Review of the utilization of HEEPF – competitive projects for educational enhancement in the Egyptian medical sector

In Egypt, the medical sector has been facing the same problems that challenged the system of higher education in the past decades, mainly an increasing student enrollment, limited resources, and old governance and bylaws. These constraints and the escalating paucity of resources have had a major negative influence on quality of education. Consequently, thoughts of educational reform came forward in the form of competitive projects, which have attracted several institutes from the health sector to improve their educational performance. The aim of this paper is to review the share of the medical sector in the higher education enhancement project fund (HEEPF), its outcomes, sustainability, and to provide recommendations for keeping the momentum of reform pursuit in the future. The methodology included obtaining statistics pertaining to the medical sector in Egypt as regards colleges, students, and staff. We also reviewed the self-studies of the medical sector colleges, HEEPF projects reports, performance appraisal reports, and World Bank reports on HEEPF achievements in order to retrieve the required data. Results showed that medical sector had a large share of the HEEPF (28.5% of projects) as compared to its size (8% of student population). The projects covered 10 areas; the frequency distribution of which ranged between 4.4% (creation of new programs) to 97.8% (human resource development). In conclusion, educational enhancement in the medical sector in Egypt could be apparently achieved through the HEEPF competitive projects. A study of the long-term impact of these projects on the quality of education is recommende

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease