National Undergraduate Curriculum in Surgery
In 2015 we launched a new national undergraduate curriculum to address the variable teaching of basic surgery at medical schools in the UK.
The new curriculum was written by a team of medical students, surgical trainees, senior surgeons and representatives of the surgical specialty associations, for use in conjunction with the General Medical Council’s Tomorrow’s Doctors, which outlines the outcomes that are expected of a modern undergraduate curriculum.
We have produced a resource pack to help:
- students to identify and pursue their own learning
- surgeons and their colleagues to encourage students to consider careers in surgery
The pack below provides an introduction to the practical uses of the RCS National Undergraduate Curriculum in Surgery and explains how this can be used.
Surgery for medical students and foundation doctors
A resource pack for surgeons and their teams
Download this information as a PDF or a template presentation explaining the curriculum and how to use it.
Introduction
This pack provides tools to help you encourage students to consider careers in surgery. It provides an introduction to the practical uses of the College’s National Undergraduate Curriculum in Surgery and explains how this can be used. It can be used by surgeons and their colleagues.
Surgery is competitive and we want to attract and support good future surgeons. This means supporting students from an early stage. Students who go on to become surgeons need consistent access to opportunities to learn the important and urgent things and to honest information. Those who go on to other careers in medicine still need to have a good understanding of surgery.
Every student should be encouraged to scrub in and to practise the key skills, and consider how else they can learn. Foundation doctors also need support, and this approach may help. We encourage links between medical schools, hospitals, surgeons, students and foundation doctors.
Potential activity and sponsorship
As a minimum, we suggest an event in which you introduce the curriculum using the enclosed presentation. Medical students, particularly members of the university surgical societies, are normally keen to work with surgeons and to learn more about surgical careers. You may wish to enhance this with a discussion of your experiences, a general careers talk (explaining how to become a surgeon, how to build a portfolio etc.) or another topic.
The RCS careers support team can provide template presentations, literature (see below) and merchandise to support activities. The careers team also have a limited budget to sponsor events to cover catering / printing etc. Students can apply directly to the careers team for this (max £200). Please note, activities must relate to the generality of surgery, careers in surgery or women in surgery and funds will be allocated on first come, first served basis. Please ask students to contact the careers support team to arrange this.
Medical school surgical societies
Useful schemes
Encourage students to consider participating in:
Affiliate scheme
Find out more about the RCS Affiliate scheme
£15 per year providing a range of benefits including discount on courses, newsletter, and the online Funky Professor anatomy teaching resource.
Women in Surgery (WinS)
Open to medical students, foundation doctors, trainees, SAS and consultants - and open to both men and women.
WinS is free to join, and provides a range of benefits, including: access to networking events, news and a directory so that they can contact other members.
Useful links
Template presentation
Download a template presentation (.pptx) explaining the curriculum and how to use it.
Publications
- National Undergraduate Curriculum in Surgery
- Learning in Operating Theatres
- Avoiding Unconscious Bias - a guide for surgeons
- Mentoring: a guide to good practice
Elsewhere on www.rcseng.ac.uk
Contact
Careers Support Team
- For information on careers in surgery including career pathways, Women in Surgery (WinS) and flexible working.
- 0207 869 6212 / careers@rcseng.ac.uk
Using the National Undergraduate Curriculum in Surgery
How to use this summary
This document is intended to support students to identify and pursue their own learning needs, and to help those who train students with planning. It is summarised from the National Undergraduate Curriculum in Surgery and should be read in conjunction with this. This document summarises the recommended topics (with learning objectives for each) and key skills. These are relevant to all students, irrespective of subsequent career path.
For students
Before starting in a placement, you should identify which areas to focus on. Remember the topics common to all surgical specialties. You will need to refer to the curriculum for the learning objectives of each topic. There are some topics that you will not cover easily because your placements, so you should find a way to cover these too.
For those teaching students
Please familiarise yourself with the topics that all future doctors are expected to know pertaining to your specialty and those common to all specialties. You should also consider the list of procedures and skills that are expected. You may need to run separate skills or clinical examination teaching sessions to address these. You may wish to consider where particular learning opportunities are needed for the topics that are unlikely to be covered. The conditions listed are the minimum for any future doctor. The curriculum has additional resources for those aiming to be surgeons.
For all
The RCS guide Learning in Operating Theatres and the section of the National Undergraduate Curriculum in Surgery entitled Ways of teaching and learning in surgery may be helpful.
Interventional procedures and practical skills
The section on Interventional procedures and practical skills lists the key skills and interventional procedures that should be covered. You should review this list at every placement as most can be addressed in any specialty.
Essential interventional procedures, as mandated by the GMC (learning objectives 24-31 from Tomorrow's Doctors):
| 1 | 24. Use of local anaesthetics |
|---|---|
| 2 | 25. Skin suturing |
| 3 | 26. Wound care and basic wound dressing |
| 4 | 28. Giving information about the procedure, obtaining and recording consent, and ensuring appropriate aftercare procedure. |
| 5 | 29. Hand washing (including surgical 'scrubbing up') |
| 6 | 30. Use of personal protective equipment (gloves, gowns, masks) |
| 7 | 31. Infection control in relation to procedures |
| 8 | 32. Safe disposal of clinical waste, needles and other 'sharps' |
Examinations and other essential practical skills:
| 9 | Removal of stitches and staples |
|---|---|
| 10 | Applications of dressings and bandages |
| 11 | Examination of a lump (e.g. its size, consistency, location, mobility, and whether it is tender, pulsatile or transillimunitory) |
| 12 | Assessment of a wound |
| 13 | Examination for fitness for surgery (chest, heart, neck, and mouth opening) |
| 14 | Examination of the abdomen |
| 15 | P.R. examination |
| 16 | Examination of the groin |
| 17 | Examination of the scrotum |
| 18 | Examination of the soft tissues of the neck |
| 19 | Examination of pulses |
| 20 | Examination of the breast |
| 21 | Examination of the hip |
| 22 | Examination of the knee |
| 23 | Examination of the back |
| 24 | Examination of the ear |
| 25 | Examination of the nose |
| 26 | Examination of the throat |
The key surgical conditions
| Usual surgical specialty | Also seen in |
|||
|---|---|---|---|---|
| 1 | Abdominal pain | Gen | ||
| 2 | Abdominal swelling | Gen | ||
| 3 | Change in bowel habit / rectal bleeding | Gen | ||
| 4 | Vomiting blood | Gen | ||
| 5 | Difficulty swallowing / dyspepsia / dysphagia | Gen | ||
| 6 | Jaundice | Gen | ||
| 7 | Lumps in groin | Gen | ||
| 8 | Lumps in scrotum / scrotal pain | Urol | ||
| 9 | Pain in loin | Urol | ||
| 10 | Urinary retention or flow obstruction | Urol | ||
| 11 | Haematuria (including stones and tumour) | Urol | ||
| 12 | Leg ulceration | Vasc | Neuro | T&O |
| 13 | Painful and/or paralysed limb | Vasc | Neuro | T&O |
| 14 | Breast lumps and nipple discharge | Gen (Breast) | Plast | |
| 15 | Lumps in the neck | ENT | MaxF | |
| 16 | Nose bleeds (epistaxis) | ENT | MaxF | |
| 17 | Ear discharge | ENT | MaxF | |
| 18 | Deafness | ENT | MaxF | |
| 19 | Acute airway obstruction and adults and children | ENT | MaxF | |
| 20 | Upper airway infection and rhino-sinusitis | ENT | MaxF | |
| 21 | Fractures or dislocation with displacement or wound | T&O | Plast | |
| 22 | Fractures without displacement | T&O | ||
| 23 | Swollen painful joint | T&O | ||
| 24 | Back pain and/or sciatica (including cauda equina) | Neuro | T&O | |
| 25 | Peripheral nerve injuries/palsies | Neuro | Plast | T&O |
| 26 | Raised intracranial pressure / Intracranial blood clots and intracranial mass lesions | Neuro | Gen | |
| 27 | Limping child | PaedS | T&O | |
| 28 | Groin lump in child | PaedS | ||
| 29 | Consent for surgery including mental capacity | ALL | ||
| 30 | Caring for the post-operative patient, including nutrition, enhanced recovery and the critically ill patient; advice regarding return to activities | ALL | ||
| 31 | Understanding wound healing | ALL | Plast | |
| 32 | Trauma, including head injury | ALL | ||
| 33 | Sepsis and infection | ALL | ||
| 34 | Surgical safety (WHO checklist, minimising complications, errors, communication and team-working) | ALL | ||
| 35 | Caring for the patient before and after surgery, including fitness | ALL | Cardio | |
Vascular surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Vascular Surgery |
|
| 12 |
Leg ulceration |
| 13 |
Painful and/or paralysed limb |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Urology
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Urology |
|
| 8 |
Lumps in scrotum / scrotal pain |
| 9 |
Pain in loin |
| 10 |
Urinary retention or flow obstruction |
| 11 |
Haematuria (including stones and tumours) |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Trauma & Orthopaedic Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Trauma & Orthodpaedic Surgery |
|
| 21 |
Fractures or dislocations with displacement or wound |
| 22 |
Fractures without displacement |
| 23 | Swollen painful joint |
| 12 | Leg ulceration |
| 13 | Painful and/or paralysed limb |
| 24 | Back pain and/or sciatica (including cauda equina) |
| 25 | Peripheral nerve injuries / palsies |
| 27 | Limping child |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Plastic Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Plastic Surgery |
|
| 14 |
Breast lumps and nipple discharge |
| 21 |
Fractures or dislocations with displacement or wound |
| 25 |
Peripheral nerve injuries/palsies |
| 31 |
Understanding wound healing |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Paediatric Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Paediatric Surgery |
|
| 27 |
Limping child |
| 28 |
Groin limp in child |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Oral & Maxillofacial Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Oral & Maxillofacial Surgery |
|
| 15 |
Lumps in the neck |
| 16 |
Nose bleeds (epistaxis) |
| 17 |
Ear discharge/pain |
| 18 |
Deafness |
| 19 |
Acute airway obstruction in adults and children |
| 20 |
Upper airway infection and rhino-sinusitis |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Neurosurgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Neurosurgery |
|
| 24 |
Back pain and/or sciatica (including cauda equina) |
| 25 |
Peripheral nerve injuries/palsies |
| 26 |
Raised intracranial pressure/Intracranial blood clots and intracranial mass lesions |
| 12 |
Leg ulceration |
| 13 |
Painful and/or paralysed limb |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
General Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| General Surgery |
|
| 1 |
Abdominal pain |
| 2 |
Abdominal swelling |
| 3 |
Change in bowel habit/rectal bleeding |
| 4 |
Vomiting blood |
| 5 |
Difficulty swallowing/dyspepsia/dysphagia |
| 6 |
Jaundice |
| 7 |
Lumps in groin |
| 14 |
Breast lumps and nipple discharge |
| 26 |
Raised intracranial pressure / Intracranial blood clots and intracranial mass lesions |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Ear, Nose and Throat Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Ear, Nose and Throat Surgery |
|
| 15 |
Lumps in the neck |
| 16 |
Nose bleeds (epistaxis) |
| 17 |
Ear discharge/pain |
| 18 |
Deafness |
| 19 |
Actue airway obstruction in adults and children |
| 20 |
Upper airway infection and rhino-sinusitis |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.
Cardiothoracic Surgery
| Common to all specialties |
|
|---|---|
| 29 | Consent for surgery, including mental capacity |
| 30 |
Caring for post-operative patient, including nutrition, enhanced recovery and the critically-ill patient; advice regarding return to activities |
| 31 |
Understanding wound healing |
| 32 |
Trauma, including head injury |
| 33 |
Sepsis and infection |
| 34 |
Surgical safety (WHO checklist, minimising complications, errors, communication and team-working |
| 35 |
Caring for the patient before and after surgery, including fitness |
| Cardiothoracic Surgery |
|
| 35 |
Caring for the patient before and after surgery including fitness |
Additional points to note
- No student will do a placement in every specialty, yet all 35 essential conditions need to be covered. It may be that this placement is their best opportunity to come across other essential conditions, or their timetable could be adapted to allow them to focus on a patient with a key condition, or to have teaching about this.
- Please remember the skills that should be acquired.
- There is overlap with other interventional specialties, and surgery is linked with anaesthesia, interventional radiology and emergency medicine.
A number of basic surgical principles can be taught, for example: [from main curriculum]
- Concepts of surgery: The practicalities of operations include removing tissue, releasing collections of fluid, unblocking vessels or other tubes, repairing tissue and rearranging anatomy.
- Every doctor must be able to discuss in general terms the risks and benefits of different courses of action and understand complications.