MSF recruits 01 Gynecologic oncology surgeons (M/F)
Médecins Sans Frontières (MSF) is an international medical and humanitarian association founded in 1971 that provides assistance to populations in distress, affected by natural or man-made disasters as well as armed conflicts. MSF is present in more than 60 countries worldwide.
MSF is URGENTLY seeking for Gynecologic oncology surgeons.
Background and Justification:
Malawi has the highest cervical cancer incidence (76/100,000) and mortality rate (50/100,000) in the world, representing an estimated 3,684 new cases and 2,314 deaths annually. Eastern and Southern Africa, including Malawi, also has one of the highest HIV prevalence, which contributes significantly to the cancer incidence, as HIV positive women are significantly more likely to develop cervical cancer when infected with HPV. Despite ongoing efforts to provide cancer screening and treatment services by the Ministry of Health and international organizations, the coverage remains low in comparison to the scale of the need in the country.
MSF, in response to this need, has implemented a unique comprehensive oncology project in Malawi. The project aims to encompass all components of gynecologic oncology care (mostly cervical cancers) from primary to tertiary prevention through the collaborative work of a multidisciplinary medical team embedded at the Queen Elizabeth Central Hospital (QECH) and community health centers in the Blantyre and Chiradzulu districts in Malawi. The surgical team is a vital component of the program, which will provide diagnosis, treatment, and follow-up services for gynecologic oncology patients at QECH in collaboration with a multidisciplinary team.
MSF is seeking a surgeon experienced in gyneco-oncologic care in this rapidly developing project. General responsibilities include organizing and carrying out surgery activities, ensuring pre and post-operative surgical care, in accordance with MSF policies, protocols and universal hygiene standards and in close collaboration with medical staff in the gynecology, oncology, palliative, intensive wards, and operation theatre in order to improve patients’ health conditions.
This is a unique position encompassing the following characteristics:
- Unique opportunities to engage in hands-on clinical activity in a tertiary referral hospital in Malawi among a diverse case-mix referred from district hospitals that combines oncology with tropical medicine (i.e. Malaria, STIs, TB, and HIV)
- Substantial opportunity to engage in surgical coaching, bed-side, and theoretical teaching to medical students, interns, residents, clinical officers, registrars, and nurses in a tertiary academic medical institution in Malawi
- Opportunities to develop strong leadership, management, and negotiation skills in global health while tackling clinical and public-health challenges within a multinational and multidisciplinary team.
The position is an ideal opportunity for a physician with a special interested in providing surgical care to gynecologic oncology patients in resource-limited contexts, offering clinical mentorship and capacity-building of future providers of cancer care in Malawi and engaging in challenging experiences in project management and leadership. As the project is still new in its implementation phase, much flexibility, patience, and diligence will be required. The oncosurgeon will be asked to assist in the set-up of the surgical and associated clinical services for the first months of the mission with the gynecologic oncology referent and the medical focal point. Until the implementation and services are stabilized, the surgeon must be willing to step out of his/her comfort zone, take initiative, and be a proactive and cooperative member of the project launching team, as he/she may be asked to engage in non-surgical activities (e.g. protocol development) during the initial stages.
- The surgical cases will primarily be cervical cancers, but depending on the project development, the surgeon may be asked to perform surgeries for other gynaecological cancers (e.g. vulvar cancer, endometrial cancer, and ovarian cancer). The expected case load will be one to two planned surgeries a day, for five days a week, although these numbers may change.
- Coordinate the implementation of MSF clinical policies, tools, guidelines and protocols (antibiotic prophylaxis, post-operative pain management, thrombo-prophylaxis, gyneco-oncologic surgeries, blood transfusion, admission and inpatient orders, etc) and recommendations (standard hygiene and sterilization rules, prevention to HIV, TB, Syphilis and Hep B exposure) in order to minimize clinical risks.
- Undertake pre-operative consultations, evaluating the surgical risks with the anaesthetist and/or other medical staff involved, and obtaining the patient’s signed consent to operate.
- Carry out emergency and programmed surgical intervention following MSF protocols and policies including swab counts, ensuring appropriate use of surgical equipment and proper OT registry entry/documentation of all OT intervention.
- Carry out post-operative clinical care and ward rounds collaborating with the anesthetist, the Operating Theatre Nurse and ward staff or other Unit Managers to ensure compliance with MSF protocols and rational use of medicines. Attend OPD, emergency room when required.
- In collaboration with the anaesthetist, carry-out the collection and analysis of quantitative surgical- anaesthesia data, using post-operative observation sheets, routine data collected, patient files, operating department register, patient file, etc to monitor quality. Monthly revue data and analyze clinical trends and comment on adverse events / poor clinical outcome. Support organizing the operating program and with OT staff monitor use of material and equipment and advise on instrument needs and coordinates patient referral.,
- Put in place the emergency disaster response plan of the hospital along with the anesthetist and the medical doctor and /or the responsible nurse and run role hospital practical rehearsals, in order to ensure the continuity of the services under any circumstance
- Knows and helps implement the accidental blood exposure policy.
- Plan, evaluate, and supervise the training of the staff (emergency and the out-patient teams) in order to ensure the amount of knowledge required and to improve people diagnosing, triage, and early detection capabilities.
- Supports other medical teams/wards when needed.
- Participate in the multidisciplinary team (MDT) meetings and work harmoniously and collaboratively with other members of the MDT and other specialists to discuss and plan the best care plan for the patient. Work with the MDT to ensure that oncology care respects the international clinical guidelines and patients’ best interest as best as possible given the resources and context.
- Lead the gynecologic oncology surgeries and procedures (abortions may be requested).
- With the assistant of the pathology technicians, prepare the pathological samples for shipment to the reference lab
- Take responsibility in the day-to-day management of patients in the wards and the outpatient clinics by performing comprehensive patient assessment, staging, management, treatment, review, and follow-up of patients under MSF services.
- Keep the patient and/or his/her family informed about the illness and provide appropriate explanations about the treatment to follow, checking they have understood. Ensuring that patients’ wishes and desires for their care are respected as much as possible, given the resources available.
- Leading ward rounds and medical conferences, recording operative reports, progress notes, care plans, admission notes, and discharge summaries.
- Participate in the evening and weekend medical on-call rotation and respond to emergencies. Participate in shifts and replace other doctors, if necessary. Provide technical advice to medical colleagues when asked via the phone or in person. Respond to medical emergency and assist in responding to emergency needs or emergency consultations.
- Providing surgical, bed-side, and in-class (theoretical) training to medical students, interns, residents, clinical officers, nurses, registrars, and other healthcare professionals when needed
- Oversee the quality and safety of medical services provided by the doctors, clinical officers, and nurses on the team, and work with the medical focal point and other MSF colleagues to develop ways to continuously monitor and improve care quality.
Secondary responsibilities (when possible, assist in the following):
- Assist in the development of clinical guidelines, protocols, and SOPs relating to the medical activities with the coordination (Medical Focal Point and Medical Coordinator) and technical referents, and ensure they are implemented and followed on site.
- Assist the activity manager to put in place protocols to ensure the safety and quality of medical services, disinfection and sterilization of the medical material. Assure general compliance with standing hygiene standards. Check that universal precautions are followed at all times and reducing biohazard risks and improving infection control.
- Work with the medical focal point and activity manager to put in place protocols to prevent medical errors before, during, and after surgical care
- In cooperation with the pharmacist, activity manager, and the medical focal point, assist the management and running of the medical equipment and pharmacy activity, preparing new orders when required, supervising expiration terms and consumption patterns, in order to ensure its rational use as well as that pharmacy stock levels are permanently updated and above minimum safety point.
- In close coordination with the HR and activity manager, assist the recruitment, training, performance evaluation, development and internal communication of the staff under his/ her responsibility in order to improve staff capabilities and to ensure both the sizing and the amount of knowledge required.
- In close coordination with the logistics manager, identify and address non-medical support needs (material, infrastructure, transport, etc.), assist in the set-up of the surgical theater, procedure rooms, pathology referral, consultation rooms, and inpatient wards
- Assist the medical focal point in developing tools to monitor, evaluate, and ensure the quality of the medical service provided by the team.
- Participate in the collection and analysis of epidemiological data, checking its validity and informing the line manager about any problem or complication of the patients’ illness, medical error and monitors the proper functioning of the department, equipment or material.
- Ensuring that medical activities objectives under his/her responsibility are achieved, reporting to the technical referent any problem arising in the service.
Expériences / Formation
- Completion of medical education and residency/clinical training in gynecology (essential) and board certification in gynecology is essential
- Additional fellowship (subspecialty) training in oncology is strongly preferred
- Knowledge and/or training in HIV, TB, Malaria, and STIs would be an asset due to the high prevalence.
- Essential working experience in gynecologic oncology
- Ability to perform gastrointestinal and urinary tract procedures are a critical asset
- Clinical experience in a tertiary care hospital or oncology centers are desirable
- Experience in resource limited settings within MSF or other NGOs are desirable, but not essential.
Languages: Fluency in English (B2 level as a minimum)
Knowledge: Essential computer literacy (word, excel, internet)
Availability: 1 month
Status: MSF contract or volunteer agreement. Monthly per diem. Insurances: medical health coverage, repatriation.
Mission location: Malawi, Blantyre.
Positions to be filled: as of November 2022
Please send your application (cover letter and CV) until 15/12/2022 included.
Only the candidates whose applications have been selected will be contacted
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