Core surgical training and progression into specialty surgical training: how do we get the balance right?

2011 ◽  
Vol 93 (7) ◽  
pp. 244-248 ◽  
Author(s):  
Alison S Carr ◽  
Chris Munsch ◽  
Steve Buggle ◽  
Patricia Hamilton
Keyword(s):  
Surgical Training ◽  
Training Programme ◽  
Specialty Training ◽  
Surgical Experience ◽  
Surgical Specialty ◽  
Competitive Process

Doctors training in surgery in England usually complete a two-year core surgical training programme (CT1 and CT2) and then apply for entry into a surgical specialty training programme at ST3. This is a highly competitive process. Currently, ST3 is the only level of entry into specialty training and all doctors wishing to obtain a Certificate of Completion of Training (CCT) in a surgical specialty must apply for ST3 posts, irrespective of their previous surgical experience. Consequently, doctors who apply for ST3 entry directly from core surgical training find themselves competing against doctors with considerably more surgical experience.

Maxillofacial Trauma Experience for OMFS Registrars: A Comparison of Surgical Experience and Aetiology in 1980 and 2010

2012 ◽  
Vol 94 (9) ◽  
pp. 312-314
Author(s):  
BS Nandra ◽  
KK Shah ◽  
AM Felstead ◽  
PJ Revington
Keyword(s):  
Medical Association ◽  
Surgical Training ◽  
Royal College ◽  
Training Programme ◽  
Clinical Governance ◽  
Maxillofacial Trauma ◽  
Junior Doctors ◽  
Surgical Experience ◽  
European Working ◽  
Conclusive Data

Surgical training has undergone considerable reforms in order to emphasise a structured training programme with supervision in a framework of clinical governance. This was following Sir Kenneth Calman's proposed reforms of the registrar grades in 1993. The European Working Time Regulations (EWTR) became part of British law in 1998 and since August 2009 also includes junior doctors, limiting maximum working times to 48 hours per week with specific rest requirements. This has raised concerns from organisations, such as the British Medical Association and the Royal College of Surgeons, regarding the effect on training and whether changes are needed to prevent a loss in competency and confidence. The 2010 report by Professor Sir John Temple found a lack of conclusive data on the effects of the EWTR on training. However, it recommended that fundamental changes must be made to the way training and service are delivered.

scholarly journals Neurosurgical trainees' perceptions of course value and study leave budgets

2011 ◽  
Vol 93 (3) ◽  
pp. 94-95 ◽  
Author(s):  
Stephen Metcalfe
Keyword(s):  
Surgical Training ◽  
Specialty Training ◽  
Surgical Specialty ◽  
Medical Careers ◽  
Core Training ◽  
Training Programmes ◽  
Course Value

With the advent of Modernising Medical Careers (MMC) in 2007 neurosurgery adopted 'run-through' training, whereby trainees apply to a neurosurgical rotation that takes them through from foundation training to its completion and the award of the Certificate of Completion of Training (CCT). This is in contrast to the post-MMC training programmes for the rest of the surgical specialties, in which trainees apply to a core surgical training (CST) rotation, followed by open competition after their second core training (CT2) year for appointment into a specialty training (ST) rotation in the surgical specialty of their choice.

SP2.2.1Improving surgical training: core programme performance related to rotation theme, design, and trainee protocol engagement

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Performance Management ◽  
Outcome Measures ◽  
Surgical Training ◽  
General Surgery ◽  
Primary Outcome ◽  
Multivariable Analysis ◽  
Scientific Article ◽  
Specialty Training ◽  
Surgical Specialty ◽  
National Training

Abstract Aims Core Surgical Training (CST) and Improving ST (IST) programmes are in flux and their design controversial. This study aimed to evaluate the relative performance of a single Statutory Education Board’s (SEB) CST and IST programmes related to rotation design, theme, and protocol engagement. Methods Individual rotations numbering 181 were analysed prospectively over six-years (2014 to 2020). Primary outcome measures were MRCS pass and specialty National Training Number (NTN) appointment. Results Overall MRCS pass was 68.5% and NTN appointment 39.2%. NTN appointment related to rotation design varied from zero to 100% (median 40.0%). Conversion to NTN varied by specialty theme and ranged from: General surgery CST 35.6% to General surgery (IST pilot) 87.5% (p = 0.004). Multivariable analysis revealed NTN appointment was associated with: operative logbook caseload >464 (OR 3.02, p = 0.068), scientific article publication (OR 4.82, p = 0.006), and universal ARCP Outcome 1 (OR 37.83, p < 0.001), and IST (OR 55.54, p = 0.006). Conclusions Focused rotational design allied to enhanced performance management, and protocol engagement, were associated with improved conversion to higher surgical specialty training.

scholarly journals Changes in UK ophthalmology surgical training: analysis of cumulative surgical experience 2009–2015

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018526 ◽  
Author(s):  
Jeremy Hoffman ◽  
Fiona Spencer ◽  
Daniel Ezra ◽  
Alexander C Day
Keyword(s):  
Surgical Training ◽  
Secondary Level ◽  
Training Programme ◽  
Median Number ◽  
Specialist Training ◽  
Surgical Experience ◽  
Training Scheme ◽  
Higher Surgical Training ◽  
National Training ◽  
The Uk

ObjectiveTo investigate changes in the patterns of cumulative surgical experience for ophthalmologists in the UK following the introduction of a new national training scheme.DesignRetrospective review of all surgical training records submitted to the UK Royal College of Ophthalmologists by trainees for the award of Certificate of Completion of Training (CCT) for the period 2009–2015.SettingSecondary level care, UK.Participants539 trainees achieving CCT over the 7-year study period.InterventionsHigher specialist training or ophthalmology specialist training.Outcome measuresNumber of CCT awards by years and procedures performed for cataract surgery, strabismus, corneal grafts, vitreoretinal (VR) procedures, oculoplastics and glaucoma.ResultsCataract surgical experience showed little change with median number performed/performed supervised (P/PS) 592, IQR: 472–738; mean: 631. Similarly, the median number of strabismus (P/PS 34), corneal grafts (assisted, 9) and VR procedures (assisted, 34) appeared constant. There was a trend towards increasing surgical numbers for oculoplastics (median 116) and glaucoma (57). Overall case numbers for ophthalmic specialist training (OST) trainees (7-year training programme) were higher than higher surgical training (HST) trainees (4.5-year programme) with the exception of squint (P/PS), corneal grafts (P/PS) and VR cases (P/PS).ConclusionsOverall case numbers reported at time of CCT application appear stable or with a marginal trend towards increasing case numbers. HST (4.5-year programme) case numbers do not include those performed before entry to HST, and although case numbers tended to be higher for OST trainees (7-year programme) compared with HST trainees, they were not proportionately so.

A Short history of the post-graduate surgical training in Fiji - where to from here?

2018 ◽  
Vol 21 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Jitoko Kelepi Cama ◽  
Sonal Singh Nagra
Keyword(s):  
Surgical Training ◽  
Training Programme ◽  
Post Graduate ◽  
School Of Medicine ◽  
Postgraduate Training Programme ◽  
The Pacific ◽  
National University ◽  
History Of ◽  
Training Of Surgeons ◽  
Pacific Island Nations

Post-graduate surgical training at the Fiji National University (FNU), previously known as the Fiji School of Medicine) has recently been updated by incorporating elements from the Royal Australasian College of Surgeons (RACS) training curriculum. The revised curriculum maintains strong contextual relevance to the needs and pathologies of the Pacific Island nations.  This paper outlines why the FNU surgical postgraduate training programme should be applauded as a successful programme in the training of surgeons for the region.

scholarly journals P38 COVID-19 impact on Surgical Training And Recovery Planning (COVID-STAR) Survey

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Surgical Trainee ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Training Time ◽  
Surgical Trainees ◽  
And Training

Abstract Background The COVID-19 pandemic has resulted in dynamic changes to healthcare delivery. Surgery as a specialty has been significantly affected and with that the delivery of surgical training. Method This national, collaborative, cross sectional study comprising 13 surgical trainee associations distributed a pan surgical specialty survey on the COVID-19 impact on surgical training over a 4-week period (11th May - 8th June 2020). The survey was voluntary and open to medical students and surgical trainees of all specialties and training grades. All aspects of training were qualitatively assessed. This study was reported according to STROBE guidelines. Results 810 completed responses were analysed. (M401: F 390) with representation from all deaneries and training grades. 41% of respondents (n = 301) were redeployed with 74% (n = 223) redeployed > 4 weeks. Complete loss of training was reported in elective operating (69.5% n = 474), outpatient activity (67.3%, n = 457), Elective endoscopy (69.5% n = 246) with > 50% reduction in training time reported in emergency operating (48%, n = 326) and completion of work-based assessments (WBA) (46%, n = 309). 81% (n = 551) reported course cancellations and departmental and regional teaching programmes were cancelled without rescheduling in 58% and 60% of cases respectively. A perceived lack of Elective operative exposure and completions of WBA’s were the primary reported factor affecting potential training progression. Overall, > 50% of trainees (n = 377) felt they would not meet the competencies required for that training period. Conclusion This study has demonstrated a perceived negative impact on numerous aspects of surgical training affecting all training specialties and grades.

scholarly journals 934 Remote one-to-one virtual surgical skills training: Evolving the delivery of operative skills training in the UK

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Christian Asher ◽  
Ibrahim Ibrahim ◽  
Eyfrossini Katsarma
Keyword(s):  
Surgical Training ◽  
Wound Closure ◽  
Cost Effective ◽  
Skills Training ◽  
Training Programme ◽  
Surgical Skills ◽  
Wound Closure Techniques ◽  
Surgical Skills Training ◽  
Speciality Training ◽  
One To One

Abstract Introduction COVID-19 has had an unprecedented effect on surgical training, including prerequisite entry-level courses to speciality training. We describe the implementation of a virtual, one-to-one training programme aimed at the acquisition and retention of operative skills. Methods Enrolment commenced 8th May 2020 for wound closure techniques or an extended programme including tendon repairs, delivered by Specialist Registrars in Plastic Surgery using Zoom® (v. 5.0.5) via mobile device. Participant feedback was collected retrospectively using a 5-point scale following course completion. Results 5 participants completed the wound closure programme, and 3 the extended programme, over an average of 5 weeks, with 2 sessions per week. 5 participants were male, 3 female and were of the following grades: 2 CT2, 4 FY2, 1 FY1 and 1 medical student. A total of 103.5 hours of training was recorded to 7 September 2020. Participants reported that all virtual skills taught were readily transferable to the theatre environment. Following the course, all participants felt confident to complete the skills learnt independently, rating the course as excellent. Conclusions The COVID-19 crisis has placed insurmountable obstacles in the face of surgical training. With further validation, we aim to develop surgical skills training with virtual, easily reproducible, cost-effective, trainee centred programmes.

scholarly journals Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education

2019 ◽  
Vol 4 ◽  
pp. 187
Author(s):  
William Dean ◽  
Stephen Gichuhi ◽  
John Buchan ◽  
Ibrahim Matende ◽  
Ronnie Graham ◽  
...  
Keyword(s):  
Surgical Training ◽  
Southern Africa ◽  
Surgical Education ◽  
Training Programme ◽  
Sub Saharan Africa ◽  
African Region ◽  
Cross Sectional Survey ◽  
Small Incision Cataract Surgery ◽  
Cross Sectional ◽  
Recent Graduates

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as ‘somewhat satisfied’ or ‘very satisfied’ by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

scholarly journals SP2.2.18UK Surgical Training in the Independent Sector During COVID-19 – A Snapshot Survey

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Valdone Kolaityte ◽  
Charlotte El-Sayed ◽  
Josh Burke
Keyword(s):  
Surgical Training ◽  
Online Survey ◽  
Elective Surgery ◽  
Final Analysis ◽  
Training Programme ◽  
Barriers To Access ◽  
Resource Requirements ◽  
Operating List ◽  
Independent Sector ◽  
Training Opportunities

Abstract Aims In response to the COVID-19 pandemic and the cancellation of elective surgery, the Independent sector (IS) has been utilised to provide COVID-light sites. On average operative log book numbers have been reduced by 50% due to a reduction in operative exposure. The Four Educational Bodies continue to support training within the independent sector. This study aimed to qualitatively assess access and barriers to UK surgical training in the Independent Sector. Methods A snap-shot online survey was distributed to ASIT members of all training specialities and grades between 21/10/2020-11/11/2020 . Data measures included participant demographics, frequency of access, participation in training opportunities including outpatient clinic, theatre lists and endoscopy and any barriers encountered. A mixture of Likert scale and short answer questions were utilised. Results 249 complete responses representing all grades and specialities were included in the final analysis (34.29% CST and 56.3% HST). 35.7% of trainees reported access to the IS. 22.9% had access to at least one operating list whilst 70.3% had none. Access to outpatient clinics and endoscopy was negligible. 75% of trainees ‘strongly agreed’ that when access was achievable, it was beneficial to their training. Multiple barriers were identified including Human Resource requirements and local service provision. Conclusions Within the sample, access to the IS has been poor. There is wide variation in barriers to access across the 4 nations and IS providers. Trainees and Trainers should maximise training opportunities in the IS. Where barriers exist, they should be reported to local Training Programme Directors.

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