Exploring the quality of postgraduate general surgery training at a tertiary care hospital of Khyber Pakhtunkhwa : A mixed method study

Date of Award

10-2025

Degree Type

Thesis

Degree Name

Master of Health Professions Education (MPHE)

First Advisor

Dr Amber Sultan

Second Advisor

Dr Ali Sarfraz Siddique

Third Advisor

Professor Rehana Rehman

Department

Educational Development

Abstract

Introduction: Postgraduate general surgery training is vital for developing skilled and safe surgeons. In countries like Pakistan, residents face challenges such as unstructured curricula, limited supervision, inconsistent feedback, and heavy workloads that hinder learning. Addressing these issues is essential to enhance training quality and align it with global competency-based standards. Objectives: To explore the perspectives of residents and faculty regarding the quality of postgraduate general surgery training at Lady Reading Hospital (I,R11), identify key strengths and deficiencies in the current program. and propose strategies for improving postgraduate surgical education at LRH.
Methods: This mixed method study comprises of a quantitative phase. where a structured questionnaire was administered to 90 general surgery residents. to explore their perspectives on key aspects of postgraduate general surgery training like curriculum implementation. mentorship and supervision. feedback, operative exposure. workload. academic activities. research opportunities, and overall satisfaction. The data was analyzed using descriptive and inferential statistics. The qualitative phase of the study comprised four in-depth interviews with faculty members. The data was analyzed in accordance with the Braun and Clarke's framework to contextualize and enrich quantitative findings. The study was guided by Kolb's theory and Vygotsky's Zone of Proximal Development (ZPD) in accordance with the Competency-Based Medical Education (CBME) principles, which emphasize progressive supervised learning, structured feedback. and development from dependent to independent surgical practice.
Result: Results of the study revealed that while residents acknowledged adequate operative exposure. particularly in emergency surgery, major deficiencies were noted in elective and subspecialty training, structured academic activities, research opportunities. supervision. and mentorship. Only 12% of residents reported regular structured teaching. and fewer than 20% experienced consistent mentorship. Faculty interviews highlighted similar concerns, emphasizing consultant-dependent supervision, weak rewarch culture, informal mentorship, lack of simulation facilities, and overwhelming workload a systemic barriers. integrated findings underscored the urgent need for structured curriculum. formalized feedback systems. institutional support for research. faculty development. and simulation-based training facilities.
Conclusion: This study explored residents' and faculty perspectives on surgical training at LRH, revealing strong clinical exposure but notable gaps in academic activities. structured supervision, and institutional support. Addressing these deficiencies is essential to strengthen training quality and develop competent surgeons.

First Page

1

Last Page

98

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