Australia Vietnam Hand Surgery Course Experience in Hue Central Hospital
Some learning can only happen when you stand beside an experienced surgeon, examine a patient together, plan the operation, and then see that plan carried into theatre. That was the value of the Australia Vietnam Hand Surgery Course at Hue Central Hospital. It was not just a week of lectures. It was a week of clinics, operating, teaching, practical skills, and shared experience.
The course has a long history. It began in 1998 as a collaboration between Australia and Vietnam, built around a simple but powerful goal: to improve hand surgery care through teaching, partnership, and shared clinical practice. Each year, a team of experienced Australian hand surgeons travels to Vietnam to work with Vietnamese surgeons and trainees. The programme usually runs for one week and covers a wide range of hand surgery conditions.
This year, I was fortunate to attend as an international trainee from Samoa, trained under PIOA. For me, it was a rare opportunity to learn in a high-volume orthopaedic centre, work with generous mentors, and compare another health system with what we experience in Samoa.
A course built on long-term partnership
The strength of this programme comes from its continuity. A course that has continued since 1998 is more than a visiting team model. It shows a long-term commitment between two countries to build surgical skills, support local services, and improve patient care.
Hand surgery is a highly specialised field. It requires detailed knowledge of anatomy, careful examination, good decision-making, and precise operative technique. The hand is small, but the impact of hand injury or disease is large. A painful wrist, stiff finger, tendon injury, nerve injury, infection, tumour, or fracture can affect work, family duties, and daily independence.
That is why courses like this matter. They create a space where trainees can see real cases, ask questions, practise skills, and understand not only how to operate, but when to operate and how to plan properly.
The Australian team brought many years of experience. They did not only teach from slides. They joined clinics, discussed patients, operated with local teams, and guided trainees during practical sessions. The Vietnamese surgeons and staff at Hue Central Hospital also provided a strong learning environment, with excellent organisation and a high number of cases.
For an international trainee from Samoa, this was especially valuable. Samoa has dedicated clinicians and skilled teams, but the scale is different. The chance to observe a larger orthopaedic unit helped me see what is possible when theatre access, case volume, team structure, and teaching are all aligned.
Learning began in the clinic
One of the most important parts of the week was clinic assessment. Before any operation, the team saw patients together, examined them, reviewed the clinical findings, and discussed the most suitable management plan.
This step was a reminder that good surgery starts before theatre. The examination matters. The history matters. The explanation to the patient matters.
One case that stood out involved a young female patient with a haemangioma on her left hand. The team examined her in clinic, explained the condition, discussed the planned surgery, and gained consent. The case was then booked for theatre.
I was fortunate to assist in this operation with Dr Richard Lawson and Dr Richard Atkinson. For a trainee, that kind of experience is very valuable. These are the cases many trainees would hope to assist with, because they combine careful planning, delicate anatomy, and direct teaching from surgeons with deep experience.
The lesson was not only about removing a lesion. It was about the whole process:
taking time with clinical assessment
explaining the diagnosis clearly
discussing the operation in a way the patient can understand
preparing the theatre team
respecting the anatomy of the hand
learning through close supervision
In hand surgery, small decisions can have a large effect on function. Watching experienced surgeons work through each step helped me appreciate the discipline and patience required.
Theatre organisation at Hue Central Hospital was an eye-opener
The Orthopaedic Department at Hue Central Hospital had eight running tables for orthopaedic cases. Coming from Samoa, this was one of the biggest differences I noticed. Theatre time is often one of the major limits in smaller health systems. In Hue, the volume and organisation allowed many cases to proceed efficiently.
There was no long delay from searching for available theatre time. The department had the structure to keep orthopaedic cases moving. For a trainee, this meant more exposure. For patients, it meant a clearer pathway from clinic decision to operation.
The team also had a clear routine before and after theatre. At the start of the day, the cases were confirmed. At the end of the day, the team reviewed what had been completed and confirmed the list for the following day. This simple rhythm helped everyone understand the plan.
That structure stood out to me because it supports safety. When a surgical team knows the list, the order of cases, the equipment needed, and the expected plan, the day runs better. It reduces confusion and gives trainees a clearer learning experience.
Dr Peter Scougall was the leader and main coordinator of the course, working with his Australian colleagues and the local team. His role was important not only in organising the teaching, but also in setting the tone for the week. The course felt active, focused, and generous. The mentors were approachable, and the teaching continued in theatre, in clinics, and during discussions.
A well-run surgical course needs much more than expert surgeons. It needs coordination, theatre planning, patient selection, local support, translation when needed, teaching materials, equipment, and a shared purpose. Hue Central Hospital provided that foundation.
Hue Central Hospital
Eight orthopaedic tables allowed a high number of cases and consistent theatre exposure.
Course structure
Daily briefings helped confirm completed cases and prepare the next list.
Samoa comparison
Theatre access can be more limited, making every available operating session very important.
Training value
Clear planning made the week easier to follow and improved learning for trainees.
Classroom teaching connected theory with real cases
The course was not only focused on operating. Classroom teaching was another important part of the week. These sessions helped connect the practical cases with the principles behind them.
Dr Matt White taught trainees on wrist arthroscopy and WALANT concepts. WALANT stands for Wide Awake Local Anaesthesia No Tourniquet. It is an approach used in some hand surgery procedures where the patient remains awake under local anaesthesia, without the use of a tourniquet. The teaching was particularly useful for managing acute hand injuries when they present to hospital centres.
The classroom sessions gave us time to slow down and ask why. In theatre, the pace can be quick. In class, we could discuss indications, anatomy, patient selection, possible complications, and decision-making.
Wrist arthroscopy was a valuable topic because it requires a strong understanding of wrist anatomy and pathology. For many trainees, wrist pain and wrist injuries can be challenging. The anatomy is compact, and the symptoms may not always appear clear at first. Teaching on arthroscopy helped build a better understanding of how surgeons assess and treat specific wrist problems.
The WALANT discussion was also relevant to settings with limited resources. In many Pacific and regional hospitals, safe and practical approaches matter. A technique that can reduce the need for general anaesthesia in selected cases may be useful, as long as the team has proper training, protocols, and patient selection.
This content is for educational reflection only. Clinical decisions should always follow local policy, senior guidance, patient consent, and appropriate training.
Practical sessions made the teaching hands-on
One of the most useful parts of the course was the practical training. We had sessions using saw bones to practise fixation of distal radius fractures with a volar locking plate.
This kind of session is valuable because it gives trainees the chance to handle instruments, understand plate position, practise screw placement, and think about fracture alignment without the pressure of a live operation.
Distal radius fractures are common in orthopaedic practice. Some can be managed without surgery, but others need fixation. When surgery is required, good technique matters. Poor reduction, poor plate placement, or incorrect screw length can affect movement, healing, and function.
The saw bone session helped reinforce several key points:
restore alignment before fixation
understand the shape of the distal radius
choose plate position carefully
check screw direction and length
respect the soft tissues
think about early movement and hand function after surgery
For me, this was a strong reminder that practical skills improve through repetition. Watching an operation is important, but using the instruments yourself helps build confidence. It also exposes small gaps in knowledge. A trainee may understand the theory, but when holding the plate and drill guide, new questions appear.
That is the value of guided practice. Senior surgeons can correct technique early, explain why a step matters, and help trainees build safe habits.
What I learned as a trainee from Samoa
Attending the course made me reflect on the needs of smaller island health systems. Samoa faces different challenges from a large hospital such as Hue Central Hospital. Patient numbers, theatre availability, equipment, and subspecialty access are not the same. Yet the principles of good care are shared.
The first lesson was the importance of structured assessment. A careful clinic review can prevent poor decisions later. When hand cases present, the clinician must identify the injury pattern, assess the function, check circulation and sensation, and decide which cases need urgent referral or surgery.
The second lesson was the value of preparation. The daily theatre briefings were simple but effective. They helped the team move with purpose. In smaller hospitals, a similar habit can still improve care even with fewer cases.
The third lesson was that mentorship matters. A visiting course can leave a lasting effect when mentors teach in a respectful and practical way. The Australian team did not only show what they could do. They helped trainees understand how to think.
The fourth lesson was that exposure changes perspective. Seeing eight orthopaedic tables running made me think about how service design affects training and patient care. A trainee learns more when there are enough cases, enough supervision, and enough time to discuss.
The fifth lesson was the importance of networks. The relationship between Australia and Vietnam has continued for many years through this course. For Pacific trainees, joining these opportunities can help build wider professional links and bring knowledge back to our own hospitals.
The human side of surgical education
Technical skills are easy to name. Plates, screws, arthroscopy, haemangioma excision, tendon repair, fracture fixation. But the human side of the course was just as important.
Patients placed their trust in the team. Local staff managed the flow of clinics and theatre. Visiting surgeons gave their time. Trainees came ready to learn. Each part mattered.
What impressed me most was the shared attitude. The course showed that surgical education works best when people are willing to stand beside each other, share experience, and ask honest questions. No trainee learns hand surgery in one week. But one good week can change how a trainee examines, plans, assists, and thinks.
The Australia Vietnam Hand Surgery Course Experience in Hue Central Hospital gave me a clearer view of what strong surgical training can look like. It combined patient care, theatre exposure, classroom teaching, and practical skills in a way that felt complete.
A week that will shape my practice
Leaving Hue, I carried more than notes from lectures. I carried examples of how to run a surgical teaching week, how to structure theatre days, how to guide trainees, and how to care for hand surgery patients with patience and precision.
The course reminded me that improvement in healthcare does not happen only through equipment or buildings. It also happens through relationships, repeated teaching, shared standards, and the willingness to learn from other systems.
For me as a trainee from Samoa, this experience was a privilege. It strengthened my interest in hand surgery and gave me practical lessons I can bring back to my own setting. The week showed that even when countries and hospitals differ in size and resources, the goal remains the same: safe surgery, better function, and better care for patients.
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