Surgical Training

“The mind is not a vessel to be filled, but a fire to be kindled” - Plutarch 46-120 A.D.

Malta has a distinguished surgical history.

The first documented barber-surgeon in Malta was called Xema Girbi. He was such a popular clinician that he was elected President of the Jewish community in Malta in 1486. His patients soon campaigned to relieve him of his office so that he would have more time for his craft!

The hospitaler knights of St John built the Sacra Infermeria in the new city called Valletta. It was one of the best hospitals in Europe, where the knights attended the sick personally using silver utensils. The knights gave birth to our medical school in 1676, one of the oldest in the English speaking world. A foundation for the teaching of surgery was established by Bali Fra Clemente Resseigner in 1775. During these times Maltese surgeons trained in France and Italy.

Of course surgery was then performed without anaesthesia and speed was essential. The surgeon Michel’Angelo Grima was renowned for his skill, performing lithotomy in two and a half minutes and mastectomy in three minutes. These were dangerous times for surgeons. Ship surgeon Claudio Camilleri was captured by the Turks. While a slave he became the personal surgeon of the Commander of the Turkish galleys at Rhodes, Mustapha Basha on board the flagship Lupa. In 1784 the Christian slaves rose against the Turks and took possession of the ship and sailed to Malta with the Mustapha Basha as their prisoner.

In the 19th Century Malta became a British military base and many talented young surgeons worked here during the early stages of their career. Sir Thomas Spencer Wells served for six years as assistant surgeon at the Naval hospital at Bighi. He introduced ether anaesthesia to Malta in March 1847, only four months after it was first used in the United States. He is recognized as a pioneer of abdominal surgery and was appointed Hunterian Professor and President of the Royal College of Surgeons of England. Almost a century later, a relative of his, Sir Winston Spencer Churchill, met President Roosevelt in Malta before the Yalta conference.

Another President of the English College, Lord Berkeley Moynihan, was born in Malta in 1865. His father was a serviceman based in Malta who died shortly after his son was born. The young Moynihan’s family returned to England where he became one of the country’s most prominent surgeons.

Maltese surgeons have rendered sterling service locally and have also reached prestigious positions abroad. Michelangelo Grima published prize-winning papers on head injuries, intestinal anastamosis and splenectomy in Paris, Venice and Florence in the late 18th century. Joseph Barth was Professor of Anatomy and Physiology in Vienna until his death in 1818. He also held the first chair of Ophthalmology in Europe.

Most contemporary Maltese surgeons have trained in the United Kingdom and some others trained in Germany and Italy. We have also had contact with a substantial number of European surgeons that have worked in Malta over the last three decades.

Since Malta joined the European Union the Association of Surgeons of Malta has been given the task of organising post-graduate surgical training. The ASM has compiled this curriculum for General Surgery, Emergency Medicine, Urology, Orthopaedics and Trauma, Otolaryngology and Plastic Surgery. I would like to thank all those who have worked very hard to compile this document.

Surgery in Malta is about to enter a new era in a brand new hospital. We have established strong links with foreign institutions and the Government is committed to postgraduate education. The ASM has already tapped the European Social Fund to organise training. It is now time to establish the infrastructure to start postgraduate training.

This curriculum should allow Maltese surgery to give a distinguished future to its prestigious past.

Gordon Caruana-Dingli
Former ASM President
August 2007