epicardial pacing wires
o Placement of Intra Aortic Balloon Pump catheter

3. Ischaemic Heart Disease

o Harvest of conduits ( saphenous vein, radial and mammary arteries )
o Coronary by-pass graft ( on-pump & off-pump ) ( distal and proximal anastomosis )
o Surgery of complications of IHD ; Surgery for mitral regurgitation , VSD and ventricular
aneurysm

4. Heart Valve Disease

o Closed mitral valvotomy
o Valve replacement ( Mitral , Aortic ) (Mechanical , Biological )
o Valve repair ( Mitral , Tricuspid )
o Combined CABG & Valve surgery

5. Aortovascular disease
o Repair of acute dissection of ascending aorta

6. Cardiothoracic Trauma
o Emergency thoracotomy / sternotomy
o Surgery for haemopericardium , haemothorax
o Repair of wound in heart chambers and great vessels

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 7. Pericardial disease
o Drainage of pericardial effusion ( Echo guidance pericardiocentesis, catheter insertion , open
, VATS pericardial drainage and window )

8. Congenital Heart Disease

o Closure of PDA, ASD ,VSD
o Pulmonary-systemic shunt / BT shunt
o Pulmonary artery Banding
o Repair of Coarctation of Aorta

Vascular Surgery

1. Aortic Aneurysm
o Elective open repair tube graft
o Elective open repair bifurcated graft
o Endovascular repair
o Ruptured aneurysm repair

2. Carotid artery disease

o Carotid endarterectomy

3. Infra-inguinal bypass
o Above knee run-off
o Below knee popliteal run-off
o Calf vessel run-off
o Popliteal artery exclusion bypass

4. Emergency lower limb

o Femoral embolectomy
o Compartment fasciotomy
o Repair of false femoral artery aneurysm

5. Emergency upper limb

o Brachial artery embolectomy

6. Re-do vascular sugery

o Removal of infected graft

7. Varicose vein surgery

o Sapheno-femoral and sapheno-popliteal ligation
o Endovenous LSV and SSV ablation
o Injection sclerotherapy

8. Vascular access
o AV fistula at wrist , upper arm
o Revision of failed AV fistula

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5.2. Learning/ Teaching Methods
 Basically it should be skill practicing, on-job training program (Learning by doing)

 Problem solving approach should be encouraged ( Self-directed learning)

1. Clinical – a) Outpatient care

b) Inpatient care
c) Technical skills
(Including Skill Courses in skill lab, animal lab and
simulation center)
d) Communication skill
2. Academic – a) Teaching assignments
b) Journal readings, topic discussions, mortality and
morbidity meeting
c) Clinical meetings, Grand rounds
d) Conferences, seminars and workshops
(National/ Regional/ International)
e) Scientific Paper publication
(National/ Regional/ International journals)

For Year One:

o Trainee has to be attached to the first year course of [Link] (General Surgery) training for
one year.
o Trainee must follow the time-table, duty roster and training programme of respective
departments.
o Trainee should complete applied basic science and general surgery topics according to the
syllabus.
o Trainee should complete the research methodology course, basic surgical skill course and
advanced trauma life support (ATLS) course.
o Trainee should also attend regular journal reading, surgical audit and topic discussion held at the
Department of Cardiovascular Surgery.
o Trainee must submit the dissertation protocol to the academic board of the University of
Medicine (2), Yangon.

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For Year Two:

o Trainee has to be allocated to Department of Cardiovascular Surgery for the whole year.
o During this year, the candidates should acquire appropriate level of competency to cover both
cardiac and vascular surgery topics according to syllabus.
o Data collection for dissertation should be done during this year.

For Year Three:

o Trainees should be allocated to Department of Cardiovascular Surgery as well as other related
speciality departments of University of Medicine (2), Yangon :
1. Department of Cardiology, UM (2) (2) months
2. Department of Thoracic Surgery, UM (2) (1) month
3. Department of Paediatric Cardiac Surgery (2) months
4. Department of Cardiac Anaesthesiology and ICU, UM (2) (1) month

For Year Four (Final Year):

o Trainees should be allocated to the Department of Cardiovascular Surgery for the whole year.
o During this year, the candidates should acquire appropriate level of competency to cover both
cardiac and vascular surgery topics according to syllabus.
o The candidate must achieve the recommendation of satisfactory progress by Annual Review
of Competency Progression (ARCP) board of examiners before entering to sit for the final year
summative examination.
o Dissertation should be submitted 3 months before the end of final year.

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 6. Assessment System
Overview
o Assessment system includes both formative and summative assessments throughout the four-
year course and must provide feedback to trainees.
o There will be a series of continuous formative assessment to be conducted throughout the
course by supervisors.
o Surgical log book and Portfolio must be submitted for assessment.
o Supervisor report must be submitted to chairman of the course after a defined period.
o Summative assessment shall be done for year one, year two and year four.
o Each domain of competency shall be assessed by using appropriate assessment tools:

Competency Domain Assessment Tools

1 Medical knowledge CEX, CBD, Supervisor

Report, Examination
2 Clinical skill and judgement CEX, CBD, PBA, Supervisor
report, Examination
3 Technical and operative skill DOPS, PBA, surgical log
book, Supervisor report
4 Management and leadership skill CBD, supervisor report,

5 Academic performance CBD, supervisor report,

portfolio, research
6 Professionalism and ethics CBD, Supervisor report

CEX (Clinical Evaluation Exercise)

DOPS (direct observation of procedural skills in surgery)

CBD (case based discussion)

PBA (procedural based assessment)

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6.1 Formative Assessment
For all years of the course:
 Assessment tools:
1. Workplace based assessment (WPBA)
 Year one will be done by General Surgery
 CEX( Clinical Evaluation Exercise) will be used in year two(two times per
month)
 CEX and DOPS(direct observation of procedural skills in surgery) will be used
in year three
CEX will be done at other wards (Cardiac Medical ward , Chest Surgical ward,
Paediatric Cardiac Surgical ward) within 6 months
2 times per month)
DOPS will be done at Cardiovascular Surgical ward (within 6 months
2 times per month)
 6 months CBD(case based discussion) and 6 months PBA (procedural based
assessment) to be done in years four (1 time per 2 months)
 The number of each type of WPBA in each month will be initially
determined by the learning agreement.
 WPBA should also be done in each period of allocation to specialty
departments.
 If the desired result is not achieved, the candidate must have the further
attempts to get the desired result.

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 WPBA CEX DOPS CBD PBA
Year
Year one
(General Surgery) − − − −
Year two 2 per month − − −

Year three 2 per month at Cardiovascular

Chest Surgical , Surgery
Cardiology,
Paediatric Cardiac
Surgery Department
Years four 6 months 6 month
per year per year

2. Surgical log book

3. Portfolio
 Maintenance of up-to-date record for surgical logbook and portfolio is a
mandatory requirement of the curriculum before annual review of
competence progression (ARCP).

4. Assessment of Audit
5. Teaching assignment
6. Learning agreement
 It is a written statement of mutually agreed learning goals and strategies
negotiated between a trainee and the supervisor. It will be reviewed as
necessarily.
7. Supervisor’s report (every 6 months)

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8. Annual review of competence progression (ARCP) by board of examiners of the
course at the last month of year 1, 2 and 3. At final year, ARCP will be done at 3
months before the final examination and reassessed again just before entering to
sit for the final examination for the candidates who do not achieve satisfactory
progress.
 ARCP shall include WPBA, surgical logbook assessment, portfolio
assessment, supervisor reports.

 The ARCP panel will make over of the following recommendation about
each trainee;
a) Satisfactory progress- achieving progress and competencies of the
expected rate
b) Unsatisfactory progress –
i. Additional training time not required
ii. Additional training time required (within one month)
 If ARCP panel recommend unsatisfactory progress, the candidate must not
be allowed to sit for the final examination.
 The candidate must achieve satisfactory progress before sitting for the
supplementary examination.
9. Formative Annual Examination (Additional)
 For Year One:
 MCQ theory questions (minus system carried over) (2 hours)
 Viva
 For Year Two:
 Four essay-type questions paper (1) + paper (2) (6 hours)
 Viva
 Clinical
 For Year Three:
 Four essay-type questions (3 hours)
 Viva
 For Year Four:
 Four essay-type questions paper (1) + paper (2) (6 hours)
 Viva
 Clinical

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6.2. Summative Assessment

For Year One:

The candidates should be assessed according to the schedule of [Link] (General Surgery)
course at 9th month of the course.

o MCQ type theory questions (Minus system carried over) (2 hours)

o Pass mark is 60% and if candidate failed, another two attempts could be done at 3 months
intervals. If the candidate fails after 3rd attempt, he/ she will be dismissed from the course.
o If candidate passed, he/ she will be allocated back to the Department of Cardiovascular
Surgery to proceed to the remaining training course.
For Year Two:

The candidates should be assessed at the last month of second year.

1. Theory – two papers
a) Day (1) - Paper (1) – Cardiac Surgery
Four essay type questions for 3 hours
b) Day (2) - Paper (2) – Vascular Surgery
Four essay type questions for 3 hours

Marking Scheme for each paper

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

2. Viva voce (Day 3 Morning) –

3 Bays (20 minutes each with total of 1 hour)

a) Applied physiology and critical care Bay 1

b) Surgical anatomy and operative surgery Bay 2
c) Surgical pathology and surgical management Bay 3

Marking Scheme

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

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 3. Clinical (Day 3 Afternoon) – (90 minutes)
a) One medium case – history taking 15 minutes
Discussion 30 minutes
b) Short cases – 45 minutes (at least 4 cases)

Marking Scheme

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

Total score – 18 (pass mark)

Theory 6

Clinical 6

Viva 6

If the candidate fails at the second year assessment, he/she has to sit for the supplementary
examination after 6 months and if failed again, third attempt (last attempt) at next 6 months. If the
candidate fails to pass at third attempt, he/she will be dismissed from the course.

For Year Three:

o The candidates should be assessed at the last month of third year.

o Four essay-type questions (3hours)
Marking Scheme for each paper
Excellent 8
Good 7
Pass 6
Fail 5
Poor 4
o Viva voce (Day 3 Morning) –

3 Bays (20 minutes each with total of 1 hour)

o Applied physiology and critical care Bay 1

o Surgical anatomy and operative surgery Bay 2
o Surgical pathology and surgical management Bay 3

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 Marking Scheme

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4
o If the candidate fails at the third year assessment, he/she has to sit for the supplementary
examination within 3 months and if failed again, third attempt (last attempt) within 6 months.
If the candidate fails to pass at third attempt, he/she will be dismissed from the course.

For Year Four (Final Year):

The candidates should be assessed at the last month of final year.
4. Theory – two papers
b) Day (1) - Paper (1) – Cardiac Surgery
Four essay type questions for 3 hours
c) Day (2) - Paper (2) – Vascular Surgery
Four essay type questions for 3 hours

Marking Scheme for each paper

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

5. Viva voce (Day 3 Morning) –

3 Bays (20 minutes each with total of 1 hour)

a) Applied physiology and critical care Bay 1

b) Surgical anatomy and operative surgery Bay 2
c) Surgical pathology and surgical management Bay 3

Marking Scheme

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

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 6. Clinical (Day 3 Afternoon) – (90 minutes)
a) One medium case – history taking 15 minutes
Discussion 30 minutes
b) Short cases – 45 minutes (at least 4 cases)

Marking Scheme

Excellent 8
Good 7
Pass 6
Fail 5
Poor 4

Total score – 18 (pass mark)

Theory 6

Clinical 6

Viva 6

o If the candidate fails at the final year assessment, he/she has to sit for the supplementary
examination after 6 months and if failed again, third attempt (last attempt) at next 6 months.
If the candidate fails to pass at third attempt, he/she will be dismissed from the course.

6.3. Research

o Research is made up of a dissertation upon the actual work performed by the trainee and it
has to be submitted.
o It is a compulsory component of the master course.
o Protocol for the dissertation should be submitted and accepted by Board of Study for
[Link] (Cardiovascular Surgery) course, UM (2) during first year of the training course.
o Dissertation must be submitted at three month before the end of final year and have to be
assessed by at least two assessors
o The pass mark is 60% and if candidate failed, repair and resubmission must be done until to
get satisfactory result.

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7. Resources

7.1 Personnel

Professor/ Associate Professor/ Lecturer/ Consultant

7.2 Training Areas

Department of Cardiovascular Surgery, University of Medicine (2) is the center of training

course. The candidate may need to work in related departments for a defined period to get as
much larger experience and skill as possible

7.3 Libraries

University library/ Hospital library/ E-library

7.4 Reference books

Applied basic Sciences and General Surgery

1. Anatomy
i. Last’s Anatomy: Regional and Applied
R.J Lastand Chummy Sintanamby
2. Physiology
i. Ganong’s review of Medical Physiology
ii. Applied Critical Care; [Link]
3. Pathology
i. Robbins Basic Pathology: Vinay Kumar
ii. Walter and Israel Clinical Pathology
iii. Watt and Spence Pathology for Surgeons
4. Basic Science
i. Applied basic Science of basic Surgical training
Andrew T Raftery
5. General Surgery
i. Bailey and Love’s Short Practice of Surgery
ii. Essential Surgical Practice: Alfred Cushieri
6. Operative Surgery
i. Faquharson’s Textbook of operative general surgery
ii. Basic Surgical Techniques: [Link]

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Cardiac Surgery

1. Cardiac surgery
Kirklin, Barratt-Boyes
2. Glenn’s Thoracic and Cardiovascular surgery
Arther [Link],
3. Sabiston & Spencer surgery of the chest
Frank W. Sellke, Pedro [Link] Nido, Scott J. Swanson
4. Manual of perioperative care in adult cardiac surgery
Robert M Bojar
5. Pediatric cardiac surgery
Constantine Mavroudis, Carl Backer, Richid [Link]
6. Cardiac Surgery Operative Technique
Donald B. Doty, John R. Doty
7. Handbook of patient care in Cardiac Surgery:
Lemmer, Richenbacher, Vlahakes
8. Oxford Handbook of Cardiothoracic Surgery:
Chikwe, Beddow, Glenville
9. Atlas of Cardiac Surgical Techniques:
Sellke, Rule

Vascular Surgery

1. Rutherford’s Textbooks on vascular Surgery:

[Link], K.W. Johnston
2. Oxford Handbook of Vascular Surgery:
Hands, Linda; Murphy, Michael; Sharp, Michael; Ray-Chaudhuri, Simon
3. Veith, Hobsoll, Williams, Wilson Operative Surgery (Vascular Surgery)
Atlas of Vascular Surgery and Endovascular Therapy:
4. [Link], [Link]
Comprehensive text book of vascular access
Berman Scott [Link] Bruce E. Ruffenach Stephen K

8. Degree Conferred
At the end of training programme, the candidate who passed the final year assessment and got
satisfactory result in dissertation will be conferred.

Master of Medical Science, [Link] (Cardiovascular Surgery)

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Governence
1. Board of Study

Board of Study for [Link] (Cardiovascular Surgery) course, UM (2) include;

1. Professor/ Head Chairman

Department of Cardiovascular Surgery, University of Medicine (2)
2. Professor/ Head Member
Department of Cardiovascular Surgery, University of Medicine (1)
3. Professor/Head Member
Department of Cardiovascular Surgery, University of Medicine Mandalay
4. Professor/ Head Member
Department of Cardiology, University of Medicine (2)
5. Professor/ Head Member
Department of Surgery, University of Medicine (2)
6. Professor/ Head Member
Department of Thoracic Surgery, University of Medicine (2)
7. Professor / Head Member
Department of Anaesthesiology, University of Medicine (2)
8. Professor / Head Member
Department of Preventive & Social Medicine, University of Medicine (2)
9. Professor / Head Member
Department of Forensic Medicine , University of Medicine (2)
10. Professor/ Associate Professor Member
Cardiac Anaesthesiology Unit, University of Medicine (2)
11. Professor/ Associate Professor/ Consultant Surgeon Secretary
Department of Cardiovascular Surgery, University of Medicine (2)

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2. Selection of Candidates

2.1. Criteria for application

1. The applicant must be a citizen of Myanmar.

2. He / She must be a holder of MBBS or equivalent degree recognized by Myanmar Medical
Council.
3. He / She must have appropriate service in the government hospital after graduation from
medical university according to the criteria of Post Graduate entrance selection committee,
Department of Human Resource for Health, Ministry of Health.
4. The candidate must be within the age limit according to the criteria of Post Graduate entrance
selection committee at the time of application.

2.2. Selection Examination

There will be a selection examination conducted by the Selection Board of Postgraduate
Studies, University of Medicine (2), Yangon.

The candidate must sit for examination not only on the subject matter but also in English
proficiency. Although competency in the subject matter is of first priority, a candidate also must have
minimum acceptable proficiency in English.

Nobody will be exempted from the selection process.

(1) Subject Matter

Multiple Choice Question theory paper, (minus system not carried over) on applied basic
science, principles of surgery and cardiovascular surgery;
(60) stems for two hours.

Only those who scored passed marks in the written examination can proceed to the interview.

2.3. Number of Candidates Intake

2 – 3 candidates per academic year.

3. Career Ladder
The candidate is to be recognized as a qualified specialist after completion of the Post
[Link] training program.

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