General practitioners' knowledge of hand surgery in Singapore: a survey study

Hand surgery is a subspecialty with a dedicated training programme in Singapore. Currently, Singapore is one of two countries in the world that still provides dedicated advanced hand specialty training. As hand surgeons depend on referrals from institutions and general practitioners, appropriate hand surgical referral requires the referring physician to have knowledge and understanding of common hand conditions as well as less common but more urgent surgical conditions, and their available surgical treatments. This study aimed to determine the knowledge of hand surgery and hand surgical conditions among general practitioners.

A questionnaire survey was conducted during a continuing medical education symposium on hand surgery in Singapore. Participants responded to 12 questions on hand trauma by keying the answers into a computer database system. The results were then analysed.

A total of 35 general practitioners responded to our survey, and they were able to answer 53% of the questions correctly. We found knowledge gaps among the participants regarding hand surgical conditions, and identified areas where increased education during medical school, postgraduate training and continuing medical education may be beneficial. Areas that were found to be weak included recognising injuries that pose a high risk for developing wound infection, complications of topical steroid injection in trigger finger treatment and hand tumours.

Improving hand surgery knowledge among general practitioners not only leads to improved primary care, but it can also facilitate prompt recognition of surgical problems and subsequent referral to appropriate hand surgeons for treatment. This may possibly reduce the load of tertiary institutions in treating non-urgent hand conditions.