Been trained in this system, I am very familiar with the American surgical training system.  Medical school that involves first two years of didactic lectures followed by two more years of clinical rotations.  For those in surgical field, as the training in post graduation years advance, so is the time spent learning in the operating room under direct supervision.  Subsequently there are fellowship programs ranging from one to three years in various specialties.  For most, this ends formal training and begins an era of real learning in surgery from personal experiences.

The field of surgery is evolving and we are constantly challenged to improve our patient outcomes by improving or improvising our work.  So how do we keep ourselves abreast, learn from each other outside a formal training program?  If learning were to be inert after the formal training, most of us would be performing antiquated procedures and be forced out of our practices at a time when we have rich experience but have become formidably rigid in our ways.  Thus it is imperative we keep up-to-date on current developments in surgery.

Surgery, unlike Medicine not only involves didactic portion but also entails performing the operation that is acquired by pouring in countless hours in the operating room.  Most conferences that are the main modality of learning outside the formal training have video sections with edited version of the procedure.  This hardly simulates real operation where all the unwanted or should I say the most valuable part of the surgery that teaches us lessons is edited out to show case a well performed surgery.  Moreover it does not reproduce the mood, orchestration and the set up of the operating room, the external environment.  Thus there is a real necessity for better tools of teaching in surgery other then didactic or video presentation or transmitting live surgery just within the confines of adjacent lecture hall.

Last month I witnessed didactic lectures from the lecture hall with perfect streaming of the live surgeries of robotic gastrectomy, robotic heller myotomy, robotic liver resection, robotic whipple, robotic transaxillary thyroidectomy, robotic renal artery aneurysm resection with four feeding arteries and a live chat discussion to ask the moderator and the surgeon performing the operation questions.  I was able to see transmissions from United States, France, China, and Italy all within the confines of my house or office at University of Illinois at Chicago, and virtually visited all these places and interacted with other surgeons from different continents without having to put up the economical burden and time constraints if done in reality.  The live surgeries were performed at Grosseto, Italy and transmitted through the Virtual Learning University on the CRSA website with 1248 visits from 292 cities around the world.

This is a gigantic leap forward in the way we teach and learn, to create the most advanced Clinical Virtual University for surgeons that simulates being in the operating room, and interact with different surgeons from different continents.  The society since then has moved forward with creation of its faculty, a curriculum and plans to transmit live surgeries every month on the website.  So stay tuned…

Subhashini Ayloo MD FACS

Editor in Chief


One Response to “Clinical Virtual University”

  1. dmquinones Says:

    Dear Dr. Ayloo,

    With much pleasure I received the invitation of Professor Giulianotti to be part of the distance learning course, with the pioneering project of its kind called “Clinical Virtual University”. It was truly a unique experience and very rewarding to interact directly from my country with all participants in the world, asking questions and commenting on all the issues presented in the course. Despite the fact that I had to get up early every day at one o’clock in the morning to connect to the live broadcast of the event due to existing time difference with Italy, I must confess that I really worth it. I consider it a great privilege to be able to learn from the expertise and experience of the foremost speakers, as well as the robotic surgical procedure directly from the operating room.

    I completely agree with you, which is a quantum leap in the way we teach and learn, and also I would like to add that every participant attending this magnificent event, have a feeling that many other people are also attending it, giving the importance and magnitude of an event like this. Like conventional operating theater, the participants within a virtual operating room, can exchange and share their experiences with themselves or with the Surgeons in real time. From the set up of the operating room, through the preparation to the patient, and continuing with the surgical procedure stepwise, it is possible to sense the feelings of the surgeon when things are coming along well or when the going gets tough, that of course, it is not possible when you look at an edited video.

    Finally, congratulations again for your nice presentation. I learn a lot.


    Diego Quiñones MD

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