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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

There is a student surgical society in each of the UK’s 34 medical schools.

Surgical societies' contact details can be found here.

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)

Find out more about 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.

Contact

Regional team

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 displocatins 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 criticall 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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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.

Download this information as a PDF

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