Introduction: Microsurgery is a general term for surgery requiring an operating microscope, small specialized microsurgical instruments, and microsurgical sutures, permitting very delicate operations, as the "reconnection" of severed blood vessels and nerves The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerve coaptation (typically less than 3 mm in diameter) which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as: general surgery, ophthalmology, orthopedic surgery, gynecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic surgery, and pediatric surgery.

Objectives of the lesson: The students are introduced by a specialized instructor to the basic techniques of microsurgery, such as how to use the microinstruments and handle microsutures, under the microscope. Furthermore, literature was handed out to the students to provide theoretical information on basic techniques. Furthermore, students do practice suturing and knots on different planes using latex rubber glove practice card, and silastic lumen. From our experience with the course, we can state that the students were really impressed by the simple models and had a lot of fun with the practical exercises.

Lesson contents: Objective of Microsurgery. History of Microsurgery. Experimental Surgery. Microscope, Microsurgical instruments and Microsutures. How can be Microsurgeon. Replantations after fingers and hand amputations. Indications and Contraindications. Decision for replantation. Overview of technique of replantation. Microvascular grafts. Microsurgery for Brachial Plexus and peripheral nerve injuries. Nerve repair with nerve grafts. Application of Microsurgery in Orthopaedic trauma and Reconstruction. Free and pedicled flaps. Free flap transfer for extensive tissue defects of the limbs, extensive bone defects, complex trauma injuries, oncological resections, and congenital abnormalities. Research and Future of Microsurgery.

Learning outcomes: The course besides the theoretical introduction is combined with practical training with the use of the operating microscope, micro instruments, fine suture 8-0, 9-0 by practicing suturing on different planes using latex rubber glove practice card. At the end of the program the basic techniques can be learned by students and most of them are able to apply sutures and tying the knots under the microscope on nonvital models . Each student encouraged to submit a "small thesis" on different microsurgical fields, for the final examination test of the program.

Hours of training per student: 26

From the 8th Semester

ECTS: 2

Objectives of the course: The course is designed to enable students to understand the necessity of a holistic bio-psycho-social approach in the management and treatment of patients with physical diseases as well as with 'functional' (somatoform) disorders. The course aims at offering basic knowledge on how to examine patients suffering from physical diseases and psychiatric comorbidities and on how to diagnose psychiatric disorders in these patients, which might be a challenging task in every day clinical practice. An additional aim is to teach students to be able to establish a patient/doctor relationship based on trust and understanding and to acknowledge and interpret the patient's reactions and ways of adjustment/coping with the physical illness. They are also taught how to break bad news, how to deal with terminally ill patients or with patients who are in pain and how to integrate the dynamics between the present physical illness and the patient's life story.

Contents of the course: The origins of Psychosomatic Medicine: Neurobiology, Psychoanalysis and Consultation-Liaison (C-L) Psychiatry – The psychiatric assessment of the medically ill patient - Psychosomatic medicine in primary care - Functional somatic syndromes and medically unexplained symptoms - Psychoanalysis and psychosomatics - Ego mechanisms of defense –Patient/doctor relationship: Breaking bad news, the dying patient, grief, transference and countertransference - The psychodynamic life narrative of the patient with physical illness – Psychological reactions to physical illness –Taking personality into account when managing hospitalized patients - Ethics - Brief psychiatric assessment of the medically ill patient and the 'doctor's pocket card' – Specific topics: Postnatal depression, amputation, the role of the skin in normal and abnormal development - Research in Psychosomatics.

Mode and outcomes of teaching: Learning occurs through lectures by mental health professionals as well as by assigning projects to the students distributed in 12 thematic entities. After the completion of the course the students present their projects at an one day conference. By the end of the course the students should be able to recognize psychiatric symptoms in medically ill patients, the patients' psychological reactions and the way that the physical illness is integrated into the patient's life narrative. They should also have gained knowledge in diagnosing and managing functional syndromes and somatoform disorders. They should also be familiar with the assessment and management of the medically ill patient with psychiatric comorbidities, with how to break bad news, how to manage the grieving and the dying patients, with the dynamics of the patient/doctor relationship and with the principles of ethics and deontology. Finally, they should have achieved a satisfactory degree of knowledge in research in psychosomatic medicine by being able to do literature review, to be familiar with studies' design and to critically appraise a scientific manuscript.

Hours of training per student: 26

From the 8th Semester

ECTS: 2

Objectives of the course: The course offers gaining of knowledge regarding the immunology, the immunosuppression and the basic principles in solid organ transplantation, with emphasis to kidney, liver, pancreas, small bowel, heart and lung transplantation.

Contents of the course: History of Transplantation. Basic principles in transplantation immunobiology and immunosuppression. Methods of organ preservation. Pathophysiology of ischemia-reperfusion syndrome and clinical implications. Organ rejection. Kidney transplantation: causes of end stage kidney failure, immune response, patient selection, donors, surgical technique, immunosuppression, postoperative complications, graft rejection. Liver transplantation: causes of end stage liver failure, patient selection, preoperative assessment, indications, donors, surgical technique, immunosuppression, postoperative complications, graft rejection, HCC and liver transplantation. Pancreas transplantation: patient selection, preoperative assessment, indications, surgical technique, immunosuppression, postoperative complications, graft rejection, simultaneous pancreas and kidney transplantation. Small bowel transplantation: short bowel syndrome, patient selection, preoperative assessment, indications, surgical technique, immunosuppression, postoperative complications, graft rejection. Heart transplantation: patient selection, preoperative assessment, indications, donors, surgical technique, immunosuppression, postoperative complications, graft rejection. Combined heart-lung transplantation. Lung transplantation: preoperative assessment, indications, donors, surgical technique, immunosuppression, postoperative complications, graft rejection.

Mode and outcomes of teaching: The course is taught in several lectures. At the same time, the students are responsible for the presentation of a recent scientific paper on an interesting topic of solid organ transplantation and this makes the course very interactive. The students have the opportunity to attend the multi-organ retrievals and the renal transplantations from cadaveric and living donors, which take place in theater, during the semester the course is taught. They are also encouraged to participate in the experimental work, which is related to solid organ transplantation, in the basic research center of the hospital. At the end of the course the students have gained good knowledge on transplant immunology and immunosuppression. They are also familiar with the indications and the results in solid organ transplantation.

Hours of training per student: 26

From the 8th Semester

ECTS: 2