Summary Background Undergraduate medical students frequently report inadequate basic surgical skills such as suturing and knot tying. In recent years, peer assisted learning (PAL) has proven to be an effective method of teaching basic surgical skills. The consistency of the teaching and the quality of the content may be questionable in these workshops. This study aimed to develop a consultant led peer assisted learning model (CL‐PAL) to facilitate the quality‐controlled delivery of basic suturing skills in undergraduate medical education. Methods A video on basic suturing techniques was developed with the assistance of an experienced plastic and reconstructive surgeon. Sixty students were recruited and allocated to four workshops across 2 days. Each student was provided with a pre and post workshop form to self‐assess their confidence levels with different suturing techniques and theories of suturing. Three PAL facilitators rotated through student stations to address any concerns and to improve the learning experience. Results From the post‐workshop assessment, students expressed increased confidence in handling surgical instruments, suturing and understanding sharp safety. Following this workshop, 90% of the students reported that they were more likely to attend self‐directed learning sessions to maintain their acquired skills. Workshop providers also had an opportunity to develop teaching skills such as communication and the demonstration of suturing skills. Conclusion CL‐PAL uses technology aided resources created by an experienced surgeon to facilitate the delivery of high quality basic surgical teaching. This model is not only applicable to basic skills training but can also be developed for applications in other specialties.

Squamous cell carcinoma (SCC) arising from a suprapubic cystostomy tract is a rare complication of long-term suprapubic catheterization (SPC). A 53-year-old man with paraplegia secondary to spina bifida presented with a painful granulomatous lesion around his SPC site that was being treated with silver nitrate cauterization in the community. Consequently, he developed a sacral pressure sore due to reduced mobility from the pain. He also had increasing difficulties with defaecation secondary to his spina bifida. His sacral pressure sore was secondary to a cryptoglandular fistula with coccygeal osteomylelitis. Post-operative pathology revealed infiltrative SCC involving full thickness of the specimen from skin to the bladder wall with clear surgical margins. We describe the first case requiring a simultaneous suprapubic tract SCC excision and colostomy formation. We recommend early investigation of lesions arising from a long-term suprapubic tract especially in patients with spinal cord injuries or congenital defects.

ObjectiveThis paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma.Case reportA 64-year-old male, diagnosed with a primary p16-negative squamous cell carcinoma in the right tonsil, was treated with a course of chemoradiotherapy with curative intent. Positron emission tomography/computed tomography, performed at six months post-treatment, revealed a good local response and no distant metastases. The patient was placed on routine follow up at two-monthly intervals. Two months into follow up, he presented with a right-sided oculomotor nerve palsy and partial Horner's syndrome. Imaging and biopsy revealed a pituitary fossa metastasis (p16-negative squamous cell carcinoma), and a further positron emission tomography/computed tomography visualised this lesion. He was deemed unsuitable for further intervention and underwent palliative radiotherapy for symptom control.ConclusionThis case represents the first reported isolated pituitary fossa metastasis from a tonsillar squamous cell carcinoma. A high degree of clinical suspicion is recommended, along with a low threshold for biopsy and a cautioned use of positron emission tomography/computed tomography, when investigating such patients.