College of Surgeons

29th May 2020

University of Birmingham and College of Surgeons, Academy of Medicine of Malaysia news release

COVID-19 patients who undergo surgery are at increased risk of postoperative death - global study

  • Patients are at increased risk of dying after surgery if they contract COVID-19
  • Non-critical surgery should be postponed during COVID-19 outbreaks
  • Investment is urgently needed to increase safety of surgery during COVID-19 outbreaks

Patients undergoing surgery after contracting coronavirus are at greatly increased risk of postoperative death, a new global study published in The Lancet reveals. Researchers found that amongst SARS-CoV-2 infected patients who underwent surgery, mortality rates approach those of the sickest patients admitted to intensive care after contracting the virus in the community.

Researchers examined data for 1,128 patients from 235 hospitals. A total of 24 countries participated, predominantly in Europe, although hospitals in Africa, Asia, and North America also contributed. 

Experts at the University of Birmingham-led NIHR Global Research Health Unit on Global Surgery have now published their findings that SARS-CoV-2 infected patients who undergo surgery experience substantially worse postoperative outcomes than would be expected for similar patients who do not have SARS-CoV-2 infection.

Overall 30-day mortality in the study was 23.8%. Mortality was disproportionately high across all subgroups, including elective surgery (18.9%), emergency surgery (25.6%), minor surgery such as appendicectomy or hernia repair (16.3%), and major surgery such as hip surgery or colon cancer surgery (26.9%).

The study identified that mortality rates were higher in men (28.4%) versus women (18.2%), and in patients aged 70 years or over (33.7%) versus those aged under 70 years (13.9%). In addition to age and sex, risk factors for postoperative death included having severe pre-existing medical problems, undergoing cancer surgery, undergoing major procedures, and undergoing emergency surgery.

» Click here to read the full paper

27th March 2020

College of Surgeons Office

Dear Members,

Following the escalation of COVID-19 cases in Malaysia, healthcare services, including surgery, are under increased strain. This is reflected in the morbidity and mortality affecting the healthcare workers.

It is ESSENTIAL for adoption of a safe or cautious approach towards surgery. The guiding principles are:

  1. PROTECTION of health care workers and patients
  2. MAINTENANCE of a safe healthcare environments, including operating theatres and surgical wards
  3. CONSERVATION of resources - personnel, personal protective equipment (PPE), ventilators etc.

Based on emerging evidence, the College of Surgeons, Academy of Medicine of Malaysia (CSAMM), with its integrated Chapters, STRONGLY ADVISE members to do the following:

  1. Assume all patients are potential contacts and take adequate precautions.
  2. Postpone all non-urgent clinic appointments.
  3. Stop all elective operations and aerosol-generating procedures (AGPs, such as dental and oropharyngeal procedures, endoscopy).
  4. Use enhanced PPE if surgery/AGP in COVID-positive patients is unavoidable, minimize involved staff.
  5. Avoid laparoscopy if surgery is necessary. If laparoscopy is deemed essential, filtration devices for aerosolized particles must be used.

Other advisory measures, WHERE FEASIBLE, include:

  1. COVID-testing for all patients undergoing emergent surgery.
  2. A non-operative approach for some emergent conditions e.g. cholecystitis, appendicitis, provided the clinical status allows.
  3. CT thorax prior to emergent surgery in high-risk patients
  4. Cessation of positive pressure ventilation in OT during the procedure until 20 minutes after patient leaves.
  5. Isolation of, and full PPE when nursing, post-operative patients until COVID status known

It is IMPERATIVE that the surgical community takes leadership in flattening the curve in this pandemic, for the safety of ALL. The above measures are advised until further evidence becomes available, or until such time that the Ministry of Health declares a return to normalcy of health services.


Prof Dr April Camilla Roslani, President, College of Surgeons, Academy of Medicine of Malaysia
Dato’ Dr Selvalingam Sothilingam, Chair, Urology Chapter
Assoc Prof Dato’ Dr Hari Chandran Thambinayagam, Chair, Neurosurgery Chapter
Dato’ Dr Imi Sairi bin Ab Hadi, Chair, Breast and Endocrine Chapter
Prof Dr Jamal Azmi Mohamad, Chair, Orthopaedic Surgery Chapter
Dr Chew Loon Guan, Chair, Vascular Surgery Chapter
Dr Lim Yang Kwang, Chair, Maxillofacial, Aesthetic, Plastic Surgery Chapter
Prof Dr Raja Amin Raja Mokhtar, Chair, Thoracic & Cardiovascular Surgery Chapter
Dr Siow Sze Li, Chair, Upper GI Chapter
Prof Dr Tang Ing Ping, Chair, Otorhinolaryngologists - Head and Neck Surgeons Chapter
Dato’ Dr Zakaria Zahari, Chair, Paediatric Surgery Chapter
Assoc Prof Datuk Dr Ismail Sagap, Chair, Colorectal Surgery Chapter


1. Surgical smoke and infection control. Alp E et al J Hosp Infect 2006.
2. Detecting hepatitis B virus in surgical smoke emitted during laparoscopic surgery. Kwak HD et al Occup Environ Med 2016.
3. Coronavirus (COVID-19) outbreak: what the department of endoscopy should know. Repici A et al Gastrointest Endosc 2020.
4. Perioperative considerations for the 2019 Novel Coronavirus (COVID-19) Zucco L et al Anesthesia Patient Safety Foundation 2020
5. Correlation of chest CT and RT-PCR testing in Coronavirus Disease 2019 (COVID-19) in China: A report of 1014 cases. Ai T et al RSNA 2020

18 March 2020

College of Surgeons Office

The Malaysian Government has imposed a 14-day Movement Control Order from 18th to 31st March 2020 nationwide to curb the spread of Covid-19 infection in Malaysia. The office of the College will be closed during this period and the staff will be working from home. 

We would like to also announce that all CSAMM-related events until 30th June 2020 (including exams) have been postponed pending further notice in compliance with the directive from the Registrar of Societies. 

If you have any enquiry pertaining to the College matters, please email

The College Council and Committees have and will continue to hold essential administrative meetings via teleconferencing. 

Thank you very much.


College of Surgeons 
Academy of Medicine of Malaysia

18 March 2020


Dear Members,

In light of the recent escalation of the COVID-19 outbreak in Malaysia, the College of Surgeons, Academy of Medicine of Malaysia (CSAMM) would like to provide the following guidance on the triage of 'non-emergent' surgical operations.

The re-deployment of staff and resources towards managing the outbreak has limited delivery of elective surgeries. Nevertheless, CSAMM is of the opinion that deferring all elective surgeries risks progression of disease states that will present further down the line with more complexity and worse outcomes.

In rationalizing the use of limited resources, the following should be considered:

1. Surgical case-mix:

Surgeries can be categorized according to the urgency of surgery as per the Perioperative Mortality Review (POMR) Guidelines: Prioritization of Cases for Emergency and Elective Surgery (2nd Revision) 2018. As an example, hospitals may choose to concentrate resources on emergencies and category one electives.

The POMR Guidelines can be accessed via the link below

» Guidelines - Perioperative Mortality Review (POMR): Prioritisation of Cases for Emergency and Elective Surgery (2nd Revision)

2. Hospital capacity:

Consideration should be given to the available resources: human resources, facilities, equipment and consumables. Designated COVID-19 hospitals may not be able to support all elective cases, in particular those that require post-operative intensive care or significant use of blood products.

3. Balance of risks:

Surgeons, in consultation with anaesthetic and nursing colleagues, should weigh the risks of proceeding (exposure, lack of resources) against those of deferment (progression of disease, worse patient outcomes). Hospital-wide policies should be fluid, and guided by emerging data.

Further guidance can be obtained from the American College of Surgeons website:



Prof Dr April Camilla Roslani
College of Surgeons
Academy of Medicine of Malaysia

Meeting of the CSAMM Council with Chairmen of Chapters - 23rd June 2019

Benefits of Becoming Member of the ORL Chapter Members

[ Downlaod PDF ]

OTTAWA 2020, Kuala Lumpur, Malaysia

29 February - 4 March, 2020
Kuala Lumpur Convention Centre, Kuala Lumpur, Malaysia

[ Flyer | Programme | Website ]

Advanced Trauma Life Support (ATLS) Course 2019

[ Click here for more information ]

Royal College of Surgeons of England International Surgical Training Programme (ISTP)

[ Click here for more information | Download as PDF ]

Press Release - Signing of Memorandum of Understanding (MOU)

6th Malaysian Breast & Endocrine Surgery (BES) Course 2018

[ Click here for more information ]

Care of the Critically Ill Surgical Patient (CCrISP®) Course 2018

This two-day course is designed to advance the practical, theoretical and personal skills necessary for the care of critically ill surgical patients. The course is suitable for candidates who are now undergoing their surgical training (Master of Surgery) or just obtained their Master of Surgery. If you are in the earlier part of surgical training you must submit a CV with your application. For further information, please see below.

[ Click here for more information ]


09:00-09:15 Registration & welcome  
09:15-09:30 Introduction and 'demystifying' the OSCE Interactive lecture
09:30-10:00 OSCE circuit run through Interactive lecture
10:00-10:20 Assessing anatomy/physiology/pathology Interactive group session
10:20-10:40 Coffee Break  
10:40-11:00 Introduction to Communication Skills Interactive lecture
11:00-11:30 Communication skills candidate video: 
Information receiving (taking a history)
Interactive sessions demonstrating good & borderline performances
Interactive video group session
11:30-12:00 Communication skills candidate video: 
Information giving (delivering bad news)
Interactive sessions demonstrating good & borderline performances
Interactive video group session
12:00-12:45 Lunch Break  
12:45-13:00 Communication skills recap Interactive lecture
13:00-16:00 Breakout sessions:
  • Group 1 - Communication 1: Information giving
  • Group 2 - Communication 2: Information receiving
  • Group 3 - Communication 3: Telephone station
  • Group 4 - Anatomy & Surgical Pathology
  • Group 5 - Physiology & Critical Care
Interactive individual assessments with feedback
16:00-16:30 Your questions answered  
16:30 Coffee & workshop close


3rd Annual South East Asia Breast Cancer Symposium 2018:
Patient Centered Care

3rd-5th August 2018
Kuching, Sarawak, Malaysia

First Announcement - PDF, 819 KB

International ACS NSQIP Scholarship Information to International ATLS Providers

The American College of Surgeons is now offering a program for international surgeons concerned with issues of quality improvement, the International ACS NSQIP® Scholarships. Applications are now being accepted for the year 2016. The closing date for receipt of applications and all supporting documentation is 15 February 2016.

Each Scholarship offers a stipend of $10,000 US, participation in the annual National Surgical Quality Improvement Program conference, which takes place July 16-19, 2016 in San Diego, California, and the expectation of meeting with Program Leadership and Surgeon Champions from ACS NSQIP participating hospitals. Following the NSQIP conference, the candidate will visit 1-2 hospitals reflecting the candidate's specific clinical interests. These hospitals should also have strong quality programs. Assistance will be provided to make hotel reservations in the conference city.

More information regarding the ACS National Surgical Quality Improvement Program can be found at

The online requirements include all pertinent information about eligibility and a link to the online application process itself.

Scholarship requirements and the online application form may be accessed from:


Please note that scholarship applications and additional materials must be submitted in English.

Please direct questions to Ms. Kate Early, International Liaison, via email, at

The deadline for receipt of all application materials for the International ACS NSQIP® Scholarships is 15 February 2016 for attendance at the July 2016 NSQIP conference.

A Tribute to a Pioneer in Liver Surgery

Dato' Dr M Balasegaram, often referred to as 'Prof Bala', passed away on 5th May 2014 at the age of 85. A memorial lecture was held at the Lecture Theatre of the state-of-the-art Advanced Surgical Skills Centre, UKM Medical Centre, Kuala Lumpur on 23rd November 2014 to honor his immense contributions to the development of gastrointestinal surgery in the country. A strict disciplinarian with rigorous standards, he groomed many of top surgeons. Dr Balasegaram is best noted for his pioneering work in liver surgery. He researched and added more information to the understanding of the anatomy of the liver, and subsequently simplified liver surgery with his new specially designed liver instruments. Read more...

Guidelines for Surgical Specialists Undertaking Aesthetic Medical / Surgical Practice in Malaysia
12th May 2013
[ Download Handbook - PDF, 1.34 MB ]

Annual Scientific Meeting & Annual General Meeting 2013 Report

Download Report in PDF format (1.14 MB)

The College of Surgeons of Malaysia was founded in November 1972 with a membership of twenty- three fellows and Tan Sri Dato’ Dr Abdul Majid Ismail as its first President. This significant milestone has played a pivotal role in shaping history of surgery in Malaysia. The primary objective of the College is to maintain and promote the highest standards of surgical practice in the country.

In 1992, fellows of the College felt the need to extend their responsibility in the profession and through a resolution opted to merge with the Academy of Medicine of Malaysia. The merger was formalised on 16th December 1995.The College represents the diverse interest of surgical specialties and actively promotes the art and science of the various surgical disciplines. It offers excellent services to its members and is actively engaged in training, supporting continuing professional development programmes, research and the promotion of quality patient care by developing good practice guidelines.

There is desire and enthusiasm among its fellows to see expansion of surgery in Malaysia parallels that of the best in the world.