Housemanship postings
Housemanship: general surgery
The general surgery posting teaches a house officer to look after patients before and after operations and to recognise surgical emergencies. A psychiatrist uses these skills when assessing self-harm, eating disorders and confused patients after surgery.
Depth by stage, Pre-U → Consultant (details)
What is it?
In general surgery the house officer prepares patients for theatre, looks after them afterwards, and assesses new patients with abdominal pain, trauma and wounds. The pace is fast and the hours are long, especially during on-call.
The HO learns basic procedures such as inserting drips and catheters, simple suturing, dressing wounds and assisting in theatre. Equally important is learning how a patient's condition changes after an operation: pain, bleeding, infection and confusion.
For someone who later chooses psychiatry, surgery builds confidence with acutely ill patients, wounds and emergencies, and shows how illness and operations affect mood, sleep and behaviour.
Why does a psychiatrist need it?
Psychiatrists regularly see patients who have cut or burned themselves, swallowed objects or chemicals, or become delirious after surgery. Liaison psychiatrists are often called to surgical wards. Knowing how surgical teams work, and what a wound or post-operative complication means, makes the psychiatrist safer and more useful.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalNot expected
- ClinicalUnderstandsClerks surgical patients, observes operations and learns basic examination of the abdomen and lumps.
- HousemanshipAppliesManages pre- and post-operative care and recognises surgical emergencies under supervision.
- Medical officerUnderstandsRetains surgical first-aid skills; psychiatry MOs use them when patients self-harm.
- Psych traineeUnderstandsAssesses self-harm wounds, post-operative delirium and capacity to consent for surgery.
- Specialist / consultantUnderstandsAdvises surgical teams on complex cases such as bariatric surgery assessment or repeated self-injury.
What are the key topics?
Peri-operative care
- Pre-operative assessment and fasting instructions
- Consent: explaining risks and checking understanding
- Post-operative pain control including opioid safety
- Fluid and electrolyte management after surgery
- Recognising bleeding, infection, anastomotic leak and pulmonary embolism
Surgical emergencies
- Acute abdomen: appendicitis, bowel obstruction, perforation
- Trauma assessment using a structured approach
- Burns first aid and fluid estimation
- Upper and lower gastrointestinal bleeding
Procedures
- Intravenous cannulation and blood taking
- Urinary catheterisation
- Simple wound suturing and dressing
- Nasogastric tube insertion
- Assisting in theatre and sterile technique
Links to psychiatry
- Assessment of deliberate self-harm wounds
- Post-operative delirium in older patients
- Alcohol withdrawal emerging after emergency admission
- Capacity to consent or refuse surgery
- Ingestion of foreign bodies or corrosives in mental illness
How is it learned and assessed?
- Ward work, theatre sessions and on-call duty
- Procedure logbook signed by supervisors
- End-of-posting evaluation by the surgical department
- Informal teaching on rounds and in theatre
Typical textbooks and resources
- Oxford Handbook of Clinical Surgery — Oxford University Press
- Bailey and Love's Short Practice of Surgery — CRC Press; standard reference
- Hospital surgical protocols and MOH guidance
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Do psychiatrists use surgical skills?
Rarely in the operating sense, but they assess self-harm wounds, recognise when a patient needs surgical review, and are often asked to see confused or distressed patients on surgical wards. Housemanship gives them the background to do this safely.
Is the surgical posting compulsory?
General surgery is typically one of the core housemanship postings in Malaysia. Check the current Ministry of Health housemanship guidelines for the exact structure.