I am a postgraduate in surgery. I am from India, working in New Delhi, and have passed the membership exam for the Royal College of Surgeons (MRCS). Kindly tell me how to enter the FRCS (general surgery) programme in the UK?

Sunder R Gopaul

doi:10.1136/bmj.334.7595.s114-c

Low Pass-rate in postgraduate surgical examination in Nigeria and its contribution to the low surgeon workforce in the country; a review article

SICOT-J ◽

10.1051/sicotj/2018008 ◽

2018 ◽

Vol 4 ◽

pp. 36

Author(s):

Jonathan L. Ajah

Keyword(s):

United States ◽

Royal College ◽

General Surgery ◽

The United States ◽

Pass Rate ◽

Medical College ◽

Low Pass ◽

Certifying Examination ◽

The Uk ◽

American Board Of Surgery

Surgical postgraduate examiners and examinees in Nigeria complain of the low pass rate at all levels of the postgraduate surgical training examinations to which several factors are contributing. For several years there has been being a persistently low surgeon workforce in the country despite having two surgeon producing institutions been for at least 37 years. A review of the probable causes was carried out to shed more light on the matter. At the time of writing there are 52 National Postgraduate Medical College of Nigeria (NPMCN) and 46 West African College of Surgeons (WACS) accredited post graduate surgery training programs in Nigeria compared with 99 in the United Kingdom (UK) and 1056 in the United States (US). Based on available data Nigeria has approximately 572 surgery residency training slots yearly compared with approximately 646 in the UK and 4225 in the US. Examination pass rate was less than 40% for primary WACS compared with 98% pass rate in USMLE (United States Medical Licensing Examination) 3, pass rate at part I was 28.8% for WACS compared with 37% at MRCS (Membership Royal College of Surgeons) part A and 57% for MRCS part B. For the exit examination or part II WACS pass rate was 31.5% (general surgery) while it was 64% for Fellowship Royal College of Surgeons (FRCS) cumulative and 70% in the American board of surgery (ABS). Surgeon per 100 000 population was 0.69 for Nigeria compared with 11.7 and 25.6 for the UK and US respectively. In the last 35 years WACS has produced 1638 surgeons (2.8 times more than NPMCN) in surgery and NPMCN has produced 572. The frequency of examination were twice per year for both WACS and NPMCN examinations, 3 times per year for the USMLE step 3, MRCS (A & B) and Fellowship Royal College of Surgeons (FRCS) general surgery. The American Board of Surgery (ABS) is once per year for Qualifying Examination (QE) and 5 times per year for Certifying Examination (CE).

P-EGS06 Evaluating the impact of COVID-19 on the trend of emergency laparoscopic cholecystectomy

British Journal of Surgery ◽

10.1093/bjs/znab430.066 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Simrita Agrawal ◽

Chaminda Sellahewa

Keyword(s):

Laparoscopic Cholecystectomy ◽

Laparoscopic Surgery ◽

Royal College ◽

General Surgery ◽

Gallstone Disease ◽

Surgical Care ◽

Unknown Risk ◽

The Uk ◽

Emergency Cholecystectomy ◽

The Impact

Abstract Background Since the spread of the new SARS-CoV2 coronavirus in March 2020 to the UK, contradictory recommendations on the practice of laparoscopic cholecystectomies fuelled some debates among surgeons. The British Intercollegiate General Surgery Guidance recommended laparoscopic cholecystectomy as the treatment of choice for acute cholecystitis during the COVID-19 pandemic. Contradictorily, the Royal College of Surgeons of England warned about the unknown risk of viral infection and the release of pressurised gas from laparoscopic surgery. The audit aimed to identify the differences in surgical care before and during the pandemic to study their impact on patients. Methods Retrospective patient data was obtained from September 2019 to September 2020 to include data six months before the pandemic and six months during the pandemic. The data obtained had the patient hospital number, fitness for cholecystectomy, decision made regarding surgery, date of admission and date of surgery. Results 178 patients before COVID-19 and 242 patients during COVID-19 were admitted with gallstone disease. Before COVID-19, 60.67% (n = 108) patients were fit and consenting for surgery. Of these patients, 60.19% (n = 65) were discharged for surgery later and 39.81% (n = 43) had inpatient emergency surgery. During COVID-19, 71.49% (n = 173) patients were fit and consenting for surgery. However, 87.86% (n = 152) were discharged for surgery and only 12.14% (n = 21) had inpatient surgery. The average time from admission to surgery increased from 8 days to 51 days during COVID-19. Although majority of inpatient surgeries were performed within eight days, the percentage performed was fewer during COVID-19. Conclusions The COVID-19 pandemic significantly affected emergency laparoscopic cholecystectomies performed in the hospital with a substantial increase in the average time taken from admission to surgery. More emergency laparoscopic cholecystectomies should be included in the weekly elective lists, design for dedicated emergency cholecystectomy lists and increase utilisation of the CEPOD theatres along with staff availability are required to achieve the emergency cholecystectomy service as guided by the Royal Colleges.

Thy 3F and 3a malignancy rate, a multisite regional retrospective case series

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0103 ◽

2018 ◽

Vol 100 (7) ◽

pp. 545-550 ◽

Cited By ~ 2

Author(s):

V Alexander ◽

J Rudd ◽

D Walker ◽

G Wong ◽

A Lunt ◽

...

Keyword(s):

Thyroid Cancer ◽

Royal College ◽

Case Series ◽

Thyroid Malignancy ◽

Retrospective Case ◽

Retrospective Case Series ◽

Indeterminate Nodules ◽

The Uk ◽

Diagnosis Of Thyroid Cancer ◽

Benign Thyroid

Introduction The aim of this study was to ascertain the incidence of thyroid cancer for patients categorised as Thy3, 3a or 3f across four tertiary thyroid multidisciplinary centres in the UK. Material and methods This is a retrospective case series examining patients who presented with a thyroid nodule and diagnosed as Thy3, 3a or 3f according to the Royal College of Pathologists modified British Thyroid Association and Royal College of Physicians Thy system. Results In total, 395 patients were included in this study. Of these, 136 turned out to have benign thyroid disease and 24 had micropapillary thyroid carcinomas. The overall rate of thyroid malignancy was 28.8%. For each subcategory, the rate of malignancy was Thy3 24.7.7%, Thy3a 30.4% and Thy3f 29.2. However, the incidence of thyroid malignancy varied considerably between the four centres (Thy 3f 18-54%). Discussion The diagnosis of thyroid cancer is evolving but detection for malignancy for indeterminate nodules remains below 50% for most centres around the world. In 2014, the British Thyroid Association subdivided the original Thy3 category into Thy3a and Thy3f and recommended a more conservative approach to management for Thy3a nodules. Despite this, only two centres yielded a higher conversion rate of malignancy in the new higher graded Thy3f group compared with Thy3a. Conclusion It is debateable whether the new ‘Thy3’ subcategories are more useful than the original. Local thyroid malignancy rates may also be more useful than national averages to inform treatment decisions.

892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance

British Journal of Surgery ◽

10.1093/bjs/znab134.502 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

K Hashmi ◽

S Khalid ◽

K Raja ◽

A Zaka ◽

J Easterbrook

Keyword(s):

Informed Consent ◽

Royal College ◽

Mortality Risk ◽

General Surgery ◽

Surgical Care ◽

District General Hospital ◽

Emergency General Surgery ◽

Surgical Practice ◽

Full Compliance ◽

Type Of Surgery

Abstract Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.

The NACPDE: new opportunities for dentists trained overseas

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363509x468266 ◽

2009 ◽

Vol 91 (8) ◽

pp. 283-283 ◽

Cited By ~ 2

Author(s):

Margaret Wilson

Keyword(s):

Royal College ◽

Clinical Training ◽

Dental Education ◽

Postgraduate Education ◽

Dental Surgery ◽

Department Of Health ◽

The World ◽

The Uk

The National Advice Centre for Postgraduate Dental Education (NACPDE) was founded in 1978 and is based in the Faculty of Dental Surgery of The Royal College of Surgeons of England and funded by the Department of Health. The UK has traditionally played an important part in providing clinical training and postgraduate education for dentists from all parts of the world. But it is equally important to recognise the contribution oversea-strained dentists have made to the NHS.

The International Fellowship Scheme for consultant psychiatrists: trainees' perspective

Psychiatric Bulletin ◽

10.1192/pb.30.6.229 ◽

2006 ◽

Vol 30 (6) ◽

pp. 229-231 ◽

Cited By ~ 2

Author(s):

Sanju George ◽

Bill Calthorpe ◽

Sudhir Khandelwal

Keyword(s):

Royal College ◽

Home Country ◽

Department Of Health ◽

Job Opportunities ◽

International Fellowship ◽

The Uk

The NHS International Fellowship Scheme for consultants offers overseas consultants, in specialties including psychiatry, an opportunity to work in the UK (Goldberg, 2003). This was launched by the Department of Health in 2002 and so far over 100 consultant psychiatrists have been recruited. However, there are several aspects of the project that are unclear. How long will this recruitment continue? Are there any arrangements in place to encourage overseas consultants to return to their home country at the end of their fellowship? Are they eligible to train senior house officers (SHOs) and specialist registrars (SpRs)? Will the recruitment under the scheme have an impact on job opportunities for SpRs currently training in the UK? Why is membership of the Royal College of Psychiatrists being granted to the newly recruited consultants without an examination? These and many more concerns have arisen in the wake of this scheme. In this article, we evaluate the scheme, discuss its implications and suggest possible ways forward.

Liaison psychiatry services in south England

The Psychiatrist ◽

10.1192/pb.bp.109.026468 ◽

2010 ◽

Vol 34 (7) ◽

pp. 270-273 ◽

Cited By ~ 2

Author(s):

Jackie Gordon ◽

Sonia Wolf

Keyword(s):

Royal College ◽

Full Time ◽

The South ◽

Liaison Psychiatry ◽

Hospital Size ◽

Staffing Levels ◽

The Past ◽

Patient Groups ◽

The Uk ◽

And Function

Aims and methodTo investigate liaison psychiatry services across 38 acute trusts in the south of England. We used a telephone survey and compared the results to service structure and function as recommended by the Royal College of Physicians and the Royal College of Psychiatrists.ResultsApproximately two-thirds of trusts surveyed had a dedicated liaison service and this was not significantly related to hospital size. Most liaison teams were understaffed in all disciplines and only a third had a full-time consultant. Services for specialist patient groups were generally well provided for; 37% of teams had been created in the past 5 years and 33% were planning to increase their staffing levels in future.Clinical implicationsLiaison services in the south of England are similar to those in other parts of the UK that have been surveyed. Although the services did not meet the Colleges' recommendations, our study shows some recent growth and development in this specialty.

Tick, tock, lock: night-time confinement in high security – history, practice, ethics and practicalities

BJPsych Bulletin ◽

10.1192/bjb.2018.80 ◽

2018 ◽

Vol 43 (1) ◽

pp. 1-3

Author(s):

Ed Silva ◽

Andrew Shepherd

Keyword(s):

Royal College ◽

Night Time ◽

Advisory Body ◽

High Security ◽

The Future ◽

The Uk

SummaryNight-time confinement, locking patients in their bedrooms overnight, is practiced within high-secure hospitals in the UK. This article provides context, sets out the history and reviews the ethical and pragmatic issues at stake. Thought is given to the future, where we appear to be moving toward a different approach.Declaration of interestE.S. is a consultant forensic psychiatrist at Ashworth Hospital. All his patients are confined at night. He represents the Royal College of Psychiatrists Forensic Faculty at the National Oversight Group, which is the strategic advisory body providing assurance to NHS England regarding the commissioning and provision of high-secure services.

TP10.1.5The reorganisation of Emergency General Surgery services during the COVID-19 pandemic in the UK: Outcomes of delayed presentation, mortality and BAME patients

British Journal of Surgery ◽

10.1093/bjs/znab362.131 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Anthony Chan ◽

Panos Stathakis ◽

Paul Goldsmith ◽

Stella Smith ◽

Christian Macutkiewicz

Keyword(s):

General Surgery ◽

Lower Proportion ◽

University Teaching ◽

Perioperative Outcomes ◽

Delayed Presentation ◽

Global Public Health ◽

Emergency General Surgery ◽

Duration Of Symptoms ◽

Co Morbidity ◽

The Uk

Abstract Background The COVID-19 pandemic is a global public health emergency. The reconfiguration of local healthcare systems to accommodate the increase in Critical Care capacity has put strain on ‘non-COVID’ specialities. This study characterises the utilisation of Emergency General Surgery (EGS) services at a busy UK university teaching hospital during the COVID-19 lockdown period to evaluate outcomes and to identify patient groups with worse outcomes. Method This retrospective study compares EGS admissions during the UK’s lockdown period (23rd March-28th May 2020) to the same period in 2019. Patient demographics were recorded together with details of their hospital stay and treatment outcomes. Results A total of 645 patients were included, comprising 223 in the COVID-19 and 422 in the non-COVID-19 periods. There was no difference in age, sex, co-morbidity or socioeconomical status. A lower proportion of Black, Asian and Minority Ethnic (BAME) patients were admitted during the COVID-19 period (20.6% vs 35.4%, p < 0.05). The duration of symptoms prior to presentation were longer, and admission Early Warning Scores and serum inflammatory markers were higher. More patients present with acute kidney injury (9.9% vs 4.7%, p = 0.012). There was no difference in perioperative outcomes or 30-day mortality, but more patients were readmitted following conservative management (10.6% vs 4.7%, p = 0.023). Conclusion We show that the UK reorganisation of EGS services has been successful in terms of outcomes and access to services despite a more unwell population. There was a lower proportion of BAME admissions suggesting additional barriers to access to healthcare under pandemic lockdown conditions.

Body Mass Index and Waist Circumference Cut-Points in Multi-Ethnic Populations from the UK and India: The ADDITION-Leicester, Jaipur Heart Watch and New Delhi Cross-Sectional Studies

PLoS ONE ◽

10.1371/journal.pone.0090813 ◽

2014 ◽

Vol 9 (3) ◽

pp. e90813 ◽

Cited By ~ 25

Author(s):

Danielle H. Bodicoat ◽

Laura J. Gray ◽

Joseph Henson ◽

David Webb ◽

Arvind Guru ◽

...

Keyword(s):

Body Mass Index ◽

Waist Circumference ◽

Body Mass ◽

New Delhi ◽

Cross Sectional ◽

Cut Points ◽

Ethnic Populations ◽

Cross Sectional Studies ◽

The Uk