Viking Surgeons Association - Annual Conference 2020

Hosted by Faculty of Remote, Rural and Humanitarian Healthcare (FRRHH)

The Viking Surgeons Association (VSA) Annual Conference 2020 hosted by The Royal College of Surgeons of Edinburgh’s Faculty of Remote, Rural and Humanitarian Healthcare (FRRHH) took place as three, one-hour long webinars on the evenings of Tuesday 15th to Thursday 17th September 2020.

Each one-hour webinar included topics under the headings: ‘Trauma in Rural Areas’, ‘Tips and Tricks for the Rural General Surgeon’ and ‘How do we train a Rural General Surgeon?’. The aim was to provide a programme of interest to rural general surgeons in the UK, trainees in general surgery, and the many rural surgeons practicing throughout the world.

The Viking Surgeons Association is comprised of surgeons working in remote areas of Scotland and Nordic Countries and it is hoped during this series to forge links and discuss problems relevant to rural surgeons throughout the world.

1. Trauma in Rural Areas

This webinar, the first of a series of three sessions, focuses on trauma in rural areas, including pre-hospital assessment, local hospital treatment/stabilisation and transfer to a major trauma centre. Who needs treatment at the local hospital? Who should we transfer from the roadside to the trauma centre? How do we make that assessment and decision?

The webinar was chaired by Prof Angus Watson, Consultant General and Colorectal Surgeon, who is also Director of Research and Development at NHS Highland.


  • Luke Regan RCEM, DRTM - Overview of North of Scotland Trauma Network and Prehospital Care”
    Luke is an Emergency Medicine Consultant in Inverness with roles in the trauma and prehospital teams based there. His real passions lie in fair weather visiting of the more interesting hilly and watery bits of the highlands and in any opportunity offered to argue with relative strangers about the state of the world.

  • Dr. Jan Jansen, MBBS PhD FRCS FFICM - "Rural Trauma Care in the USA - View from the Centre"
    Dr. Jansen is a Trauma Surgeon and Associate Professor of Surgery at the University of Alabama at Birmingham (UAB), in the United States. He also directs UAB’s Center for Injury Science, serves as his Division’s Director of Research, and is the Department of Surgery’s Associate Vice Chair for Clinical Trials.
  • David Sedgwick MBChB FRCSEd - “A view from Rural Scotland”
    David has been a Consultant Surgeon in Rural Hospitals for 28 years. He has been an ATLS and Basic Surgical Skills Course (BSSC) Instructor for over 25 years and BSSC Convener for over 15 years on behalf of the RCSEd.. He convenes courses in Rwanda, Palestine and Cambodia as well as the UK. Retaining general surgery in the Rural General Hospitals and establishing a training pathway for those committed to this in Scotland have been two objectives in the past decade.



2. Tips and Tricks for the Rural General Surgeon

The second webinar in the series focuses on how the trainee working in a district hospital, and the consultant general surgeon working in a rural unit will deal with a huge variety of cases across the surgical specialties and subspecialties. This session aims to give some practical guidance to some of the common problems and highlights some of the issues that arise where the relevant expertise may be a 4-hour flight away.

The session was chaired by Mr Stuart Fergusson (BSc(Med Sci), ChM, FRCS, DRCOG, PGCAP, FHEA), who is a Trainee in General Surgery based in the West of Scotland. Stuart has interests in global health advocacy, medical education and surgical outcomes research, and intends to combine these interests with a career as a general surgeon in one of Scotland’s remote and rural hospitals.


  • Karina Laing MBChB MSc FRCS (Urol) - Testicular torsion and the difficult catheter”
    Dr Karina Laing qualified from Glasgow University in 2005. She started urology training as part of the East of Scotland rotation in 2009 and was appointed as a Consultant Urologist at Raigmore Hospital in Inverness in 2005. Her specialist interest is in female, neurological and urodynamic urology but she also does core urology and enjoys peripheral clinics at the Western Isles Hospital.  Since starting at Raigmore, she has reinstated an incontinence service and has introduced video urodynamics and a greenlight laser for bladder outlet obstruction. She is the Clinical Lead for urology and is in the process of setting up a diagnostic urology centre. She has always had a keen interest in teaching and set up and ran the course entitled ‘Urological Emergencies for the General Surgeons’ in 2019. She plans to run this on a regular basis for local trainees and general surgical consultants and hopes to extend it to candidates wider afield in the near future.

  • Keith Buchan MB ChB FRCS C/Th - "Pneumo/haemothorax: insertion, adjustment, removal”
    Keith is a Consultant in Cardiothoracic Surgery at ARI since 2001 and Higher Cardiothoracic Surgical Training in Glasgow, Cambridge and Cardiff. He spent 4 years in general surgical training, including one year in South Africa (Durban). His professional interests include research and teaching and is the author of 66 publications, many first authored by medical students.

  • Beatrix Weber FRCS(Ed) “Bleeding into the peritoneum”
    Ms Beatrix Weber, FRCS(Ed) is working as a true Remote and Rural Consultant General Surgeon on the most northern archipelago of the United Kingdom, Shetland. As such, she is a member of the Viking Surgical Club. Already during medical school in Germany and Austria, she tried to experience different settings and cultures with overseas electives. Training years gave further opportunities to work in various countries (Germany, U.K., Australia and South Africa). The first consultant post was in England, but since 8 years she is part of the team on the Scottish islands. When time and Corona or Ebola viruses permit, she does charitable work overseas.

  • Andrew W Kent MBChB FRCSEd (Tr&Orth) - “Fingertip injury and dislocated shoulder”
    Born in Malaysia and brought up in Fife, Scotland, Andy attended Edinburgh University Medical School and whilst there he became a Commissioned Army Officer in the Royal Army Medical Corp. He trained in the services to become a Consultant Orthopaedic Surgeon and was deployed throughout the globe including active duty in several austere and hostile environments. Andy has always been engaged in training and humanitarian work. He continues to teach on Advanced Orthopaedic, ATLS, and primary trauma courses and very recently has been appointed as the Surgical Director for UK-Med.



3. How do we train a Rural General Surgeon?

This third webinar of the series looks at how surgical care is becoming increasingly subspecialised and how training has become much more focused on small areas of expertise. Yet 46% of the world’s population is classified as rural (World Bank 2016), and the majority will never have ready access to this type of care. How do we train surgeons to work in these locations when specialist equipment and expertise may be a huge distance or many hours away? What has worked well? Where are we encountering problems?

The session was chaired by Dr Ken Walker, Colorectal Surgeon in Inverness and Professor of Surgical Training.


  • Gordon McFarlane, ChM FRCS
    Gordon is a Consultant Surgeon in Lerwick, Shetland Islands. He worked for 9 years as a Surgeon in Chogoria, Kenya, a 300 bed rural church hospital. Whilst there he undertook a ChM thesis on H. Pylori and gastric cancer. On returning to the UK, Gordon spent 4 years on the West of Scotland training rotation in general surgery, the last year of which was as a Rural Surgical Trainee with the North of Scotland Deanery. He was appointed to Gilbert Bain Hospital, Shetland in 2004. A Fellow of the College of Surgeons of East Central and Southern Africa, and a member of the Viking Surgeons Association, Gordon maintains an interest in rural surgical training and surgery in Africa.

  • Dr. Jesudian Gnanaraj, MS, MCh [Urology], FICS, FARSI, FIAGES
    Jesudian is a Urologist and Laparoscopic Surgeon trained at CMC Vellore. He has over 400 publications in national and international journals related to rural surgery and is part of the editorial board for several national and international medical journals. Jesudian has many innovations awards and several patents. His low-cost equipment is listed in the WHO compendium of medical equipment for resource poor setting. He has helped more than 30 hospitals start Minimally Invasive Surgeries and his popular innovations that have made MIS possible in rural areas are the Gas Insufflation Less Laparoscopic Surgeries and the Laptop Cystoscope.

  • Dr. Sally Butchers, BMed (Newcastle), FRACS
    Sally is a General Surgeon working in Lismore NSW Australia since 2008. She did part of her post fellowship training in Crosshouse Hospital, Ayrshire. She is currently the Vice President of the General Surgeons Australia and on the committee of the Provincial Surgeons of Australia. She is Chair of the PFET Program in Rural Surgery (Post Fellowship Education & Training) She is the immediate past Chair of the Rural Surgery Section of the Royal Australasian College of Surgeons, having been on the committee for 9 years. She was also on the NSW RACS State committee. Through these roles she has been and continues to be a strong advocate for rural surgery and training.


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