Transcript Core Training in Surgery - RCS — The Royal College of

Core Training in Surgery
Are we nearly there yet?
Chris Munsch
Joint Committee on Surgical Training
Principles of design



Purpose
Function
Form
What is the purpose of core training?





Acquire relevant competencies
Determine career choice
Determine suitability for that career
Acquire relevant transferable competencies
Allow movement into another (more
appropriate) career
What should core training deliver?




Generic professional competencies
Generic surgical competencies
Specialty specific competencies to allow
progress into higher surgical training
Career advice/direction
The structure of core training?







The F2 question
Career choice – when and how?
Run through, themed or generic programmes?
How long?
Management of core training
Assessment and selection
The role of non surgical modules
The F2 Question



Here to stay (for now)
Generic or vocationally themed
2x6 or 3x4?
Career choice – when and how?




Limited information, probably inconsistent
Influence of undergraduate and F1/2 experience
Most know what they don’t want to do
If the system forces people to make a choice then
they will
Career choice – when and how?

Survey of timing of career choice by T&O surgeons (Willett)
–
–
–
–
–


35% by year 1
56% by year 3
84% by year 5
77% previous experience was major factor in choice
73% ‘what I want to do’
Data can be used to support or refute concept of run through
Is T&O representative of all surgical specialities?
Run-through, themed or generic?



T&O and Neuro (and Scotland) continue to favour
run through
Generic surgical programmes
Themed programmes:
–
–
–

Musculoskeletal
Head and neck
Torso
Mixed economy?
How long? (2 or 3 years)





Nature of F2
Different for run through and core programmes?
Acquisition of generic vs speciality specific
competencies
ST3 entry requirements not being consistently met
by 2 year core eprogrammes
EWTD – more to come
Competency
based progression
Foundation 2
Selection
Specialty Run
Through
Programme
ST1
Core Surgical
Programme
CST1
Generic
ST 2
CST2
CST3
ST3 (Higher Specialty Training)
Themed
Management of core





Competencies defined in ISCP
‘Light touch’ from JCST
Deaneries and Schools of Surgery determine
delivery
External QA?
Oversight group for core surgery?
Assessment and selection


Run through programmes - selection at end of F2
Entry to HST dependant on satisfactory progress

Themed/generic – ‘soft’ selection at ST1
National selection into HST at end of core

Selection ratio of 1.2 : 1.?

MRCS exam generic within the context of three themes
(musculoskletal, head and neck or torso)

Role of non surgical specialities

General professional competencies relevant to surgery
–

Speciality specific competencies
–



A&E, HDU
Neurosciences programme
Do they add educational value?
Require more programme time
Transferable skills inform career choice and aid movement
Summary






Core surgical training is not yet a ‘done deal’
3 year core programmes are preferred
Mixed economy might work but needs piloting
Light touch from JCST
More work is needed on factors affecting career
choice
Things will change