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Aleksandra Dunin-Borkowska,1 Alexandra M Cardoso Pinto,1 Joshua Xu,1 Nikhil Bhandari,2 Lasith Ranasinghe3 1Department of Medicine, Imperial College London, London, UK; 2Department of Medicine, St George’s Medical School, University of London, London, UK; 3Department of Acute Internal Medicine, Homerton Healthcare NHS Foundation Trust, London, UKCorrespondence: Aleksandra Dunin-Borkowska, Department of Medicine, School of Medicine, Imperial College London, London, UK, Tel +44 7378324178, Email ad6618@ic.ac.ukBackground: Starting the Foundation Programme can be challenging for many medical graduates, as medical school alone may not adequately prepare them for complex tasks like managing comorbidities or emergencies. Growing evidence supports the role of transition interventions to meet this knowledge gap, however data on the utility of situation-based learning are limited. This pilot study aimed to assess the efficacy of a near-peer case-based course in improving knowledge and preparedness for foundation training in recent medical graduates.Methods: Recent Imperial College graduates who attended a “Junior Doctor on Call” course were eligible for inclusion. This transition intervention, designed and delivered by a Foundation Year 1 doctor, covered six patient cases that integrated high-yield clinical concepts and practical tips. An online questionnaire was distributed one week before and after the course to assess perceptions of knowledge, confidence, and preparedness for training. Participants were also invited to attend an online semi-structured after the course.Results: Out of 19 attendees, 17 (89.5% response rate) completed the pre-course questionnaire, 14 (73.7% response rate) completed the post-course questionnaire, and 3 completed the interview. 68.75% (n=11) had not previously attended a preparatory course for foundation training. Results demonstrated that 85.7% of participants felt more knowledgeable than before in the key topics covered. Participants also demonstrated an increase in self-rated confidence in commencing work as a junior doctor following the course, with 92.9% of participants stating that they felt more confident.Conclusion: This study offers support for short-term situation-based courses in enhancing medical students’ knowledge and confidence for foundation training. These findings add to the growing evidence-base encouraging implementation of short-term courses in preparing for practice. However, further research on the utility of such transition interventions is critical to inform the development of evidence-based recommendations for recent medical graduates, educators, and programme directors.Keywords: medical education, clinical practice, situation-based learning, near-peer learning, foundation training

RM Karmacharya, BK Shrestha, B Shrestha, AK Singh, N Bhandari, P Dhakal, S Dahal Department of Surgery, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, NepalCorrespondence: RM KarmacharyaDepartment of Surgery (Cardio Thoracic and Vascular), Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel Hospital Road, PO Box no 45210, Dhulikhel, Kavrepalanchok, NepalTel +977 981 872 9013Email reachrobin773@hotmail.comIntroduction: Varicose vein is a common venous condition affecting quality of life presenting as an asymptomatic condition to a feeling of heaviness, pain, pigmentation, palpable superficial veins, itchiness and ulceration. Proper management of varicose vein is of huge importance due to its high prevalence and the impact it has on patients’ quality of life, productivity as well as on health-care resource burden. Various conservative and invasive interventions are available for the management of varicose veins. Here we present our experience with the invasive intervention of varicose veins during a period of six years at a tertiary care center (Dhulikhel Hospital) in Nepal. Although Radio Frequency Ablation (RFA) is recently introduced in Nepal, it has shown promising outcome.Method: This is a retrospective descriptive cross-sectional study between the years 2013 and 2018 at the Dhulikhel Hospital among patients that underwent surgical management of varicose veins. For ease in interpretation, patients who underwent surgery for both lower limbs in the same setting are considered as separate cases.Results: In a total of 533 limbs, the most common vein involved was isolated great saphenous vein in 70.4%. In terms of side affected, 157 patients (33.8%) were affected on the right side, 238 (51.3%) were affected on the left side and 69 (14.9%) patients had bilateral involvement. The most common clinical feature was prominent vein present in 94.5% limbs. This was followed by pain in 55.7%, pigmentation in 25.3%, itchiness in 14.6% and ulceration in 13.1%. Mean hospital stay was 1.1 days (S.D. 0.64, Range 0–3). In terms of complication, one case with deep vein thrombosis (0.18%) developed in the seventh postoperative period. There was skin burn in two cases (0.53% of RFA cases) and in 11 cases (2.06%) there was painful superficial thrombosed veins of which three required excision under local anesthesia (0.56%).Conclusion: There are multiple invasive interventions for varicose veins. With the availability of the facilities, RFA is the procedure of choice in feasible cases. The most common complication after surgical treatment was painful thrombosed superficial veins. DVT was a rare complication.Keywords: varicose veins, varicose vein surgery, radiofrequency ablation