The central role of the Fer à Moulin surgery school in surgical training for a century
Public Assistance – Paris Hospitals (AP-HP) has for many years managed a surgery school, located at 7, within its center of common interest, the General Agency for Health Equipment and Products (AGEPS). , rue du Fer-à-Moulin in Paris 5eas well as a body donation center. For more than a century, the school played a central role in the training of interns and young surgeons practicing in Île-de-France.
The six universities constituting with the AP-HP the university hospital center (CHU) of Île-de-France (Paris Cité University, Sorbonne University, Paris-Saclay, Versailles-Saint-Quentin-en-Yvelines, Paris Est- Créteil, Sorbonne-Paris Nord), use this school as part of their “Health” component to organize practical workshops associated with DES, Masters and DU in surgical disciplines.
The inclusion of the surgical campus project in a logic of accelerating the transformation of teaching conditions and in the emergence of a French and Ile-de-France sector of new professions and technologies in the operating room
Noting that its surgery school, due to its small size and outdated equipment, no longer made it possible to meet training needs, Since 2018, the AP-HP has carried out studies with a view to hosting on the site of the former Broussais hospital (Paris 14e), in new premises, the training of surgeons, doctors and interventional radiologists.
The term “surgeon” referred to those who treated with their hands. Initially limited to draining abscesses or stopping bleeding, surgery allowed the removal of tumors or the repair of diseased organs using large surgical approaches intended to control the procedure. This time has largely passed since the development of minimally invasive approaches and the development of procedures performed by the trans-parietal or trans-orificial route, whether percutaneous or endovascular. These procedures, called interventional, better tolerated by patients, are carried out by teams which now include radiologists, endoscopists, doctors, surgeons, engineers and data analysts.
This evolution, amplified by medical progress enabled by surgical robots, hybrid rooms, biotherapies or even big data and artificial intelligence (AI), calls for an in-depth transformation of theoretical and practical teaching. Operative training requires learning which can no longer be ensured by the exclusive companionship of university hospital staff; nor be left to the makers of these technological advances. Its complexity and cost also require “the creation of specialized centers” at at least regional level.
In 2021the AP-HP and all the constituent universities of the CHU (Paris Cité University, Paris Est Créteil University, Versailles University – Saint-Quentin, Sorbonne Paris Nord University, Sorbonne University and Paris-Saclay University) have decided to unite to support the creation of the “Grand Paris Surgical Campus”.
Iplanted on 5,000 m2, it is dedicated to university and post-graduate teaching as well as research and innovation in interventional surgery, medicine and radiology. It is open to academic and industrial researchers as a platform for experimental research. It includes a strong innovation component, making it possible to encourage the establishment of new partnerships with large industrial groups and start-ups. In this regard, it has places for presentation, co-development and training in new cutting-edge technologies.
The six universities and the AP-HP have chosen to manage this ambitious project by pooling their resources within a public interest group (GIP) whose constituent agreement has been drawn up.
In order to manage Campus activities surgical of Greater Paris, the AP-HP and the aforementioned Île-de-France universities wished to form a public interest group (GIP) between them to pool the means necessary to carry out these activities by making them available.
Training and research activities are in fact part of those of the University Hospital and constitute an important and necessary component of university and post-university education..
Faced with the challenges of attractiveness, safety, efficiency and innovation in the surgical care sector highlighted by public authorities, the AP-HP has invested massively in recent years in robotic equipment for its hospitals as well as in the modernization of its training schools for professionals in the operating room and interventional activities (IBODE, IADE, nurses and electroradiology technicians).
The very essence of the surgical campus project is to continue this profound transformation of surgery, initiated for several years and resulting in an increasing place given to robotics in all its forms as well as the emergence of preoperative planning tools. and intraoperative guidance.
It also aims to support this movement by profoundly changing the training methods for operating theater professionals. A central place is thus given, in the future Surgical Campus of Greater Paris, to educational methods based on technical and behavioral simulation when until now they were only focused within the AP-HP surgery school on training on anatomical topics. In doing so, the Greater Paris Surgical Campus project is fully consistent with the spirit of the new legal and regulatory framework, which aims to regulate the use of anatomical subjects for training and research purposes.
The ambition to provide a secure environment, equipped with the most innovative equipment to offer very specialized practical training, as close as possible to real exercise conditions
The winner of the competition for the creation of a 5,000 m surgical campus2 in the 14e district has just been chosen.
-The objective is to provide a secure environment, equipped with the most innovative equipment and educational tools to offer very specialized practical training, as close as possible to real practice conditions:
- A first building will accommodate from September 2026, covering 900 m2so-called “dry” training activities, focused on simulation tools, as well as a hub for the co-development, presentation and evaluation of highly technical surgical and interventional innovations.
- A second building, equipped with operating theaters, hybrid rooms and research rooms, will accommodate from September 2027 those linked to the new Île-de-France body donation center (CDC IDF), which will be there also installed.
The Campus will create an unprecedented capacity for multi-professional training in new operator practices, unrivaled in France and Europe.
This professional school is primarily focused on the needs of the Île-de-France region.. However, it aims for national and international influence. Its field of activity – that of the interventional activities of today and tomorrow – will be open to new technologies (notably in imaging and for the interventional practices linked to it) and will be aimed at all public and deprived of surgery, medicine and interventional radiology:
- or the creation of practical training in initial training for 1,500 interns versus 300 today;
- i.e. the potential annual regional reception of 5,000 professionals for 500 currently in continuing training.
It is a real strike force at the regional and national level, responding to the strong demand expressed, and a vector for the influence of French surgical and medical excellence internationally.
The offer will include on-site and remote training :
- Each year, it will provide initial training to the 1,500 students of the 3e cycle of medical studies registered for the specialized studies diploma (DES) in the field of surgery and interventional medicine and to the 500 students in initial training in the operating theater in the Île-de-France region.
- It will concern the annual continuing training of the 2,000 practitioners and 1,000 paramedics in the Île-de-France region who must fulfill their three-year training and skills certification obligations.
- The continuing education offering will be open to national and international professionals in the operating room and interventional activities.
A global, innovative and ambitious educational project for all professionals in operating activities
Teaching will cover 20 surgical and interventional disciplines:
- Anesthesia-resuscitation, Interventional cardiology, Maxillofacial surgery, Oral surgery;
- Orthopedic and trauma surgery, Pediatric surgery;
- Plastic, reconstructive and aesthetic surgery;
- Thoracic and cardiovascular surgery, Vascular surgery;
- Visceral and digestive surgery, Interventional digestive endoscopy, Gynecology obstetrics Neurosurgery;
- Ophthalmology;
- ENT and head and neck surgery, Interventional pulmonology, Interventional radiology, Urology.
The teaching will use training techniques for major surgical procedures (robotic surgery, video-coelio-endoscopy, microsurgery and radio-guided interventional procedures) on the human body, on small and large animals as well as all the so-called supports. simulation.
Training on the human body is organized in conjunction with the CDC (body donation center) managed by the AP-HP in partnership with Sorbonne University, an associated establishment, under organizational and material conditions strictly in accordance with the legal framework established by the decree of April 27, 2022. It integrates new post-mortem vascularization techniques to perform surgical simulation on anatomical subjects.
Teaching about large animals is organized in partnership on the site of the national veterinary school of Alfort (ENVA).
Il will, finally, call on simulation for the development of technical skills (basic et hard skills) and behavioral (soft skills) by using all existing simulation tools – simulations on mannequins and task mannequins, 3-D printing, sophisticated exam simulators, robotic simulators, digital simulation with natural and non-natural interface. The development of specific multi-sensory surgery simulators, characterized by extremely realistic immersion within virtual operating theaters, will also make it possible to evaluate the progress of students in all these aspects.
A strong and lasting impact on the entire surgical ecosystem: attractiveness, training, research and innovation
The founders of the future GIP are already financing the current school and the university and hospital staff providing teaching in this area. They have already secured 24 million euros for the construction of the real estate project.
GIP’s future revenues are based on a robust economic model. Its business plan demonstrates, through a start-up scenario, the assurance of the annual balance of costs by operating revenues for a minimum of 55,000 annual passages in 2028.
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