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Background Super specialty (SS) courses such as Doctorate of Medicine (DM) and Master of Chirurgiae (MCh) represent the highest level of medical training in India. Understanding postgraduate (PG) perceptions toward SS is vital for workforce planning and educational reforms. Objective To assess the relationship between demographic factors and PG students' choice of SS, as well as influencing factors, perceived benefits, and barriers. Methods A cross-sectional, questionnaire-based survey was conducted among PG residents in medicine, surgery, and anesthesiology at a state medical university. Data on demographics, financial and social factors, and career motivations were analyzed using descriptive and inferential statistics. Results Among 63 respondents, 47 (74.60%) were willing to pursue SS. Recognition 20 (31.74%) and academic interest 10 (15.87%) were key motivators. Major barriers included financial constraints 4 (6.34%), either seeking early returns or having loans 32 (50.79%) and bond obligations 46 (73.01%), as well as long training durations 6 (9.52%) among the 17 respondents who were not willing to pursue SS. Critical Care was the most preferred SS 26 (41.27%), especially among anesthesiology residents. No significant associations were found with gender, income, or family medical background. Conclusion Despite strong interest, financial burden, training length, and service bonds deter many PGs. Institutional reforms, structured mentorship, and early career guidance are crucial for promoting equitable access to SS training in India.

Virtual reality (VR) has revolutionized medical education, yet its specific efficacy in teaching medical physiology remains underexplored. Conveying the complexities of physiological responses to hypoxia through traditional teaching methods poses logistical challenges, potentially hindering students' deep understanding. This study investigates the impact of incorporating VR into preclinical medical physiology teaching, focusing on students' self-reported 1) knowledge acquisition and understanding of body responses to hypoxia, 2) VR technology acceptance and satisfaction, and 3) overall learning experience. In 2022, an Australian National University (ANU) Medical School teaching enhancement grant funded data collection to develop a comprehensive storyboard for a VR hypoxia simulation program. With support from the school's Technology-Enhanced Learning and Teaching team and the university's Center for Learning and Teaching, we created an in-house limited prototype focusing on key aspects of the scripted VR simulation module to test its feasibility and perceived usefulness within our Medicinae ac Chirurgiae Doctoranda (MChD) program. The module was integrated into a year 1 practical session, followed by a two-part series of data collection, comprising a questionnaire and video interviews. The questionnaire used a mixed-methods approach, including five-point Likert scale closed-ended questions rating VR perceived usefulness and ease of use and open-ended questions allowing participants to provide qualitative responses. Interviews delved deeper into users' experience, interactivity, collaboration, realism, practicality, knowledge acquisition, improvement suggestions, and overall technology and learning satisfaction. Although the implemented intervention did not represent the full range of features envisioned for the final program, preliminary findings from the first round of data collection via questionnaires (n = 45/96) reported positive user experiences. Sixty percent of responses showed agreement [agree (n = 22) and strongly agree (n = 5)] that learning outcomes were clear and aided by VR. Qualitative findings revealed higher motivation to use VR for learning as a complementary tool to traditional approaches and an intuitive interface. Thematic analysis identified improvement opportunities, including clearer user instructions, enhancing hypoxia symptom discernibility, and refining visual resolution. These insights will inform the next study phase, refining features to improve the overall learning experience and address technical challenges. Grounded in constructivist learning theory and technology acceptance frameworks, our findings leverage realistic VR simulations to enhance knowledge acquisition and understanding of complex physiological responses.NEW & NOTEWORTHY Medical students' perceived usefulness of virtual reality (VR) in hypoxia physiology is strongly linked to the clarity of learning objectives and their alignment to the module content. Other key factors that contribute to positive attitudes toward VR include its novelty, fun and excitement, and embodied cognition.

Over the past four decades, gynecologic oncology has grown significantly as an academic discipline. In its early stages, only a handful of cancer centers offered certified training programs, providing a basic orientation to the field but lacking comprehensive, in-depth training. The discipline has become more structured today by establishing fellowship and degree programs at various tertiary-level cancer centers nationwide. However, training quality and depth still vary considerably across institutions. This nationwide survey was conducted to evaluate the strengths of current training programs and identify areas for improvement based on feedback from current trainees and early-career gynecologic oncologists. An online survey questionnaire was disseminated to a targeted group via WhatsApp messaging, adhering to specific inclusion criteria, and remained open from September 15, 2023, to November 16, 2023. The respondents comprised Gynecologic Oncology trainees enrolled in Master of Chirurgiae (MCh) or Doctorate of National Board (DrNB) programs, second-year fellows, and Gynecologic Oncologists who had completed their training within the past two years. The survey consisted of 57 questions designed to assess various aspects of training, academic activities, and expectations from the program. It also aimed to evaluate the overall exposure of trainees, focusing on the frequency and range of surgeries they participated in and their satisfaction with the surgical training. The collected responses were systematically tabulated and analyzed to derive meaningful insights. Out of 107 responses, 99 were analyzed. The findings indicated satisfactory exposure to the overall curriculum and a wide range of clinical conditions. A significant proportion (72.9%) of participants reported active involvement in open surgeries, including extensive procedures such as peritonectomy and sentinel node techniques, and receiving feedback on academic performance. However, concerns were highlighted regarding insufficient exposure to minimally invasive surgery, particularly robotic techniques, as well as specialized procedures like Heated Intraperitoneal Chemotherapy (HIPEC) and ultra-radical surgeries. This comprehensive survey, the largest of its kind among Gynecologic Oncology trainees in India, sheds light on the strengths ("hits") and areas for improvement ("misses") within the current training curriculum. Key "hits" include satisfactory exposure to open surgeries and feedback mechanisms, alongside the adoption of techniques like peritonectomy and sentinel node procedures. However, the "misses," such as limited training in minimally invasive surgery-especially robotics-and specialized procedures like Heated Intraperitoneal Chemotherapy (HIPEC) and ultra-radical surgeries, underscore further enhancement. This study serves as a valuable reference for evaluating and refining training programs. It provides a framework for future audits to standardize and elevate the quality of gynecologic oncology training in India. The online version contains supplementary material available at 10.1007/s13193-025-02250-7.

The lack of access to competent neurosurgical treatment in low-income countries is a serious concern. To advance the field, research plays a crucial role. This article provides an overview of the neurosurgical landscape in Nepal, identifying areas that require further research for better patient outcomes. Recent initiatives offer hope for closing the access gap and improving neurosurgical care globally. The authors used the PubMed database for searching articles that contain the keyword "Neurosurgery in Nepal" with at least one Nepali author. All the articles published between 1 January 2000 and 29 March 2023 were included. The data obtained from this search were downloaded in CSV format and manually entered into Excel for analysis. Additionally, data regarding the number of medical colleges that train neurosurgery residents were gathered from the website of the Ministry of Education. A review of 316 neurosurgery-related articles in Nepal revealed case reports (93) as the most common, alongside review articles (41) and clinical studies (25). Seven medical colleges provide Magister Chirurgiae training, and one institute offers National Board of Medical Specialties training, producing 11 neurosurgeons annually. This underscores the need to bridge the neurosurgical gap in Nepal. In conclusion, to address the growing demand for specialized care and provide better access to neurosurgical services, it is essential to prioritize the expansion of neurosurgical residency programs and the promotion of evidence-based medicine training.

Changing paradigms of neurosurgical training and limited operative exposure during the residency period have made it necessary to evaluate newer technologies for training. Virtual reality (VR) technology provides three-dimensional reconstruction of routine imaging, along with the ability to see as well as interact. The application of VR technology in operative planning, which is an important part of neurosurgical training, has been incompletely studied so far. Sixteen final-year residents, post-M.Ch. (magister chirurgiae) residents, and fellows were included as study participants. They were divided into 2 groups based on their seniority for further analysis. Five complex cranial cases were selected and a multiple-choice question-based test was prepared by the authors, with 5 questions for each of the cases. The pretest score was determined based on performance on the test after participants accessed routine preoperative imaging. The posttest score was calculated after use of the VR system (ImmersiveTouch VR System, ImmersiveTouch Inc.). Analysis was performed by the investigators, who were blinded to the identity of the participant. Subanalysis based on the type of case and type of question was performed. Feedback was obtained from each participant regarding VR use. There was an overall improvement in scores from pretest to posttest, which was also noted in the analysis based on the participants' seniority. This improvement was noted to be more for the vascular cases (15.89%) compared with the tumor cases (7.84%). Participants also fared better in questions related to surgical anatomy and surgical approach, compared with questions based on the diagnosis. There was overall positive feedback from participants regarding VR use, and most participants wanted VR to become a routine part of operative planning. Our study shows that there is improvement in understanding of surgical aspects after use of this VR system.

The advent of hand surgery in India reads like a fortuitous saga, a continuum of the hand deformity correction on leprosy patients pioneered by Dr. Paul Wilson Brand at the Christian Medical College (CMC) Vellore, Madras State (Tamil Nadu [TN]), in 1948. The "Hand Research Unit," established in 1951, became the largest repository for hand reconstructive surgeries and with its head-start drew in most hand dysfunctions in the country. Early industrialization and disorderly road traffic generated hand injuries that threatened workforce in India. Propitiously, a hand injury service was opened in 1971 at the Government Stanley Medical College Hospital, Chennai. The inexorable growth of hand surgery continued and incorporated the gamut of conditions that required hand care and rehabilitation, including brachial plexus injuries. Continuing Medical Education programs, Hand Surgery workshops, Indian Society for Surgery of the Hand meetings, Hand Fellowships, etc., increased the number of "hand surgery" practitioners, which drew the attention of the Medical Council of India to commence a postgraduate Hand Surgery program that it eventually gazetted. The sagacity of the members of the Board of Studies of TN Medical University honored the historical role of CMC Vellore in hand surgery and allowed it to commence the first Master of Chirurgiae Hand Surgery course in India in 2015. An intuitive understanding of 70 years of hand surgery accomplishments that redesigned and restored deformed and injured hands and protected livelihoods have made young surgeons increasingly take hand surgery as a career.

From the 1820's a great number of surgeons attended the Faculty of Medicine in Pest. The increasing number of the students was resulted by several circumstances. After the Napoleonic wars peregrination from Hapsburg lands was prohibited. The Faculty of Medicine in Pest however offerred a diploma for its students valid for the whole territory of the Hapsburg Empire. The lectures were held in Hungarian or German, in contrary to the exclusively Latin lectures for medical students. A shorter preliminary education was needed. After three years the student could get his degree Chirurgiae Magister or Chirurgus civilis--the length of studies depended on the pleriminary studies of the surgeon. The Faculty started only two courses, so the surgeons mostly repeated the second or both courses. Although these degrees proved to be inferior to the titles Doctor Medicinae or Doctor Chirurgiae, many students wanted to get it. In the beginning of this period, in 1825/1825 117 persons attended the first semesters of the German, and 59 of the Hungarian course. This growth reached its peak in the years of the cholera. In 1832/1833 255 person matriculated to the first class of the German and 148 to the Hungarian course. This new contagion damaged not only human lifes, but the popularity of the surgical education as well. The number of students began slowly decrease. Another reason for this decrease was the new possibility for peregrination from the 1830's. In 1846/1847 48 persons matriculated to the first German course, and 49 to the Hungarian, while in the second one their number was only 10 and 20. As we can see, the German course was more popular, here came students from the other parts of the Hapsburg Empire, especially Jews: from Moravia (160; 110 of them was Jew), Bohemia (134) or Galicia (178; 124 of them was Jew). Between 1825 and 1846 2618 surgeons matriculated to the Faculty of Pest, many of them however left it with or without doing their exams. 1854 students took every exam, but only 259 got his degree as Chirurgiae Magister in Pest, and 1049 as Chirurgiae Civilis. Presumably many students carried on their studies in Vienna. Although the Faculty of Medicine in Pest was less renowned, than the medical faculty of Vienna or Prague, it definitely played a remarkable role in the contemporary medical and surgical education of the Hapsburg Empire.

Background Despite the sizeable Indian paediatric population, few students have opted for postdoctoral (Magister Chirurgiae [MCh]/Diplomate of the National Board of Examinations [DNB]) courses in the past decade. We analyse the apparent loss of interest for training in paediatric surgery in India and suggest remedies. Methods We did a combination of an online questionnaire-based survey and several interviews among students, teachers and practitioners of paediatric surgery. The results were collated and analysed. Results Information from 238 questionnaires, 35 interviews and 75 feedbacks were distilled. About 83% of respondents agreed to a definite loss of interest among students in paediatric surgery, largely because of poor exposure during undergraduate/postgraduate courses and absence of a department in medical colleges. The blanket increase in seats has led to vacancies. The low saleability of paediatric surgery is linked to high personnel and infrastructure investment, modest remunerative potential and poor insurance cover for patients. Besides increasing public awareness, strategic governmental patronage in postdoctoral training (e.g. establishing a department in medical colleges, moderating the number of seats, encouraging performing training centres and rationalizing the bond after the training course) and facilitation of patient care (e.g. insurance cover for congenital conditions and paediatric surgeon in neonatal care units in district hospitals) is suggested. Conclusions The loss of interest in paediatric surgery among medical trainees is real and urgently requires a multipronged strategy by the medical fraternity, professional organizations and regulatory bodies across government and non-governmental sectors to facilitate a revival and cater to the sick surgical child in the future.

Giovanni Andrea Dalla Croce was a Venetian physician who lived in the 16th century and was famous for his treatment of wounds, which was surprisingly modern. He was the military surgeon of the Venetian Republic's naval fleet. In 1537, he published the Chirurgiae universalis opus absolutum (The absolute work on universal surgery) in Latin, then expanded and translated into vernacular Italian and published in 1574 with the title Cirugia universale e perfetta di tutte le parti pertinenti all'ottimo chirurgo (Universal and perfect surgery of all the parts necessary for the optimal surgeon). This monumental work was a comprehensive handbook of surgery, medicine, and the treatment of many kinds of wounds with techniques to be used on the battlefield. It is also notable for the inclusion of illustrations of various weapons and projectiles, for the most comprehensive description and illustrations of surgical instruments at that time, and for the first illustrations of a surgeon performing trephination of the skull in an operating room. Dalla Croce also considered the writings of his surgical forebears in formulating his own ideas. Dalla Croce was a leader of traumatology, a universal surgeon who exemplified the erudite Renaissance man, and left a tremendous legacy to military surgery of the 16th century and beyond.

Adrien Pelerin (1698-1771) was the first professor of medicine in Maastricht, the Netherlands. He received his medical education at Leiden University in the period of Boerhaave and Albinus, and in 1736 he was appointed doctor medicinae and head of the military hospital in Maastricht. He organized the medical care for a sizeable garrison and was a supervisor of the medical care in the city. From 1738 onwards Pelerin gave public anatomy lectures for doctores medicinae, barber surgeons and quite probably for students of the Illustrious School of Maastricht. The Council of State conferred the title of Professor Anatomiae et Chirurgiae on Pelerin, for giving these lectures.

Pehr af Bjerkén had his descent from a parish named Bjärka in western Sweden. His father was a medical doctor and assessor in Stockholm. At the age of sixteen Bjerkén began his studies in Uppsala. Later on he became a "chirurgiae studiosus" in Stockholm at the Serafimer hospital as a pupil of professor Olof Acrel. He defended a doctor's dissertation on "Febris puerperalis" in 1793. Thereafter Bjerkén went to London, where he spent three years. He was taken care of by mr Henry Cline and he met also John Hunter. After some time mr Cline made him a "House surgeon" at S:t Thomasis and Guys hospitals. He got good practice especially regarding the surgery of stones in the urinary bladder and in the surgery of the eye. During the stay he was appointed a member of the Medical Society of London. Back in Sweden Bjerkén practised the surgery with great success.and became physician in ordinary to the king. When in Februar 1808 the Russian tzar Alexander invaded Finland Bjerkén was appointed chief army surgeon in nothern Finland. During this war Bjerkén showed his courage on the battle fields operating and taking care of the wounded soldiers, also the enemies. Most wellknowned for us he became through a sentense in the poem "Döbeln at Juutas". In February 1809, when the Russian tzar had conquered all of Finland. Bjerkén resigned from the Finnish army. The first of June 1809 af Bjerkén was appointed to be head barber-surgeon (head surgeon) of the Serafimer hospital in Stockholm. He was then the most qualified surgeon in Sweden and was looked upon as the most important authority in surgery. Bjerkén was the first one to describe an operation and ligation of an aneurysm of the carotide artery. In 1812 he also published a ligation and resektion of a huge tongue reaching below the chin on a girl eleven years of age. Together with the description there was an engraving. This became the first illustrated publication in the proceedings of the Swedish Society of Medicine. He was especially wanted för operations of stones in the urinary bladder but had also great success in most of his operations and clinical work. In spite of this or due to his great load of surgery he wrote few scientific works. In January 1818 Bjerkén was invited to Gothenburgh to operate upon a urinary bladder stone. During the journey from Stockholm he got a stroke. Bjerkén was token care of in Jönköping by his old friend Jacob Edgren, head army surgeon. When lying on his deathbed he was told that the king Karl XIII had died. Bjerkén then said: "Well, the king of Sweden is dead and the king of the surgeons goes soon after". Bjerkén died on the 24 th of February 1818, 53 years of age. Pehr af Bjerkén was buried in the churchyard at Dala in the parish where his brother Carl-Gustaf had been the dean. Some hundred years later in 1912 a monument to the memory of Pehr af Bjerkén was erected at Dala by the Swedish Society of Medicine in connection with a commemoration.