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National Surgical Fellowship Scheme

The Royal College of Surgeons of England and the surgical specialty associations have established a national fellowship scheme to manage, quality assure and publicly recognise fellowship posts in England, Wales and Northern Ireland that comply with standards of educational quality.


Fellowship opportunities, both pre and post CCT, have existed for many years in the UK and abroad. There was no formal understanding of the range and scope of these posts, nor a universal system to advertise, quality assure and monitor them. For some time the College has wished to see this situation improved and regularised. Following meetings between the College, specialty associations and trainee bodies, it was agreed that a scheme should be created to:

  • identify, assess and approve fellowship posts (after due consideration of the future needs of the health service);
  • provide a mechanism to maintain and raise standards and ensure uniformity of fellowship provision;
  • maintain and publish a central register of high quality approved posts to assist trainees;
  • assist providers in attracting high calibre candidates;
  • ensure the availability of targeted opportunities for surgeons to obtain super-specialty and multidisciplinary skills not easily available within specialty training programmes/regions;
  • prevent indiscriminate proliferation of fellowship posts and align fellowship opportunities more closely to workforce needs;
  • ensure that the training of pre CCT surgeons is not compromised by pre or post CCT fellowships.

What is a fellowship post?

The College and specialty associations define a fellowship post as a period of additional medical training, beyond that available in a usual CCT training programme, which:

  • Provides a structured educational experience prior to (eg, ST5 or above) or immediately following CCT, designed to deliver the requirements of a particular subspecialty which are not readily available within the CCT training programme
  • Has an established curriculum (which includes levels of patient care, medical knowledge, practice-based learning and improvement, communication skills, and professionalism)
  • Where the subject matter relates to one of the following:
    • Acquisition of subspecialist skills – eg where specialist surgery has been centralised in line with commissioning decisions.
    • Acquisition of super-specialty technical skills – for example, in new technologies and treatments which may not be readily available within a given region or training programme
    • Acquisition of multidisciplinary skills in a given clinical area.
  • Does not impinge on the training of pre CCT trainees
  • Is allied to workforce opportunities
  • Takes place in an institution that assumes ultimate responsibility for delivery of the programme of training and education; this includes providing sufficient protected time for both trainer(s) and trainees (fellows) and necessary financial support for the programme
  • Has a single programme director assigned, with authority and accountability for the fellowship post
  • Has identified faculty that will assume educational and supervisory responsibilities throughout the programme
  • Has a written agreement in place specifying responsibilities for training, teaching, supervision and evaluation of the programme
  • Provides opportunities for audit and research
  • Has an external evaluation process

Further information

All approved posts are listed on the National Fellowship Register. Further information about the fellowship approval process is detailed here.

To apply for Fellowship Approval, please visit the Accreditation Portal or contact the Quality Assurance team on 020 7869 6236 or at

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