Introduction

At the end of October 2019, at the invitation of the Malaysian government, endocrine surgeons representing the International Association of Endocrine Surgery (IAES) travelled from Europe and North America to the beautiful Malaysian city of Kuching for the 7th Malaysian Breast and Endocrine Surgery Course representing the INTEREST (International Endocrine Surgical Teams) outreach program.

The premise of the INTEREST (International Endocrine Surgical Teams) program is to provide an ongoing commitment to provide an onsite, in-country teaching program in the field of endocrine surgery. The first Malaysian Breast and Endocrine Surgery Course took place in 2013 following the Memorandum of Understanding (MOU) signed in May 2012 between the Malaysian Ministry of Health, Malaysian College of Surgeons, International Association of Endocrine Surgeons (IAES) and Breast Surgery International (BSI). This agreement set out plans for the IAES and the BSI to send teams to Malaysia for 5 years.

The program was created by Prof Freda Meah who was the pioneer in Breast and Endocrine Surgery when she started the country’s first breast endocrine unit in 1978 at Universiti Kebangsaan, Malaysia. As the “mother” to many surgeons, Prof Meah inspired many in the field of Malaysian breast and endocrine surgery. One of her students was Hisham Abdullah, who after completing the TS Reeve fellowship in Sydney, Australia, initiated an endocrine surgical teaching unit in Kuala Lumpur, subsequently training a generation of subspecialty endocrine surgeons. In 2012, the Malaysian Breast and Endocrine Surgery Course was organized on a yearly basis and is held at different locations within Malaysia.

A large portion of course attendees include subspecialty Malaysian surgical fellows who had already completed medical school, a 4-year residency program in general surgery and at least 2 years of surgical practice, usually in a rural community.

This year the course began with a workshop session on thyroidectomy in the Sarawak General Hospital of Kuching. This was an opportunity for the Malaysian trainees to learn from experienced Malaysian senior colleagues with IAES faculty joining. It began with a morning lecture on how to perform safe thyroidectomy after which two intraoperative teaching sessions took place with five live thyroidectomies. Two Malaysian endocrine surgery experts were operating on goiters along with rotating trainees, and care was taken to describe the important steps of thyroid surgery. The young surgeons that were not able to attend in the operating room could watch from a room via a live connection and ask questions as they wished. Through the years, several comparable workshops have been organized alternating between endocrine surgery and breast surgery supported by international organizations including the IAES.

The second day of the course focused on breast surgery, and the third and final day saw the IAES delegates present on the various topics of thyroid, parathyroid and adrenal disease. The level of engagement of the audience was high, and questions were insightful and thought-provoking. The lecture topics were highlighted by case presentations from selected course attendees. A scholarly poster session emphasized some of the academic work being performed at the university hospitals of Malaysia.

The 7th Malaysian Breast and Endocrine Surgery Course 2019 was a great success, similar to the previous six. The Malaysian surgical society is well organized and felt to be a close and warm professional family. The organizational strength of the society made it an effective platform for knowledge exchange.

This continuation of long-term collaboration and partnership of the IAES and the Malaysian surgical society will benefit the diagnosis and treatment of those in that country suffering from endocrine surgical disease.

From the discourse at the endocrine surgical sessions, it was quite clear that, while Malaysia does have substantially less resources than many western nations, the language of endocrine surgery creates a kinship. Each lecture topic was discussed and debated, and the case examples by the Malaysian trainees set up challenging problems.

We hope that the teachings of our International experts over these past 7 years have been important to the growth of the endocrine surgery curriculum for Malaysian consultant endocrine surgeons. This course, and those of a similar nature supported by other societies (reference to AAES here), provides Malaysian surgeons as well as those practicing in a less resourced model, with a structured framework in the area of surgical endocrinology.

While realizing the INTEREST program is just one of the any global initiatives, it is a strong example of a model for developed–developing health system collaboration and makes the continued collaborations with the IAES, necessary and highly valuable.