Dáire Goodman

Background: The United Nations Global Surgery Learning Hub (SURGhub) is a community‐led, open‐access digital platform providing quality‐assured surgical education, particularly in low‐resource settings. However, growth in course numbers and learner reach does not necessarily ensure balanced coverage of competencies required in early training. We mapped SURGhub content against selected early training curricula to identify priority gaps and establish a baseline for educational improvement. Methods: We conducted a cross‐sectional curriculum mapping study of SURGhub courses available in January 2026. Courses classified as Level 1 or 2 were mapped against selected benchmark curricula in surgery, anesthesia, obstetrics and gynecology (OBGYN), and perioperative nursing. Reviewers applied a three‐component rubric assessing relevant content quantity, coverage breadth, and early training essentiality. Component scores were summed to produce a total score from 0 to 6, with domains classified as critical, high‐, moderate‐, or low‐priority curriculum gaps. Results: A total of 82 eligible courses were evaluated across 99 curriculum domains. Mean domain scores were highest for surgery at (3.67/6), followed by anesthesia (2.53), OBGYN (0.84), and perioperative nursing (0.83). Coverage was broad but uneven. Practical perioperative topics, trauma, patient safety, and procedural skills were better represented than foundational sciences and several specialty‐specific clinical domains. Critical gaps were identified in one of 12 surgical domains, five of 19 anesthesia domains, eight of 12 perioperative nursing domains, and 37 of 56 OBGYN domains. Conclusions: SURGhub demonstrates the potential of open‐access, low‐bandwidth digital education to expand access to surgical learning globally, but Levels 1 and 2 course coverage was uneven across selected benchmark curricula. Approximately two‐thirds of evaluated OBGYN and perioperative nursing domains were classified as critical gaps. This mapping establishes a baseline for curriculum‐aligned content commissioning and repeated evaluation. Future research should evaluate course uptake, completion, and learner outcomes following targeted content development while maintaining attention to accessibility, engagement, and equity.

Cranioplasty in the pediatric population presents unique challenges due to ongoing skull growth, variable bone quality, and material-specific risks. This study reviews an 18-year experience of pediatric cranioplasty at a national referral center, evaluating complication and revision rates across autologous and synthetic implant types. A retrospective chart review was performed for all patients aged younger than or equal to 16 years who underwent cranioplasty between 2006 and 2023. Data collected included demographics, implant material, storage method for autologous bone, defect characteristics, and postoperative outcomes. A total of 103 cranioplasties were performed in 94 patients, with a mean age of 10.3 years and mean defect size of 77.7 cm ² . Autologous bone was used in 52.4% of cases, hydroxyapatite in 29.1%, titanium in 10.7%, and polyetheretherketone (PEEK)/patient‑specific implants (PSI) in 7.8%. Overall complication and revision rates were 11.7% and 9.7%, respectively. Autologous bone showed the highest resorption rate (11.1%), particularly in cryopreserved flaps. Hydroxyapatite demonstrated the lowest complication rate (6.7%) but was associated with pseudomeningocele formation. PEEK/PSI implants had favorable outcomes, with one infection in a patient with extensive prior surgical intervention. Titanium implants had low complication rates but were discontinued due to patient-reported morbidity, including cold sensitivity and soft-tissue discomfort. This large single-center series highlights the importance of tailored material selection in pediatric cranial reconstruction. Although autologous bone remains widely used, synthetic materials offer favorable complication profiles. Long-term, multicentre outcomes are required to determine optimal implant choice across age groups and defect sizes.

A recent article in the BJD postulated that it may be “Time to reconsider skin cancer-related follow-up visits”. In our unit, we too have been seeing too many patient’s unnecessarily and we put in place measures to reduce the numbers of outpatient appointments thereby diverting the resources saved into professional development.