RCS Senior Clinical Fellowship Scheme

Main purpose of Fellowship Scheme The RCS Senior Clinical Fellowship Scheme was established in 2012 by the Surgical Specialty Associations (SSAs) and the RCS 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.

Programme approval 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.

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 behaviours 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 Senior Clinical Fellowships will be expected to be ambassadors for the 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 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 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 - simply download and send the completed interim feedback form to qa@rcseng.ac.uk.

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 is 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 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.

Further information please contact qa@rcseng.ac.uk

# At the time of writing, the Trauma & Orthopaedic Specialty Advisory Committee does not review Fellowship programme approval applications. For Fellowship programmes outside the UK and Republic of Ireland, suitable alternatives to the SAC and TPD are requested to review the application.

## Not all Fellowship programmes include an on-call element.

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 someguidance on looking for support from charitable trusts and foundations.

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 RCSEng may be able to help medical graduates obtain GMC registration, and provide other assistance in enabling non-UK Fellows to work in the UK.