RCS Senior Clinical Fellowship Scheme
Providing a quality mark for surgical education
The transition from senior trainee to consultant can be a challenging step. RCS England Senior Clinical Fellowships help bridge the gap. These peri-CCT Fellowships typically last for 12 months and are in a range of specialties. RCS England Senior Clinical Fellowships are jointly approved by the Royal College of Surgeons of England and the appropriate Surgical Specialty Associations. The Fellowships normally focus on expert training in a sub-specialty, such as knee, skull base, or bariatric surgery.
The RCS England Senior Clinical Fellowship Scheme was established in 2012 by the Surgical Specialty Associations (SSAs) and the Royal College of Surgeons of England for Fellowship programmes in the UK and abroad. The main purpose of the Scheme is to give Fellows high quality hands-on training, particularly in a sub-specialty, which will enhance the Fellow’s ability to provide a high level of surgical care to their patients, in a way that does not impinge on the opportunities of other trainees.
Senior Clinical Fellowship Scheme - Survey Report 2019
Former RCS Urology Robotic Fellow Jonathan Noël on how to get the most out of a Senior Clinical Fellowship.
Information for Supervisors - Create a SCF Scheme
Applying for a Fellowship Programme
Consultants who have set up a Senior Clinical Fellowship Programme, or who are planning to set up a programme, and would like to apply for approval under the RCS England Senior Clinical Fellowship Scheme can download the Application Form or apply through the Accreditation Portal.
The current fees are valid for three-years approval – these fees are subject to variation, for example, where there is more than one programme from the same provider, or if there is more than one Fellow at a time on a programme.
Each Fellowship programme has a supervisor who sets up the programme and applies for approval from the Fellowship Scheme. The programme should have clear learning aims and outcomes and should provide training typically at a level higher than normally received under the Intercollegiate Surgical Curriculum Programme. The application is reviewed by the appropriate SSA/s, Specialty Advisory Committee Liaison Member and Training Programme Director (#). If the specialty reviewers are supportive, the RCS Quality Assurance Operational Group then decides whether to approve the application. Approval is for three years; after this time, the Supervisor will need to apply for reapproval, which includes a review of previous Fellows’ logbooks.
Please note, for Fellowship programmes outside the UK and Republic of Ireland, suitable alternatives to the SAC and TPD, are requested to review the application.
- Expert review by surgeons in the appropriate specialty
- Assistance for you in attracting high calibre candidates
- Assurance that posts offer a high-quality learning and training experience, reflecting the standards set by the RCS England and the Surgical Specialty Associations
- Interim and final monitoring of Fellows
- Certification of Fellows, who can receive their Certificate at an RCS England Diplomates' Ceremony
- Extensive information about the Fellowship on the RCS England website
- Use of the RCS England Logo
- Use of the strap line ‘This RCS England Senior Clinical Fellowship post has been approved by the the Royal College of Surgeons of England and [……] [Specialty Association(s)]
- Listing in RCS Bulletin
There are four main stages in the Fellowship approval process, outlined in the chart below. At each stage, the applicant may be asked to amend their fellowship programme. The time taken between initial application and final approval can take about four to six months, depending on the availability of reviewers, the straightforwardness of the application, and the timing of RCS meetings.
- Initial application: Supervisor applies for fellowship approval or reapproval via the online application system
- Initial review: Initial desk-based review by RCS England to ensure the application is ready for specialty review.
- Specialty review: Application review by the appropriate Surgical Specialty Association/s, Specialty Advisory Committee, and Training Programme Director. The application proceeds to RCS England Quality Assurance Operational Group if the specialty reviewers recommend approval.
- Quality Assurance Operational Group: Review by the RCS England Quality Assurance Operational Group of the application and the specialty reviews. Final approval decision. If granted, fellowship approval lasts for three years.
Information for Fellows - Apply for a fellowship training
Fellows Senior surgical trainees at around the time (shortly before or shortly after) of their Certificate of Completion of Training (CCT, for UK fellows) who meet the person specification, and any other requirements, of a fellowship post, and who are eligible to work in the country where the programme is based (including having GMC registration and the appropriate visa for programmes in the UK), are eligible to apply for a fellowship post. A third of fellows are from EU counties, and a third are from non-EU countries (see international training info). The fellow will be an employee at the NHS Trust or similar organisation where the fellowship programme is based. Fellowship programmes are normally for at least 12 months, except in particular circumstances. The supervisor should ensure that colleagues the fellow works with are aware that the fellow is a senior trainee. The UK-based pre-CCT potential fellow will need to find out whether the fellowship will be considered Out of Programme for clinical Training (OOPT).
Outcomes and competencies Early in the fellowship, the fellow and their supervisor will discuss and agree a learning agreement. Over the period of their fellowship, the fellows are expected to achieve the learning outcomes (the knowledge, skills and behaviour the fellow is expected to achieve) and clinical competencies (the ability to do something successfully) for their fellowship programme. The programme should also provide opportunities for audit and research. Each programme should have a training structure in place with regular assessments to underpin the fellow’s progress.
Professionalism: Fellows appointed to RCS England Senior Clinical Fellowships will be expected to be ambassadors for RCS England and meet the requirements of the GMC’s Good Medical Practice.
Service and training The expectation is that the fellow’s timetable will enable at least a balance of service and training on the fellowship programme, or where possible more training than service, approximately as follows: Service: clinics, on-call ($); Training: theatre and endoscopy sessions with supervisors, learning activities, audit & research, multi-disciplinary team (MDT) meetings; A mix of service & training: ward rounds.
Operations Each programme has a number of main operations the fellow can expect to be involved in, with, where possible, an indication of the proportion of these which the fellow performs at an independent level. Information on learning outcomes, clinical competencies and expected operation numbers for each fellowship programme is available on the RCS England website. Fellows are required to record their operations using the eLogbook.
Interim feedback About three months after starting their post, the fellow is asked to provide an interim feedback to the RCS Senior Clinical Fellowship Scheme on their experience in the fellowship to date. This feedback is reviewed by the RCS Quality Assurance Operational Group. If there are any causes for concern, the fellowship scheme will look into these as soon as possible and report to the Scheme Chair and the QAOG. Fellows are welcome to submit interim feedback more often to the scheme or contact the Accreditation Department for any concerns.
Fellowship completion When they have completed their fellowship post, the fellow is asked to provide their logbook and final feedback on their experience as a fellow. Their supervisor is asked to provide a sign-off statement about the fellow's achievement of the learning outcomes and clinical competencies required for the fellowship. The supervisor’s sign-off will be informed by the fellow’s performance in assessments and the fellow’s logbook.
Certificate The fellow's final feedback, logbook and supervisor's sign-off are reviewed by the QAOG to determine the award of the fellowship certificate. The information on operation numbers and the fellow’s level of independence in these are used to inform the decision-making process about the award of the Certificate, but the key criterion is whether the fellow is judged to have achieved their learning outcomes and clinical competencies. The Certificate is awarded jointly by the RCS and the appropriate Surgical Specialty Association (SSA); the feedback is shared with the SSAs. The Certificate is signed by the Chair of the RCS Senior Clinical Fellowship Scheme. Fellows who are awarded their Certificate can either receive the Certificate at a RCS England Diplomates' Ceremony or the Certificate will be sent to them. There is an appeal process available to fellows who are not awarded the Certificate after completing their fellowship.
Fellows - Financial support and Applying outside the UK
Although fellows are normally employed on a salary, they often face significant additional expenditure during their fellowship. These costs can include additional accommodation and transport - and training and courses, for which financial assistance is no longer available for Post-CCT Fellows.
Some financial assistance may be available to help with RCS Education courses. The College offers a range of awards, grants and lectureships. Some Surgical Specialty Associations generously provide fellows with financial assistance - it is worth asking the Association for your specialty if any help might be available.
We also provide some guidance on looking for support from charitable trusts and foundations.
Fellows applying outside the UK
About one-third of RCS Senior Clinical Fellows are from European Union countries, and one-third are from other non-EU countries. To work in the UK, Fellows must have the appropriate visa and be registered with the General Medical Council (GMC). Through the Medical Training Initiative’s International Surgical Training Programme, the RCS England may be able to help medical graduates obtain GMC registration, and provide other assistance in enabling non-UK fellows to work in the UK.
Partnerships and Collaborations
RCS England - BESS partnership
This partnership, created between the Royal College of Surgeons of England and the British Elbow and Shoulder Society (BESS), has developed a set of standards required for shoulder and elbow clinical fellowships, including recommended criteria to be met by the unit seeking approval for a fellowship programme, and by the fellow. The criteria to be met by the unit relate to the faculty, the training structure offered, data gathering for the National Joint Registry, research and audit. The criteria to be met by the Fellow relate to professional behaviour, clinical competencies, and research and audit activity. Both the unit and the Fellow are expected to engage with BESS activities, such as attending the Annual Scientific Conference and instructional courses. The recommended criteria to be met by the unit and the fellow are set out in this document as a guideline. The duration of the fellowships will normally be 12 months, but accreditation of the fellow will be possible after a minimum of 6 months if minimum standards have been achieved and the fellowship is terminated early to allow career progression to consultant grade.
Benefits of programme approval under the RCS England – BESS Fellowship partnership
The benefits of fellowship programme approval include:
- Expert review by surgeons in the appropriate specialty
- Assistance in attracting high calibre candidates
- Assurance that posts offer a high quality learning and training experience, reflecting the appropriate standards set by BESS and RCS England
- Interim and final monitoring of fellows’ progress and performance
- Certification of fellows, who can receive their Certificate at a RCS England Diplomates' Ceremony
- Information about the fellowship on the RCS England website
- Use of the RCS England Logo
- Use of the strap line ‘This RCS England Senior Clinical Fellowship post has been approved by the Royal College of Surgeons of England based on criteria recommended by the British Elbow and Shoulder Society’
To apply see the information related to the Senior Clinical Fellowship Scheme application process (these details are described on the Senior Clinical Fellowship Scheme website - section: Applying for fellowship programme).
If the fellowship programme has more than one Fellow there will be an additional annual fee of £ 750 per fellow to accommodate additional workload.
Current Fellowship Schemes
RCS Senior Clinical Fellowships currently approved under the National Fellowship Register:
- General Surgery Fellowships
- Neurosurgery Fellowships
- Oral & Maxillofacial Surgery Fellowships
- Otolaryngology Fellowships
- Paediatric Surgery Fellowships
- Plastic & Reconstructive Surgery Fellowships
- Trauma & Orthopaedic Surgery Fellowships
- Urology Fellowships
On how to apply for a Fellowship Scheme, please visit the section "Information for Supervisors".