scholarly journals Post-EWTR: Is the UK Still a Centre of Excellence for Surgical Training?

2012 ◽  
Vol 94 (8) ◽  
pp. 268-273 ◽  
Author(s):  
MEA Khan ◽  
AD Jordan ◽  
T Strange ◽  
S Vig
Keyword(s):  
Surgical Training ◽  
Working Hours ◽  
Specialist Training ◽  
Current Generation ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
Centre Of Excellence ◽  
The Uk ◽  
Radical Transformation

Surgical training in the UK has undergone a radical transformation over the past few years. The limitation of working hours imposed by the European workingTime regulations (EWTR) and a shorter path to consultancy through Modernising Medical Careers has resulted in a shortening of training hours between qualification and completion of specialist training. Some estimate total training hours have reduced by 50%, from 30,000 in the old system to just 15,000 currently. Quite reasonably, there is concern that the current generation of surgical trainees will be less skilled and less competent than their predecessors.

scholarly journals A Critical Appraisal of the Evidence of Current Methods of Assessment for Surgical Trainees

2013 ◽  
Vol 95 (6) ◽  
pp. 7-11
Author(s):  
AJ Batchelder ◽  
MJ McCarthy
Keyword(s):  
Surgical Training ◽  
Critical Appraisal ◽  
Junior Doctors ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
The Uk ◽  
Supervision And Training ◽  
And Training

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.

scholarly journals More Trainees and Less Operative Exposure: A Quantitative Analysis of Training Opportunities for Junior Surgical Trainees

2010 ◽  
Vol 92 (5) ◽  
pp. 170-173 ◽  
Author(s):  
EC Toll ◽  
CR Davis
Keyword(s):  
Postgraduate Medical Education ◽  
Working Hours ◽  
Training Time ◽  
Surgical Services ◽  
Medical Careers ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
Training Opportunities

The evolution of postgraduate medical education in the UK continues to influence the quality of surgical training. Many reforms over the last three decades have affected training, including the Calman reforms, Modernising Medical Careers (MMC) and the European Working Time Directive (EWTD). The net effect of these changes is a reduction in working hours and shorter total training time for surgical trainees. Compounded by increasing subspecialisation, centralisation of surgical services and surgeon-specific data reporting, there may be fewer operative opportunities for surgical trainees.

Procedure-based assessments: the past, the present and the future

2019 ◽  
Vol 96 (1131) ◽  
pp. 7-8
Author(s):  
Ahmed Abdelaal
Keyword(s):  
Surgical Training ◽  
Surgical Trainee ◽  
The Past ◽  
Surgical Trainees ◽  
The Future ◽  
The Uk ◽  
Almost All

One of the most significant changes to the structure of surgical training in the UK was the introduction of workplace-based assessments (WBAs). Since its integration into the Intercollegiate Surgical Curriculum Programme, we as surgical trainees became the children of WBAs. Procedure-based assessment (PBA) is one of the pillars of WBAs and no surgical trainee portfolio is complete without a significant number of PBAs completed. As a senior trauma and orthopaedics trainee myself, I have encountered PBA on a regular basis, both as a trainee and as an assessor to my junior colleagues. My journey in understanding and implementing PBAs has not been a smooth one. This is also a reflection of almost all surgical trainees across all specialties. In this review, I aim to shed some light on my perspective on PBA, its values, limitations and concerns that have risen as a result of its introduction. I also aim to use my experiences to highlight possible ways of improvement in PBA.

The Lost Generation: Impact of the 56-hour EWTD on Current Surgical Training

2010 ◽  
Vol 92 (3) ◽  
pp. 102-106 ◽  
Author(s):  
CR Chalmers ◽  
S Joshi ◽  
PG Bentley ◽  
NH Boyle
Keyword(s):  
Shift Work ◽  
Surgical Training ◽  
New Deal ◽  
Working Hours ◽  
Lost Generation ◽  
Surgical Trainees ◽  
European Working ◽  
Working Time Directive ◽  
Training Opportunities ◽  
The New Deal

The reform of specialist surgical training – the New Deal (1991), the Calman report (1993) and the implementation of the European Working Time Directive (EWTD, 1998) – has resulted in shorter training periods with reduced working hours. The Calman reform aimed to improve and structure training with regular assessment and supervision whereas the New Deal and the EWTD have concentrated predominantly on a reduction in hours. The adoption of full or partial shift work to provide surgical cover at night compliant to a 56-hour working week, as stipulated by phase one of the EWTD, has resulted in daytime hospital attendance for surgical trainees of an average three days per week despite almost universal acknowledgement of the limited training opportunities available at night.

scholarly journals Military General Surgical Training Opportunities on Operations in Afghanistan

2009 ◽  
Vol 91 (5) ◽  
pp. 417-419 ◽  
Author(s):  
Adam J Brooks ◽  
Arul Ramasamy ◽  
David Hinsley ◽  
Mark Midwinter
Keyword(s):  
Surgical Management ◽  
Surgical Training ◽  
Trauma Surgery ◽  
Organ Injury ◽  
Surgical Trauma ◽  
Training Opportunity ◽  
Injury Management ◽  
Surgical Trainees ◽  
Specific Organ ◽  
The Uk

INTRODUCTION In the UK, general surgical specialist trainees have limited exposure to general surgical trauma. Previous work has shown that trainees are involved in only two blunt and one penetrating trauma laparotomies per annum. During their training, nearly half of trainees will not be involved in the surgical management of liver injury, 20% will not undertake a trauma splenectomy and only a quarter will see a trauma thoracotomy. Military general surgical trainees require training in, and exposure to, the surgical management of trauma and specifically military wounding patterns that is not available in the UK. The objective of this study was to determine whether operative workload in the sole British surgical unit in Helmand Province, Afghanistan (Operation HERRICK) would provide a training opportunity for military general surgical trainees. PATIENTS AND METHODS A retrospective theatre log-book review of all surgical cases performed at the Role 2 (Enhanced) treatment facility at Camp Bastion, Helmand Province on Operation HERRICK between October 2006 and October 2007, inclusive. Operative cases were analysed for general surgical trauma, laparotomy, thoracotomy, vascular trauma and specific organ injury management where available. RESULTS A total of 968 operative cases were performed during the study period. General surgical procedures included 51 laparotomies, 17 thoracotomies and 11 vascular repairs. There were a further 70 debridements of general surgical wounds. Specific organ management included five cases of liver packing for trauma, five trauma splenectomies and four nephrectomies. CONCLUSIONS A training opportunity currently exists on Operation HERRICK for military general surgical specialist trainees. If the tempo of the last 12 months is maintained, a 2-month deployment would essentially provide trainees with the equivalent trauma surgery experience to the whole of their surgical training in the UK NHS. Trainees would gain experience in military trauma as well as specific organ injury management.

scholarly journals Surgical anatomy in the age of EWTD and ISCP

2008 ◽  
Vol 90 (7) ◽  
pp. 245-245
Author(s):  
Vishy Mahadevan
Keyword(s):  
Surgical Training ◽  
Surgical Anatomy ◽  
Working Time ◽  
European Working Time Directive ◽  
Medical Careers ◽  
European Working ◽  
The Face ◽  
Considerable Impact ◽  
The Uk ◽  
Working Time Directive

Four major new initiatives being implemented nationally are set to have a considerable impact on the nature of surgical training in the UK. When fully operational, these developments will alter the face of surgical training: the European Working Time Directive (EWTD), Modernising Medical Careers (MMC), the Intercollegiate Surgical Curriculum Programme (ISCP) and the new MRCS examination.

scholarly journals Training and selection of surgeons 2008: a personal view

2008 ◽  
Vol 90 (7) ◽  
pp. 238-239
Author(s):  
M Lewis
Keyword(s):  
Surgical Training ◽  
Medical Training ◽  
Personal View ◽  
Extensive Experience ◽  
Medical Careers ◽  
Application Service ◽  
International Reputation ◽  
Training Of Surgeons ◽  
The Uk ◽  
Selection Of

For decades Britain has maintained an international reputation for training of surgeons, both from the UK and principally the Commonwealth countries. Consultants proffered their extensive experience and time: their reward being the satisfaction of watching inexperienced trainees mature into competent surgeons. This 'educational agreement' has existed for many years. Currently, the organisation of surgical training has been destabilised somewhat by Modernising Medical Careers, the Medical Training Application Service (MTAS) and the Tooke report.

Basic surgical training outcomes in the era of the EWTD

2006 ◽  
Vol 88 (6) ◽  
pp. 206-207 ◽  
Author(s):  
BM Frost ◽  
C Beaton ◽  
AN Hopper ◽  
MR Stephens ◽  
WG Lewis
Keyword(s):  
Surgical Training ◽  
Medical Profession ◽  
Junior Doctors ◽  
Training Outcomes ◽  
Mixed Response ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
The New Deal

The European Working Time Directive (EWTD) represents the latest challenge to surgical training in the UK, following Calmanisation and the implementation of the New Deal on junior doctors' hours. Compliance with the EWTD in the UK demands shift working patterns and as such it has received a mixed response from the UK medical profession. While physicians in training are relatively content with the regulations of the EWTD, surgical trainees have voiced concerns regarding the potential impact of an altered working week on their clinical experience and training as well as quality of life.

Career Intentions of UK Plastic Surgery Trainees

2009 ◽  
Vol 91 (8) ◽  
pp. 284-287
Author(s):  
O Quaba ◽  
V Sivarajan ◽  
SW Waterston
Keyword(s):  
Medical School ◽  
Plastic Surgery ◽  
Surgical Training ◽  
Training Level ◽  
Specialist Training ◽  
Career Intentions ◽  
The Uk

In the UK higher specialist surgical training can begin a minimum of two years following graduation from medical school and currently lasts at least seven or eight years depending on specialty. This is far from the whole story for most trainees, however. Due to high levels of competition, extended periods at pre-specialist training level or formal research have been required to secure a post in most surgical specialties.

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