General Surgery Fellowships

Based at: Ashford & St Peter’s Hospitals NHS Foundation Trust, Surrey

Surgical Specialty Association approving: BOMSS

Approval period: June 2021 - May 2024

Supervisor / Lead Consultant: Mr Samer Humadi, Consultant Upper GI and Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Demonstrate an understanding of the entire care pathway for patients with severe obesity and metabolic disease, including the stabilisation and management of medical and psychological co-morbidities and the effect this may have on their suitability for surgical intervention.
• Demonstrate an understanding of the treatment options for patients with severe obesity, their modes of action, indications (including knowledge of guidelines and commissioning criteria) and their potential complication profile.
• Demonstrate competence in counselling patients regarding treatment options for the management of severe obesity.
• Demonstrate competence and independence in reading and reporting pH and manometry studies.
• Demonstrate competence and independence in laparoscopic bariatric surgery and complex hiatal surgery.
• Demonstrate an understanding of the longer term follow-up surgery including side effects, complications, the indications for revisional surgery (and associated guidelines and commissioning aspects) and dietary factors, including the guidance on monitoring nutritional status and using nutritional supplementation.
• Demonstrate the ability to work collaboratively with a multi-disciplinary team to develop management plans for patients referred for bariatric surgery and those who develop postoperative complications or need revisional surgery.

Clinical competencies to be achieved:

• Competency in assessing patients presenting for bariatric or anti-reflux surgery.
• Competency in recognising and appropriately referring patients for ongoing assessment as part of a multi-disciplinary team in obesity or reflux disease.
• Competency in performing primary laparoscopic Roux en Y Gastric Bypass, One Anastomosis Gastric Bypass and Sleeve Gastrectomy (Level 4 PBAs).
• Competency in performing primary antireflux and hiatal surgery (Level 4 PBAs for fundoplication).
• Competency in the performance of 10 para-oesophageal hernia repairs and demonstrate the ability to perform independently or train registrars in 10-20 primary anti-reflux surgery.
• Competency in identifying and appropriately managing complications associated with bariatric and anti-reflux surgery.
• Competency in self-review of their recorded laparoscopic procedures and reflection on their operative performance using a deliberate practice model to improve technical performance.

Number of main operations the fellow could expect to be involved in:

• Roux-en-y gastric bypass - involved in 100 (Performed: 50)
• Sleeve gastrectomy - involved in 50 (Performed: 30)
• Primary antireflux surgery / hiatal hernia repair - involved in 30 (Performed: 20)

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Andrew Currie (Apr - Oct 21)

Based at: Western Sussex Hospitals NHS Foundation Trust

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved April 2016; reapproved October 2019 - December 2022; reapproved March 2023 - February 2026

Supervisor / Lead Consultant: Mr Will Hawkins, Consultant Surgeon, with Mr Guy Slater, Prof Chris Pring and Mr Richard Newton, Consultant Surgeons

Fellowship duration: 12 months

The Supervisor says: "We only have one fellowship which runs from October each year for 12 months. The post is advertised through NHS Jobs and applications will only be considered if made through that website (https://www.jobs.nhs.uk/). We usually run our appointment process at the beginning of the year with interviews held in February. We reserve the right to appoint two fellows for consecutive years during one interview process if two appointable candidates are interviewed. Applications will not be considered outside of the formal appointment process."

Stated learning outcomes:

• Demonstrate an understanding of whole patient care of patients with morbid obesity, including the management of their co-morbidities and how this may impact their suitability for surgical intervention.
• Demonstrate an understanding of the therapeutic options for morbid obesity, how they work, the indications for each option (including knowledge of current guidelines on commissioning and choice) and their potential pitfalls/complications.
• Demonstrate an understanding of the long term management of patients following bariatric surgery, including complications, revisional surgery and dietary aspects, including guidelines on the use of dietary supplements and monitoring of nutritional status.
• Demonstrate competence and independence in laparoscopic bariatric surgery (as laid out in the curriculum document) with an understanding of the management of intra-operative complications and when it may be necessary to convert to open surgery.
• Competence in endoscopic evaluation and intervention (including balloon dilatation) following bariatric surgery.
• Demonstrate the ability to counsel patients regarding therapeutic options for the management of morbid obesity as above.
• Engage with the multi-disciplinary team to develop management plans for patients referred for bariatric surgery and those that present with complications or problems post-operatively.

Clinical competencies to be achieved:

• Demonstrate competence and independence in laparoscopic bariatric surgery (as laid out in the curriculum document) with an understanding of the management of intra-operative complications and when it may be necessary to convert to open surgery.
• Competence in endoscopic evaluation and intervention (including balloon dilatation) following bariatric surgery.

Number of main operations the fellow could expect to be involved in:

Target Logbook per annum

The unit offers a range of bariatric operations, but about 85% of primary procedures are primary Laparoscopic Roux-en-Y Gastric Bypass and this will be reflected in the logbook of the fellow.

• Total number of weight loss operations (primary surgeon in >51%) 150;
• Minimum stapling/anastomotic operations 100;
• Minimum revisional 20.

Fellows awarded Fellowship Certificate (dates of Fellowship): 

• Waleed Al-Khyatt (Oct 16 - Oct 17)
• Sumanta Dutta (Oct 17 - Sept 18)
• Richard Newton (Oct 18 - Oct 19)
• Tamir Salih (Oct 19 - Dec 20)
• Saurav Chakravartty (Oct 20 - Oct 21)
  

Fellows' feedback

A summary of final feedback from the five most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x  x 
Strongly agree |  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x  x  x  x
Mostly training |  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4 
5  x  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x
No |

*** vacancies for this Fellowship are advertised via the NHS ***

Based at: Derby Teaching Hospitals Foundation NHS Trust 

Surgical Specialty Association approving: BOMSS

Approval period: July 2018 - June 2023

Supervisor / Lead Consultant: Mr Sherif Awad, Consultant Upper GI and Bariatric Surgeon, with Mr Waleed Al-Khyatt, Consultant Upper GI & Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Assessment and management of the morbidly obese patient.
• Knowledge of the therapeutic options for morbid obesity and revisional metabolic surgery.
• Long term management of post-operative bariatric patients.
• The management of complications and emergency presentation of patients following metabolic surgery.
• Operative skills:
• Laparoscopic access & suturing.
• Roux en-Y Gastric Bypass and one-anastomosis gastric bypass.
• Sleeve gastrectomy.
• Removal of and management of gastric band.
• Operative and non-operative management of bariatric emergencies.
• Revisional surgery for morbid obesity.

Clinical competencies to be achieved: see learning outcomes above

Number of main operations the fellow could expect to be involved in:

• Main Surgeon/supervised (MS) in 30 bypasses, and 15 as an independent operator (IO)
• Sleeves: MS 20, IO 10
• Band insertions/removals: MS 10, IO 5

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Biborka Bereczky (Mar 18 - Mar 19)
• Sylvia Krivan (May 19 - Sept 20)

Based at: Imperial College Healthcare NHS Trust, London

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved February 2013; reapproved December 2016; reapproved March 2020 - May 2023

Supervisor / Lead Consultant: Mr Ahmed Ahmed, Consultant Upper GI and Bariatric Surgeon, with Mr Krishna Moorthy, Consultant Obesity Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Perform primary bariatric procedures independently. Minimum - 50 gastric bypasses, 25 sleeve gastrectomies and 25 bands.
• Can perform pre-operative patient seminars, assessments and counselling independently.
• Accurately recognise and manage post-operative complications.
• Accurately recognise and optimise pre-operative co-morbidities.
• Patient selection and guiding patients through the various surgical procedures.
• Patient safety and development and adherence to peri-operative protocols.
• At least 3 audit projects and contribute to 2 research projects.

Clinical competencies to be achieved:

• Independent competent performance of primary bariatric procedures.
• Supervised performance of emergency and revision bariatric procedures.
• Case selection and optimisation of patients in the pre-operative period.

Number of main operations the fellow could expect to be involved in: see learning outcomes.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Naim Fakih Gomez (Oct 15 - Oct 16)
• Haris Markakis (Oct 16 - Nov 17)
• James Clark (Oct 17 - Oct 18)
• Sami Mansour (Oct 18 - Oct 19)

Fellows' feedback

A summary of final feedback from the four most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x  x  x
Mostly training |  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x
No |

Based at: Luton & Dunstable University Hospital NHSFT

Surgical Specialty Association approving: BOMSS

Approval period: First approved February 2013; reapproved September 2019 – November 2022

Supervisor / Lead Consultant: Mr Omer Al-Taan, Consultant Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• The fellow will be expected to assess a new bariatric patient referred for surgery so as to be able to lay out a suitable management pathway for the individual and anticipate difficulties.
• The fellow will be able to independently perform straightforward Gastric Sleeve and Gastric Bypass (Roux en Y and single anastomosis) operations.
• The fellow will be able to manage postoperative bariatric patients and be able to recognise complications and have a plan to deal with these with help from senior colleagues.
• The fellow will be able to analyse the roles of various members of MDT in relationship to an individual patient.
• The fellow will be able to critically analyse and appraise relevant literature in the field of bariatric surgery.

Clinical competencies:

• To safely perform all steps of operation independently in a Gastric Bypass and recognise and deal with post-operative complications
• To safely perform all steps of operation independently in a Sleeve Gastrectomy and recognise and deal with post-operative complications
• To be able to recognise and manage post-operative complications
• To be able to assess patients for Bariatric surgery before surgery and during follow up
• To understand the role of each member of MDT in Bariatric Surgery

Number of main operations the fellow could expect to be involved in:

Target Logbook per annum

The number expected for the fellows in our unit are (per year):

• Total number of cases to be involved in: 100 to 125
• Gastric bypass as the main operator: 30 to 50
• Sleeve gastrectomy as the main operator: 30 to 40
• Revisional surgery as the main operator: 10 to 20
• Band insertion/ removal as the main operator: 10 to 20

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Md Tanveer Adil (Jul 18 - Aug 19)
• Ravi Mamidanna (Oct 19 - Dec 20)

Based at: Taunton & Somerset NHS Foundation Trust

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved February 2013; reapproved April 2017; reapproved February 2021 - January 2024

Supervisor / Lead Consultant: Mr Richard Welbourn, Consultant UGI and Bariatric Surgeon, with Mr Hamish Noble, Lead Clinician UGI & Bariatrics

Fellowship duration: 12 months

Stated learning outcomes:

• Management of the patient who is morbidly obese and an understanding of the surgical treatment of morbid obesity including early and late complications.
• Knowledge of the different patterns of presentations of complications.
• To gain experience in at least two bariatric procedures and receive mentorship through the learning curve.
• Produce work of scientific value in the field of bariatric surgery.
• Engage in teaching junior medical staff and allied healthcare professionals.

Clinical competencies to be achieved: Please see the knowledge, clinical skills, technical skills and attributes sections of the curriculum (available from supervisor)

Number of main operations the fellow could expect to be involved in:

TARGET LOGBOOK (per 12 months):

• Total number of weight loss operations (primary surgeon in >51%) 100
• Minimum stapling/anastomotic operations: 50 as principal operator
• Minimum banding: 10 as principal operator
• Minimum revisional (level 2): 5 as principal operator

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Hazem Al-Momani (Oct 14 - Oct 15)
• James Hopkins (Oct 15 - Apr 16)
• Omer Al-Taan (Apr 16 - Oct 16)
• Dimitrios Pournaras (Oct 16 - Sept 17)
• Peter Mekhail (Oct 17 - Oct 18)
• Andrew Robertson (Oct 18 - Sept 19)
• Thomas Wiggins (Oct 19 - Sept 20)
• Roel Bolckmans (Oct 20 - Sept 21)

Fellows' feedback

A summary of final feedback from the six most recent completing fellows providing full feedback:

1. Learning outcomes

“I achieved all of the learning outcomes as specified in my learning agreement.”

Strongly disagree |
Disagree |
Neither agree nor disagree |  x
Agree |  x
Strongly agree |  x  x  x  x

2. Service : Training balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x  x
More training than service |
Mostly training |  x  x  x  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3  x
4
5  x  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x  x
No |

Based at: North Bristol NHS Trust

Surgical Specialty Association approving: BOMSS

Approval period: July 2018 - September 2021; reapproved October 2021 - September 2024 

Supervisor / Lead Consultant: Mr James Hewes, Consultant and Lead Bariatric Surgery, with Mr Alan Osborne, Consultant UGI and Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• History taking, examination, appropriate investigations to identify patients who benefit from bariatric surgery.
• Present the case and discuss in bariatric MDT and select appropriate bariatric procedure.
• Patient counselling, consent and preoperative preparation.
• Perform laparoscopic gastric band insertion competency ¾.
• Perform Laparoscopic sleeve gastrectomy competency ¾.
• Perform Laparoscopic roux-en-y gastric bypass competency ¾.
• Identify early and delayed postoperative complications, arrange appropriate investigations and management.
• Outpatient follow up and assessment.
• Deflating, filling, laparoscopic adjustment and removal of the gastric band.
• Communicate and liaise with a specialist nurse, dietician and psychologist.

Clinical competencies to be achieved:

• Able to assess morbidly obese patients for treatment
• Recommend the most suitable treatment and discuss this in MDT meeting
• Counselling patients and consenting
• Postoperative assessment and follow up
• Management of complications

Number of main operations the fellow could expect to be involved in:

Supervisor: “The aim is to provide an opportunity for the fellow to perform at least 30 laparoscopic roux en y gastric bypass, 20 laparoscopic sleeve gastrectomy and 15 gastric band-related procedures in one year. Assessments from ISCP are used to rate competency. Where a candidate has a longer learning curve, more time and number of procedures will be considered at appraisal.”

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Samer Zino (Oct 19 - Mar 20)
• Haritharan Nageswaran (Oct 20 - Jul 21)

Based at: University Hospitals of North Midlands NHS Trust

Surgical Specialty Association approving: BOMSS

Approval period: October 2021 - September 2024

Supervisor / Lead Consultant: Mr Alistair Sharples, Consultant Upper GI and Bariatric Surgeon, with Mr Nagammapudur Balaji, Consultant Upper GI & Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To understand the management of obesity and metabolic disorders associated with obesity and to understand the role of surgical management in the treatment of these patients
• To understand the preoperative assessment and workup of patients undergoing bariatric surgery
• To gain substantial experience within bariatric surgery with the aim, by the end of the fellowship, of being confident to independently perform common primary bariatric procedures (predominantly gastric bypass and sleeve gastrectomy)
• To gain a basic understanding of the principles behind revisional surgery and to gain operative experience of these procedures
• To understand common bariatric complications and emergencies and the development experience of their medical and surgical management
• Complete research and audit projects to be presented nationally or internationally and/or published

Clinical competencies:

• The fellow will be afforded graduated responsibilities in the operating theatre, outpatient clinic and MDT environment. Early, the fellow will assist and also perform portions of procedures commensurate with skill level. As the fellow progresses, he or she will gradually take on the role of primary operator. Similarly in the outpatient clinic, the fellow will initially shadow and progress to managing the clinic flow.
• The fellow will be expected to review patients in the perioperative period. This fellowship will have two inpatient sites. The fellow will operate at County Hospital, in Stafford (Monday, Tuesday and Wednesday) and the Royal Stoke University Hospital on Fridays. The fellow will then join, and later run, a bariatric clinic at County Hospital on a Thursday morning.

Number of main operations the fellow could expect to be involved in:

• Gastric bypass (min 75)
• Sleeve gastrectomy (min 20)
• Gastric band removal (min 5)
• Revisional bariatric surgery (min 5)

Based at: Wirral University Teaching Hospital and Alexandra Hospital Manchester.

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved December 2022 – November 2025

Supervisor / Lead Consultant: Professor David Kerrigan, Consultant Surgeon and Medical Director of Phoenix Health Ltd

Fellowship duration: 12 months

Stated learning outcomes:

• Demonstrate an understanding of the principles of safe bariatric practice.
• Demonstrate an understanding of preoperative assessment, procedure selection, international guidance on patient selection, patient counselling, management of common co-morbid conditions and consent for surgery.
• Demonstrate an understanding of the principles and practice of laparoscopic gastric banding, gastric bypass and sleeve gastrectomy including dealing with common intra-operative difficulties.
• Demonstrate the ability to perform laparoscopic gastric banding, gastric bypass and sleeve gastrectomy safely and correctly.
• Demonstrate an understanding of the principles and practice of complex and revisional surgery.

Clinical competencies to be achieved:

• Demonstrate the ability to safely assess bariatric patients for bariatric surgery with special emphasis on compliance with national guidelines, appropriate counselling and choice of the operative procedure, implications of obesity related co-morbidity, psychological issues and optimisation of concurrent medical problems.
• Demonstrate the ability to safely manage post-operative bariatric patients in the outpatient setting with special emphasis on database and information management, gastric band adjustments, early identification of common problems (e.g. gastrojejunal stenosis), optimising weight-loss outcomes, nutritional follow-up and dietary advice.
• Demonstrate an understanding of the principles of safe bariatric practice.
• Demonstrate an understanding of the principles and practice of laparoscopic adjustable gastric banding including dealing with common intra-operative difficulties.
• Demonstrate the ability to perform laparoscopic gastric banding safely.
• Demonstrate the ability to perform gastric band fills and fluoroscopic investigations (and interpret results).
• Demonstrate an understanding of the principles of post-surgical care of the bariatric patient.
• Demonstrate an understanding of the principles and practice of laparoscopic gastric bypass including dealing with common intra-operative difficulties.
• Demonstrate the ability to perform a laparoscopic gastric bypass safely and correctly (incorporating jejuno-jejunostomy, gastrojejunostomy and Petersen space closure)
• Demonstrate an understanding of the principles and practice of laparoscopic sleeve gastrectomy including dealing with common intra-operative difficulties.
• Demonstrate an understanding of the principles and practice of complex and revisional surgery
• It is accepted that fellows will not perform complex (duodenal switch) and revisional laparoscopic surgery. Revisional surgery is a spectrum of procedures encompassing emergencies (such as gastric band unbuckling/removal for slippage) and elective work (such as conversion of gastric band to gastric bypass). Fellows will be exposed to these procedures and expected to appreciate the techniques involved. Fellows should be competent in the pre- and postoperative management of these patients. This module will provide fellows with a solid clinical framework for the future development of revisional surgical competence as their experience grows.

Number of main operations the fellow could expect to be involved in:

• Major bariatric procedures (RYGB, OAGB, Sleeve and Revisional) = 547pa
• Operating experience as Primary Operating Surgeon (per Fellow - NB We run two Fellowships simultaneously) = 76 major cases pa each

Fellows will be required to complete mandatory Interim and Final Feedback as per RCS monitoring protocol.

Based at: Royal Cornwall Hospital NHS Trust

Surgical Specialty Association approving: BOMSS

Approval period: February 2021 - January 2024

Supervisor / Lead Consultant: Mr James Clark, Consultant Upper GI and Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Perform primary bariatric procedures independently. Minimum – 30 gastric bypasses, 20 sleeve gastrectomies and 5 bands.
• Perform Hiatal hernia / antireflux surgery independently. Minimum – 20.
• Perform Elective and Emergency Laparoscopic Bile Duct exploration with competency in using Laparoscopic Ultrasound On-table Cholangiogram.
• Can perform pre-operative patient seminars, assessments and counselling independently.
• Accurately recognise and manage post-operative Bariatric / Hiatal and Biliary complications.
• Accurately recognise and optimise pre-operative co-morbidities.
• Patient selection and guiding patients through the various surgical procedures.
• Patient safety and development and adherence to peri-operative protocols.

Clinical competencies to be achieved:

Operative outcomes as an independent primary surgeon / total cases experienced:

• Roux en Y Gastric Bypass 30 / 100
• Sleeve Gastrectomy 20 / 50
• Laparoscopic Gastric Band 10 / 20
• Laparoscopic Primary Hiatus hernia repair 20 / 40
• Laparoscopic Giant Paraoesophageal hernias 5 / 15
• Laparoscopic Bile Duct Exp. 15 / 30

Number of main operations the fellow could expect to be involved in:

See above

Based at: Shrewsbury and Telford Hospital NHS Trust

Surgical Specialty Association approving: BOMSS

Approval period: May 2020 - April 2024

Supervisor / Lead Consultant: Mr Manel Riera, Consultant Upper GI and Bariatric Surgeon, with Mr Rajesh Jain, Consultant Upper GI and Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To manage patients within a multidisciplinary environment.
• To become competent in common bariatric operations, particularly sleeve gastrectomy and gastric bypass.

Clinical competencies to be achieved:

• History and examination of the obese patient.
• Interpretation of Investigations in the obese patient.
• Decision making processes within the multidisciplinary team.
• Assessment of the post-operative bariatric patient.
• Assessment and management of early and late complications of morbid obesity, as well as common bariatric emergencies.

Number of main operations the fellow could expect to be involved in:

• Laparoscopic gastric bypass: Total: 35; Performed: 15
• Laparoscopic sleeve gastrectomy: Total: 35; Performed: 15
• Laparoscopic gastric band removal: Total: 20; Performed: 5
• Endoscopic gastric balloon placement/removal: Total: 15; Performed: 10
• Bariatric emergencies: Total: 20; Performed: 5

Based at: City Hospitals Sunderland NHS Foundation Trust

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved September 2012; reapproved February 2016; reapproved June 2019 - August 2022

Supervisor / Lead Consultant: Mr William Carr, Consultant General Surgeon, with Mr Peter Small, Consultant General Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To medically and surgically assess patients presenting for weight loss surgery.
• To obtain appropriate opinions on associated medical, psychological and psychiatric conditions likely to affect surgical outcomes.
• To learn and practice surgical skills required to perform bariatric surgery.
• To monitor patient progress through their surgical journey and respond appropriately to deviation from the expected path.
• To identify problems in the longer term and investigate appropriately.

Clinical competencies to be achieved:

• To assess patients presenting for bariatric surgery
• To recognise and appropriately refer patients for ongoing assessment as part of a multi-disciplinary team
• To gain surgical skills for the more common bariatric procedures
• To identify and appropriately manage complications associated with bariatric surgery

Number of main operations the fellow could expect to be involved in:

Involvement in over 100 primary bariatric cases and 15 revisions with a performance of over 50 over 12 months depending on progression.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Jamie Young (Oct 12 - Apr 13)
• Chiragkumar Parikh (Apr 13 - Oct 13)
• John Bennett (Oct 14 - Sept 15)
• Brijesh Madhok (Oct 15 - Oct 16)
• Alastair Reid (Oct 17 - Sept 18)
• Nehemiah Samuel (Oct 18 - Oct 19)
• Tarek Katbeh (Sept 19 - Mar 20)
• Ahmed Ahmed (Oct 20 - Sept 21)

Fellows' feedback

A summary of final feedback from the six most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement.”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x  x  x
Strongly agree |  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |  x
About equal |  x  x  x
More training than service |  x
Mostly training |  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x  x  x
5  x  x  x 

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x  x
No |

Based at: University College London Hospitals NHS Foundation Trust

Surgical Specialty Association approving: BOMSS

Approval period: Initially approved November 2012; reapproved March 2019 - May 2022

Supervisor / Lead Consultant: Mr Marco Adamo, Consultant General Surgeon, with Mr Mohamed Elkalaawy, Bariatric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• 50 elective bariatric operations every six months and to have a primary role in at least 20% of those.
• Assess at least 25 new bariatric patients, 50 follow up patients and prepare 100 patients for discussion at the multidisciplinary meeting.

Clinical competencies to be achieved:

• clinical management of bariatric patients;
• technical proficiency in most laparoscopic bariatric procedures.

Number of main operations the fellow could expect to be involved in:

See Learning Outcomes.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Richard Thompson (Oct 14 - Oct 15)
• Jihène El Kafsi (Oct 16 - Oct 17)
• Andrei Ilczyszyn (Oct 18 - Oct 19)

Fellows' feedback

A summary of final feedback from the four most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x  x  x
Strongly agree |  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x
More training than service |  x  x
Mostly training |  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x
No |

Based at: Western Sussex Hospitals NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI

Approval period: First approved January 2018; reapproved June 2021 - May 2024

Supervisor / Lead Consultant: Mr Guy Harris, Consultant General, Colorectal and Laparoscopic Surgeon, with Miss A.J. Skull, Consultant General, Colorectal and Laparoscopic Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• PBA assessment level 4 throughout all index operative scenarios
• Audit projects completed
• Research publication completed
• Reaching objectives reached

Clinical competencies to be achieved:

• PBA assessment level 4 throughout all index operative scenarios
• Operative logbook to have achieved a minimum of 40 right and left sided resections

Number of main operations the fellow could expect to be involved in:

The unit offers a range of colorectal operations and this will be reflected in the logbook of the fellow.

• A total number of laparoscopic resections anticipated: 130.
• Minimum stapling/anastomotic operations anticipated: 110.
• Minimum revisional colorectal operations anticipated: 20.

Expected number as primary operator - assisted at times by the trainer:

• Anterior Resection: 30
• Right Hemicolectomy: 25
• Low Anterior Resection: 15
• Reversal of Hartmann's: 10
• Left Hemicolectomy: 5
• Extended Right Hemicolectomy: 5
• Total Colectomy and IRA: 5

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Mohammad Hassan Mobasheri (Apr 18 - Oct 18)
• Adam Kimble (Oct 18 - Mar 19)
• Eimear Monaghan (May 19 - Mar 20)
• Syed Mohammed Ali (Apr 20 - Oct 21)

Fellows' feedback

A summary of final feedback from the four most recent completing Fellows

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |  x  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x
Mostly training |  x  x  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4
5  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x
No |

Based at: The Christie NHS Foundation Trust, Manchester

Surgical Specialty Association approving: ACPGBI - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: March 2020 – May 2023

Supervisor / Lead Consultant: Professor Sarah O’Dwyer, Clinical Professor of Surgery and Consultant Colorectal and Peritoneal Surgeon, with Mr Hamish Clouston, Colorectal and Peritoneal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

The Supervisor states:

“By the end of the fellowship the fellow will have the knowledge, clinical and technical skills in the management of Advanced Pelvic Malignancy. This is to a level to allow them to work as a consultant within a multi-disciplinary team undertaking surgery for advanced pelvic malignancy.

The fellow is expected to understand the surgical and non-surgical management of advanced pelvic malignancy, including the indications for neoadjuvant treatments. A detailed understanding of the anatomy of the pelvic area is expected and the significance of this anatomy in extended surgical resections.

The fellow is expected to have acquired a high level of clinical skills, both in management planning but also in communication with patients and their relatives when discussing the indications and consequences of surgery for advanced pelvic malignancy. The clinical knowledge extends to understanding the impact of patient safety when undertaking pelvic procedures. The fellow is expected to be able to partake in an MDT process to identify patients who are suitable for pelvic surgery, including recognising the need for additional expertise / clinical specialties.

Targeted outcomes in parallel with objectives: evaluation of progress through the 12 month programme at 3 monthly intervals to assure final outcomes are on target.”

Clinical competencies to be achieved:

• Advanced communication skills.
• Treatment pathway selection for patients with advanced colorectal cancer.
• Multispecialty operating as part of a pelvic oncology team.
• Multivisceral pelvic resection.
• Radical abdominoperineal resection with reconstruction.
• Cytoreduction and HIPEC.

Number of main operations the Fellow could expect to be involved in:

The Supervisor states:

“From activity figures over 350 complex and major surgical procedures are undertaken each year. The unit hosts five fellows with equal opportunities to engage in the unit activities. A realistic expectation would be for the fellow to engage with 50-70 complex and major cases as first assistant / supervised surgeon.”

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Sarah Hassan (Oct 20 - Oct 21)

Based at: Frimley Park Hospitals NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: Initially approved September 2014; reapproved March 2019 - May 2022; reapproved December 2022 November 2025

Supervisor / Lead Consultant: Mr Henry Tilney, Consultant Laparoscopic and Robotic Colorectal Surgeon, and Mr A Shiyam Nizar, Consultant Laparoscopic and Robotic Colorectal Surgeon

Fellowship duration: 6 months

Stated learning outcomes:

• Practical based learning and continual assessment using GAS forms. It is expected the trainee will be able to perform right hemicolectomy, high anterior resection and splenic flexure mobilisation without direct supervision by the end of the Fellowship. TME and pouch surgery have a long learning curve - the trainee will be in a position to develop those skills, operate independently on the more straightforward cases but also be in a position to improve skills further with joint consultant operating.
• Exposure to Robotic Colorectal Surgery and Transanal Endoscopic surgery is also available.
• Support will be given to obtain JAG Colonoscopy accreditation by the end of the Fellowship.
• To have developed the necessary practical, personal, professional and communication skills for independent practice.

Clinical competencies to be achieved:

• Demonstrate excellent communication skills with patients, relatives and colleagues.
• Demonstrate high quality patient selection and preoperative preparation. Have a full understanding of the enhanced recovery programme and be alert to potential postoperative complications
• Learning Objectives ¨ Develop experience in advanced laparoscopic colorectal surgery. It is anticipated that at the end of the 6 month period, the appointee will have performed or assisted with approximately 75 major laparoscopic procedures. It is expected that by the end of the period they will be capable of independent Consultant practice in this area". Develop experience in the training of less experienced surgeons in basic laparoscopic colorectal procedures.
  

Number of main operations the fellow could expect to be involved in:

It is anticipated that at the end of the 6 month period, the appointee will have performed or assisted with approximately 75 major laparoscopic procedures, and will be capable of independent Consultant practice in this area. Fellows are also expected to develop experience in the training of less experienced surgeons in basic laparoscopic colorectal procedures.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Christopher Nicolay (April - Oct 19)
• Nicholas Battersby (Oct 19 - Mar 20)
• Jeremy Huddy (Oct 20 - April 21)

Fellows' feedback

A summary of final feedback from the three most recent completing Fellows providing full feedback

Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x

Service : Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |
Mostly training |  x  x  x

Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4
5  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x
No |

Based at: NHS Greater Glasgow and Clyde, Glasgow Royal Infirmary

Surgical Specialty Association approving: ACPGBI - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: May 2020 - August 2023

Supervisor / Lead Consultant: Mr Peter Chong, Consultant Colorectal and Sarcoma Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To develop operative skills in advanced pelvic oncology with a focus on resectional and reconstructive techniques and the development of consultant level intra-operative decision making.
• To develop decision making skills in the pre-surgical selection of patients suitable beyond TME/ exenterative surgery.
• To develop multi-disciplinary/ cross-speciality team working skills essential for complex pelvic oncology clinical case management including an awareness of adjuvant therapies and interventions provided by other disciplines.
• To gain experience and understanding of the complexities in the preoperative and perioperative care required by patients with complex pelvic malignancies.
• To appreciate the importance of clinical audit and quality improvement projects applicable to complex pelvic surgical oncology.
• To participate in at least one clinical research project resulting in national level presentation and/ or publication.
• To participate in the department’s programme of undergraduate and postgraduate teaching.
• To contribute to the Monday educational meeting and the surgical grand rounds.

Clinical competencies to be achieved:

• To develop operative skills in advanced pelvic oncology with a focus on resectional and reconstructive techniques and development of consultant level intra-operative decision making.
• To develop decision making skills in the pre-surgical selection of patients suitable for beyond TME/ exenterative surgery.
• To develop multi-disciplinary/ cross-speciality team working skills essential for complex pelvic oncology clinical case management including an awareness of adjuvant therapies and interventions provided by other disciplines.
• To gain experience and understanding of the complexities in the preoperative and perioperative care required by patients with complex pelvic malignancies.

Number of main operations the fellow could expect to be involved in:

• Multivisceral pelvic resections / exenterations: Total: 50; Performed: 15
• Laparoscopic Colorectal Resections: Total 30; Performed: 20
• Gyn Oncology combined colon / rectal resections: Total: 30; Performed: 15
• Emergency Laparotomy: Total: 40-50; Performed: 30

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Alistair Geraghty (Aug 2020 - Aug 2021)

Based at: Leeds Teaching Hospitals NHS Trust

Surgical Specialty Association approving: ACPGBI - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: March 2021 - February 2024

Supervisor / Lead Consultant: Mr Rick Saunders, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

The Supervisor states:

“Our high volume and complex case mix, particularly with an in-house liver transplant, tertiary referral oncology and regional referral gastroenterology units, provides fellows with a fairly unique experience that will equip them with advanced skills and experience in IBD surgery, allowing them to compete for jobs in high-quality centres.”

Clinical competencies to be achieved:

• Re-operative Crohn’s resection
• Ileal pouch surgery: selection, counselling, operative skills and post-operative management of complications
• laparoscopic panproctocolectomy
• intersphincteric dissection
• complex perianal Crohn’s disease
• nutrition and intestinal failure

Number of main operations the Fellow could expect to be involved in:

The Supervisor states:

“Minimum expected cases:

• 6 pouch procedures including proctectomy
• 12 Crohn’s resections
• 12 colectomies for colitis (10 laparoscopic)
• 10 anterior resections
• 3 APER

The Fellow could expect to be a primary surgeon in (depending on the competence of the fellow) but minimum 50%, likely 80%, max 100%.”

Based at: Royal Liverpool University Hospital

Surgical Specialty Association approving: ACPGBI

Approval period: October 2021 - September 2024

Supervisor / Lead Consultant: Mr Shakil Ahmed, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• The fellow is expected to have acquired a high level of clinical skills, both in management planning but also in communication with patients and their relatives when discussing the indications and consequences of surgery. The clinical knowledge extends to understanding the impact of patient safety when undertaking colorectal laparoscopic and robotic procedures. The fellow is expected to be able to partake in a MDT process to identify patients who are suitable for different approaches, including recognising the need for additional expertise / clinical specialties.
• Targeted outcomes in parallel with objectives: evaluation of progress through the 12 month programme at 3 monthly intervals to assure final outcomes are on target. Practical based learning and continual assessment using GAS forms. It is expected the trainee will be able to perform laparoscopic right, left and rectal resections independently by the end of the fellowship.
• Assess and select appropriate cases for local excision in Early Rectal cancer.
• Maximum exposure to Robotic Colorectal Surgery and Transanal Endoscopic surgery with an adequate skill set to develop independent practice in future.
• Support will be given to continue Colonoscopy services and develop expertise in more complex procedures if desired by the end of the Fellowship.
• To have developed the necessary practical, personal, professional and communication skills for independent practice.
• To develop an in-depth understanding of, and the ability to manage standard and advanced colorectal cases.
• Ability to train more junior trainees in principles of laparoscopic colorectal surgery.
• Participate in research and audit within the department with an expectation of peer-reviewed publication.
• Participate in a busy emergency general surgical on-call rota with exposure to a high number of emergency laparotomies.
• Audit projects completed.
• Research publication completed.
• Teaching objectives reached.

Clinical competencies to be achieved:

• PBA assessment level 4 throughout all index operative scenarios
• Operative logbook to have achieved a minimum of - right and - sided resections
• Advanced communication skills
• Demonstrate excellent communication skills with patients, relatives and colleagues
• Demonstrate high quality patient selection and preoperative preparation. Have a full understanding of the enhanced recovery programme and be alert to potential postoperative complications
• Competent, safe and independent operative to undertake laparoscopic colon resections
• Competent, safe and independent to undertake laparoscopic anterior resection/total mesorectal excision
• Assessment and management of complications of colorectal resections
• Ability to assess patients with complex colorectal pathology and plan surgery and aftercare.
• Participate in on-call rota in a busy unit

Number of main operations the Fellow could expect to be involved in:

From activity figures, over 300 complex and major colorectal procedures are undertaken each year. The unit undertakes over 50 robotic resections in a year and a realistic expectation would be for the fellow to engage with all robotic cases as a first assistant or on the console as an operating surgeon under supervision.

Following are estimated numbers for various procedures the fellow will be expected to achieve in 12 months:

• Laparoscopic/robotic anterior resection/TME – 40-50
• Laparoscopic/robotic colonic resections – 50-70
• Laparoscopic/robotic ventral mesh rectopexy - 25
• Advanced Colonoscopies – 100
• Pelvic exenteration – 25-30
• TEMS - 50
• Emergency general surgical procedures: numerous.

The Fellowship aims to provide laparoscopic resections during the course of the Fellowship that the fellow would complete independently (supervisor present) and this would allow the Fellow to achieve the level of competency expected at the start of a Consultant post. Fellows are also expected to develop experience in the training of less experienced surgeons in basic laparoscopic colorectal procedures.

Based at: Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI

Approval period: October 2019 – December 2022

Supervisor / Lead Consultant: Prof Alan Horgan, Consultant Colorectal Surgeon

Fellowship duration: 6 - 12 months

Stated learning outcomes:

• The Primary Outcome is to develop the clinical, personal, professional and communication skills necessary for independent practice as a consultant.
• Understanding the spectrum of presentation of Colorectal diseases, their workup and management.
• Understanding correct patient selection for the appropriate procedure.
• Understanding the importance of positioning and correct use of energy and stapling technology.
• Understanding how to solve problems and overcome common challenges safely in the Operating Theatre.
• Understanding the importance of MDT meetings and the ability to formulate treatment plans in that setting, utilising guidelines and best evidence.
• Understanding and familiarising oneself with the principles and applications of Robotic platforms in surgery.
• To participate in at least one research project, leading to presentation or publication.
  

Clinical competencies to be achieved:

• Ability to perform Segmental Resections including splenic flexure mobilisation independently. (Level 4b)
• Ability to perform average difficulty TME independently. (Level 4b)
• Ability to assess and manage Complications.
• Ability to lead, support, effectively communicate with and involve other team members in daily work and decision making.
• Support will be given to achieve JAG Colonoscopy accreditation, if required, by the end of the fellowship.
• Ability to assist (Robot docking and bedside) and perform certain steps in Robotic resections using a modular approach, subject to completing the necessary learning modules.

Number of main operations the Fellow could expect to be involved in:

Over 6 months:

• Laparoscopic Segmental Colectomy (Right/Left): Total: 20; Perform: 17
• Laparoscopic Anterior Resection (TME): Total: 15; Perform: 12
• Laparoscopic Sub-Total Colectomy: Total: 5; Perform: 4
• Abdomino-Perineal Excision: Total: 5; Perform: 4
• Ileo-Anal Pouch: Total: 2 - 5; Perform: 2
• Multi-visceral Resections: Total: 5; Perform: 2
• Robotic Anterior Resection (TME): Total: 15; Perform: 5
• Parastomal Hernia Repair (Laparoscopic/open): Total: 5 - 10; Perform: 5 - 10
• Laparoscopic Inguinal and Ventral Hernia Repair: Total: 20; Perform: 17
• Day Case Lower GI procedures: Perform: 30 - 40
• Colonoscopy: Perform: 30 - 40

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Haseeb Khokhar (Nov 19 - May 20)
• Mohamed Shaban (Sept 20 - Jul 21)

Based at: North Bristol NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: First approved April 2016; reapproved November 2020 - October 2023

Supervisor / Lead Consultant: Ms Caroline Burt, Colorectal Consultant, with Ms Ann Lyons, Consultant Colorectal Surgeon and Lead for Colorectal Cancer

Fellowship duration: 12 months

Stated learning outcomes:

• In-depth knowledge/ ability to manage colorectal patients.
• Ability to perform independent colorectal operations (but supported as needed during post).
• Ability to perform therapeutic colonoscopy independently.

Clinical competencies to be achieved:

• 50 laparoscopic colorectal cases in 12 months.
• 100 colonoscopies in 12 months.
• 25.8.15 organiser added: “The cases indicated under ‘Clinical Competency to be achieved’ in the application form do not comprise the whole anticipated caseload for the Fellow … we have not given specific numbers for the fellow to perform procedures such as ventral mesh rectopexies, ileo-anal pouches, extra-levator abdomino-perineal resections as we anticipate biasing the successful applicant’s operative exposure depending on whether they are pursuing a pelvic floor, rectal cancer or IBD sub-specialty interest. Please see the ‘caseload’ attachment to give an indication of numbers of such procedures performed by the department. We anticipate the fellow would perform the majority of sub-speciality complex procedures as a supervised operator with the trainer scrubbed and teaching – but an appropriately experienced and senior fellow might proceed to have his or her trainer unscrubbed in theatre, and then teaching more junior trainees, in preparation for their next step to a consultant post.”

Number of main operations the fellow could expect to be involved in:

• Anterior resection - 20
• ELAPE - 2
• Laparoscopic colonic resections - 14
• Ileo-anal pouch procedure - 4
• Procedures for prolapse - 8
• Colonoscopies - 50

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Isileli Tonga (Nov 2017 - Oct 2018)
• Roel Bolckmans (Oct 2018 - Oct 2019)
• Sandeep Singh (Oct 19 - Oct 20)
• Huw Jones (Oct 20 - Apr 21)

Fellows' feedback

A summary of final feedback from the five most recent completing Fellows providing full feedback.

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement.”

Strongly disagree |
Disagree |  x
Neither agree nor disagree |
Agree |  x  x  x  x
Strongly agree |

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x  x  x  x  x
More training than service |
Mostly training |

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x  x  x  x  x
5

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x
No |

Based at: North Middlesex University Hospital NHS Trust, London

Surgical Specialty Association approving: ACPGBI

Approval period: Initially approved June 2013; reapproved April 2016; reapproved September 2019 - November 2023

Supervisor / Lead Consultant: Mr Lee Dvorkin, Consultant Colorectal Surgeon & Clinical Director for Surgery, with Mr Romesh Navaratnam, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Proficiency in Laparoscopic colorectal surgery to enable the candidate to practice at Consultant level.
• To develop an in-depth understanding of, and the ability to manage standard and advanced colorectal cases.
• Proficiency in the management of faecal incontinence and competency in neuromodulation techniques.
• Proficiency in the management of patients with fistula-in-ano.

Clinical competencies to be achieved:

• To learn a safe and reproducible technique for laparoscopic colon and rectal mobilisation and anastamosis.
• Independent proficiency in tibial and sacral nerve stimulation.
• An advanced understanding of fistula in ano surgery including; seton surgery, the LIFT procedure, advancement flaps and laying open techniques.

Number of main operations the fellow could expect to be involved in:

• Fistula Surgery: Total: 40; Performed: 15
• Right hemicolectomy / ileocaecal resection: Total: 20; Performed: 15
• Left sided and rectal resection: Total: 15; Performed: 10
• TAMIS: Total: 10; Performed: 3
• Colonoscopy/OGD: Total: 100; Performed: 60
• Other proctological procedures: Total: 50; Performed: 30
• Ano-rectal physiology and PTNS also offered
• Emergency general surgical procedures: numerous

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Manoj Nair (Apr 13 - Apr 14)
• Aikaterini Leventi (Oct 15 - Oct 16)
• Alessandra Lazzaro (Oct 17 - Oct 18)
• Dinesh Balasubramaniam (Nov 18 - Oct 19)
• Mahmoud Elnaggar (Oct 19 - Sept 21)

Fellows' feedback

A summary of final feedback from the four most recent completing Fellows.

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement.”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x  x
Strongly agree |  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x  x  x
More training than service |  x
Mostly training |

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4
5  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x
No | 

Based at: North West Anglia NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI

Approval period: Initially approved September 2012; reapproved April 2016; reapproved November 2020 - October 2023

Supervisor / Lead Consultant: Mr Rohit Makhija, Consultant Colorectal Surgeon

Fellowship duration: 6 months

Stated learning outcomes:

• Understanding of place of laparoscopic approach in colorectal surgery.
• Demonstrate appropriate indications and select the right patients.
• Selection of suitable equipment, and initial theatre set-up.
• Competence in the selection and use of various energy sources and stapling devices.
• Competence in performing segmental colectomy.
• Ability to train more junior trainees in principles of laparoscopic colorectal surgery.
• Competence in colonoscopy and basic polypectomy techniques.

Clinical competencies to be achieved:

• Competency at laparoscopic segmental colectomy.
• Experience of laparoscopic total mesorectal excision.
• Laparoscopic surgery for inflammatory bowel disease.
• Laparoscopic right hemicolectomy.
• Laparoscopic colostomy/ileostomy.
  

Number of main operations the fellow could expect to be involved in: Information being requested from Supervisor.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Rajaraman Durai (Oct 13 - Dec 13)
• Annamaria Minicozzi (Oct 15 - Apr 16)
• Aarti Kalyanaraman (Oct 16 - Oct 17)
• Samer-ul Haque (Oct 17 - Sept 18)
• Lawrence Toquero (Oct 18 - Aug 19)
• Ahmad Shehadeh (Dec 19 - Nov 20)

Fellows' feedback

A summary of final feedback from the six most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement.”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x  x  x
Mostly training |  x  x  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x  x
5  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x  x
No |

Based at: Portsmouth Hospitals NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: September 2020 – August 2023

Supervisor / Lead Consultant: Mr Jim Khan, Consultant Robotic Colorectal Surgeon, with Mr John Conti, Consultant Colorectal Surgeon, and Mr Gijs van Boxel, Consultant Oesophagogastric Surgeon

Fellowship duration: 6 - 12 months

Stated learning outcomes:

"The primary outcome of the Fellowship is registration of the Fellow as an independent practitioner on the Intuitive Surgical database for robotic colorectal surgery. This will allow the Fellow to progress to a consultant post and be able to start independent practice in cancer and benign colorectal surgery upon commencement of the post.

• Be involved in 15 - 20 TME resections for rectal cancer (1st assistant, supervised operator).
• Be involved in 10 - 15 colonic resections (1st assistant, supervised operator).
• Perform colonic mobilisation and lymphadenectomy robotic / laparoscopically under supervision.
• Perform colorectal anastomosis independently.
• Join the structured TME training program.
• Complete mandatory simulation requirements.
• Basic robotic cadaveric course (Intuitive Surgical) as the first assistant.
• Gain experience in positioning patients and equipment to set up for TME.
• Basic robotic cadaveric course (Intuitive Surgical) as a console surgeon.
• Procedure specific cadaver lab.
• Gain experience in performing part of the robotic dissection of the abdominal and pelvic phase of TME on a dual console robot under close supervision."

Clinical competencies: see Learning Outcomes above

Number of main operations the Fellow could expect to be involved in:

For a 12 month period the reasonably expected number of main operations to be independently performed (equating to the ‘P’ Performed eLogbook Supervision codes category) by the Fellow during their Fellowship:

• Robotic splenic flexure mobilization: 20
• Robotic colectomy (Right /Left): 20
• Robotic TME Surgery pelvic dissection: 20 supervised
• Robotic rectopexy: <5
• Robotic Intracorporeal Anastomosis: 10 supervised
• Laparoscopic TME: 10
• Laparoscopic Colonic resection: 20
• Independent day case LGI surgery: 100
• Emergency/unplanned colorectal surgery: >50

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Vicky Maertens (Oct 2020 - Apr 2021)
• Lalit Kumar (Apr - Oct 2021)

Based at: Royal Cornwall Hospitals NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: December 2021 - November 2024

Supervisor / Lead Consultant: Mr Paul Lidder, Consultant Colorectal Surgeon, Clinical Director Surgery & Cancer Care at the Trust

Fellowship duration: 12 months

Stated learning outcomes:

• To have carried out high volume colonic resections allowing the fellow to build their confidence and perform right hemicolectomy, left hemicolectomy, sigmoid colectomy and high anterior resection independently by the end of the fellowship.
• To have gained exposure and experience in TME / pelvic / perineal surgery.
• To have built on knowledge acquired during surgical training to enable evidence based decision using the latest evidence.
• To have attended regular MDT meetings and developed decision making skills and demonstrated appropriate patient selection and preoperative optimisation.
• To have actively participated in clinical governance activities including audit, service development and quality improvement and recognised their importance to developing a high quality and modern Colorectal service.

Clinical competencies to be achieved:

• Independent Laparoscopic Right Hemicolectomy
• Independent Laparoscopic Sigmoid Colectomy
• Safe hepatic and splenic flexure mobilisation
• Exposure / assisted rectal TME surgery / pelvic dissection
• Exposure to subtotal colectomy for Ulcerative Colitis
• Exposure to Endometrial / pelvic surgery
• Exposure to TATME /intersphincteric dissection /TEO/HRA

Number of main operations the fellow could expect to be involved in:

• 40 left and right laparoscopic colonic resections as primary surgeon
• 12 laparoscopic rectal resection as primary surgeon

Based at: Royal Shrewsbury & Telford NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: December 2018 - February 2022

Supervisor / Lead Consultant: Mr Robert Clarke, Consultant Colorectal Surgeon, with Mr Joe McCloud, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To independently assess patients for colorectal cancer surgery- select appropriate investigations and discuss at MDT coming up with a treatment plan.
• To independently perform Laparoscopic right hemicolectomy.
• To independently perform Laparoscopic Sigmoid colectomy.
• To independently perform Laparoscopic Anterior resection with Laparoscopic TME for rectal cancer.
• Assess and select appropriate cases for local excision in Early Rectal cancer.
• Gain experience in TEMS surgery if desired.

Clinical competencies to be achieved:

• Ability to assess patients with complex colorectal pathology and plan surgery and aftercare
• Exposure to all aspects of complex open colorectal surgery
• Competent, safe independent laparoscopic colonic resection
• Competent, safe independent laparoscopic anterior resection and laparoscopic TME for rectal cancer. (We would enable Laparoscopic Fellows to in excess of 30 major cancer resections as a minimum)
• The ability to perform independent laparoscopic resection would be expected on completion of the Fellowship
• Opportunity to achieve JAG accreditation in endoscopy would be offered if needed.
  

Number of main operations the fellow could expect to be involved in:

“We would enable Laparoscopic Fellows to in excess of 30 major cancer resections as a minimum”

Supervisor, 17.12.19:

"Number Achieved during 6 months Fellowship:

Total number of major Colorectal resections: 56
Total laparoscopic Colorectal resection (elective) 26
Total Right hemicolectomy 13
Total Left sided resection 11 including lap TME
Total laparoscopic subtotal colectomy 2"

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Shantanu Rout (May - Nov 2019)
• Khalid Al-Hureibi (Oct 20 - Oct 21)

Based at: Sheffield Teaching Hospitals NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: November 2020 - October 2023

Supervisor / Lead Consultant: Prof Steven Brown, Consultant Colorectal Surgeon and Honorary Professor of Surgery

Fellowship duration: 12 months

Stated learning outcomes:

• Run outpatient clinics and counsel patients on appropriate management plans.
• Operative logbook.
• IBD MDT outcomes.
• Academic output – manuscripts submitted and presentations in meetings.
• Contribution as faculty in cadaveric and wet lab courses run by the colorectal department.

Clinical competencies:

• Assess patients in the clinic and formulate an appropriate management plan.
• Discuss cases in the IBD MDT.
• Consent patients for procedures.
• Assist and perform index operations.
• Post-operative ward rounds to review patients.
• Prevent and manage complications.

Number of main operations the fellow could expect to be involved in:

• Ileoanal pouch – 10
• Ileocolic resections – 20
• Total colectomy – 10
• Proctectomy – 10
• Perianal CD – 15
• Stricturoplasty - 5

Based at: Sheffield Teaching Hospitals NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI- This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: August 2020 - July 2023

Supervisor / Lead Consultant: Prof Steven Brown, Consultant Surgeon and Honorary Professor of Surgery

Fellowship duration: 12 months

Stated learning outcomes:

• Run outpatient clinics and counsel patients on appropriate management plans
• Operative logbook
• Pelvic floor MDT outcomes
• Academic output – manuscripts submitted and presentations in meetings
• Contribution as faculty in cadaveric and wet lab courses run by the colorectal department

Clinical competencies to be achieved:

• Assess patients in PF clinic and formulate an appropriate management plan
• Discuss cases in the PF MDT
• Consent patients for procedures
• Assist and perform index operations
• Post-operative ward rounds to review patients
• Prevent and manage complications

Number of main operations the fellow could expect to be involved in:

• SNS - 40
• LVMR – 10
• Revisional prolapse surgery - 5
• Sphincter repair – 4
• Colporrhaphy – 10
• MACE – 3
• Complex anal fistula repair -10
• Perianal prolapse procedures - 6

Based at: St James’s University Hospital, Leeds

Surgical Specialty Association approving: ACPGBI

Approval period: First approved September 2012; reapproved March 2019 - May 2022

Supervisor / Lead Consultant: Prof Peter Sagar, Consultant Colorectal Surgeon and Professor of Surgery

Fellowship duration: 6 months

Stated learning outcomes:

• To be able to practice laparoscopic colorectal surgery esp index operations independently.
• Identify cases inappropriate for a lap approach.
• To be able to tackle common intraoperative problems generated with the laparoscope.
• To recognise the value of a skilled laparoscopic theatre team.
• To be safe in the pelvis with redo operations.

Clinical competencies to be achieved:

• Confident and competent in laparoscopic colorectal resection sufficient to practice independently on leaving the post.
• Sign off index operations.
  

Number of main operations the fellow could expect to be involved in:

“The Fellowship at Leeds aims to provide 50 laparoscopic resections during the course of the Fellowship that the fellow would complete independently (supervisor present) and this would allow the Fellow to achieve the level of competency expected at the start of a Consultant post.”

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Jonny Epstein (Oct 12 - Apr 13)
• Peter Mitchell (Apr 13 - Oct 13)
• Adnan Sheikh (Oct 14 - Apr 15)
• Chris Mann (Feb - Aug 17)
• Muneer Junejo (Apr 18 - Oct 18)
• Haytham Abudeeb (Apr - Sept 19)
• Jeremy Williamson (Oct 19 - Mar 20)
• Rebecca Fish (Apr - Oct 20)
• Ahsan Javed (Oct 20 - Mar 21)
• Peter Vaughan-Shaw (Apr - Oct 21)

Fellows' feedback

A summary of final feedback from the eight most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”.

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x  x  x  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x  x  x
Mostly training |  x  x  x  x  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x  x  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x  x  x  x
No |

Based at: St Mark's Hospital, London North West Healthcare NHS Trust

Surgical Specialty Association approving: ACPGBI - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: March 2020 - May 2023

Supervisor / Lead Consultant: Miss C.J. Vaizey, Consultant Colorectal Surgeon, with Mr Akash Mehta, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Proficiency in surgery aimed at restoration of intestinal continuity and / or repair of enteric fistulae.
• Proficiency in gaining access to the hostile abdomen.
• Proficiency in the multidisciplinary assessment and management of patients with intestinal failure.
• Experience in the management of complex abdominal desmoid tumours.
• Experience in complex abdominal wall reconstruction.

Clinical competencies to be achieved:

• Understand the multidisciplinary assessment and treatment of intestinal failure and enteric fistulae.
• Understand the multidisciplinary assessment and treatment of abdominal wall defects.

Number of main operations the fellow could expect to be involved in:

At least 55-60 intestinal failure-related surgical procedures, with over half involving complex abdominal wall reconstructions. The surgical faculty of this fellowship also perform a wide variety of complex open colorectal procedures which do not necessarily fall under the intestinal failure remit but will contribute to the fellow gaining proficiency in the management of the "hostile abdomen".

Based at: St Mark's Hospital, London North West Healthcare NHS Trust

Surgical Specialty Association approving: ACPGBI

Approval period: Initially approved July 2013; reapproved October 2022 - September 2025

Supervisor / Lead Consultant: Mr Ian Jenkins, Consultant Colorectal Surgeon

Fellowship duration: 6 months

Stated learning outcomes:

• Proficiency in laparoscopic and transanal TME.
• Proficiency in laparoscopic colonic resection with CME (complete mesocolic excision).
• Proficiency in laparoscopic APER.
• Proficiency in total pelvic exenteration.
• Experience in robotic colorectal resections.
• Experience in pelvic sidewall excision.
• Experience in en-bloc sacrectomy and high sacrectomy.
• Experience in CRS and HIPEC.
• Proficiency in peri-operative care.
• Proficiency in advanced colorectal cancer management and decision making.

Clinical competencies to be achieved:

• Understand the profile of postoperative recovery after major colorectal cancer and pelvic surgery
• Independent practice in laparoscopic surgery
  

Number of main operations the fellow could expect to be involved in:

• Proficiency in laparoscopic and transanal TME: 20;
• Proficiency in laparoscopic colonic resection with CME (complete mesocolic excision): 40;
• Proficiency in laparoscopic APER: 5;
• Proficiency in total pelvic exenteration: 15;
• Experience in robotic colorectal resections: 10;
• Experience in pelvic sidewall excision: 15;
• Experience in en-bloc sacrectomy and high sacrectomy: 10;
• Experience in CRS and HIPEC: 10.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Amit Patel (Oct 13 - Apr 14)
• Katrine Emmertsen (April 16 - Oct 16)
• Chris Hunter (Oct 16 - April 17)
• Nicola Hodges (Apr - Oct 17)
• Akash Mehta (Oct 17 - April 18)
• Jamish Gandhi (Apr 18 - Oct 18)
• James Read (Jan - Oct 19)
• Mit Dattani (Oct 19 - Apr 20)
• Hugh MacKenzie (Oct 19 - Apr 20)

Fellows' feedback

A summary of final feedback from the seven most recent completing fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x  x
Strongly agree |  x  x  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x
More training than service |  x  x
Mostly training |  x  x  x  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x  x  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x  x  x  x
No |

Based at: South Tyneside & Sunderland NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI

Approval period: April 2021 - March 2024

Supervisor / Lead Consultant: Mr Golam Farook, Consultant Colorectal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

The Supervisor says:

“The Primary Outcome is to develop the clinical, personal, professional and communication skills necessary for independent practice as an NHS consultant, including:

• Understanding the range of presentation of Colorectal diseases, their workup and management
• Correct patient selection for the appropriate procedure
• Understanding the importance of positioning
• Correct use of energy and stapling technology
• Understanding how to solve problems and overcome common challenges safely in the Operating Theatre
• Understanding the importance of MDT meetings and the ability to formulate treatment plans with the best evidence
• Familiarising oneself with the principles and applications of Robotic platforms in Colorectal surgery
• To participate in a research project, leading to presentation or publication

Clinical competencies:

• Ability to assist (Robot docking and first assistant) and perform certain steps in Robotic resections using a modular approach, subject to completing the necessary learning modules - online modules, dry runs etc
• Learn safety mechanisms of the robot and the console
• Gain experience at positioning patients and equipment set up for Robotic resections
• Be involved in 15 - 20 robotic resections for rectal cancer (1st assistant)
• Fully perform at least 20 robotic resections
• 15-20 robotic cases as 1st assistant / training console
• Be involved in 10 colonic resections (laparoscopic/open as 1st assistant)
• Perform colonic mobilisation robotic / laparoscopically under supervision
• Perform colorectal anastomosis independently
• Learn the principles behind TME
• Be part of TME training program in NSTC, Newcastle
• Complete mandatory simulation requirements on the robot
• Complete Robotic cadaveric course (Intuitive Surgical) as the first assistant
• Complete Robotic cadaveric course (Intuitive Surgical) as console surgeon
• Attend arranged visits to neighbouring Robotic colorectal units in RVI and Freeman Hospital
• Start performing part of the robotic dissection of the abdominal part and pelvic phase of TME (dual console robot under close supervision)
• Learn robotic suturing technique
• Learn robotic pelvic lymphadenectomy
• Have the ability to assess and manage complications

Number of main operations the Fellow could expect to be involved in:

Over a 12 month period the expected number of procedures to be independently performed (maintain eLogbook):

• Robotic vessel ligation: 20
• Robotic splenic flexure mobilization: 20
• Robotic left colonic mobilisation: 20
• Robotic TME Surgery pelvic dissection: 20 (supervised)
• Robotic mesh rectopexy (permacol): 5
• Robotic mesh repair perineal hernia: <5
• Robotic proctectomy & ileo-anal pouch: 5
• Robotic pelvic node dissection, utererolysis, posterior bladder dissection: <10
• Laparoscopic TME: 10
• Laparoscopic Colonic resection: 15
• TAMIS: 5
• Abdominal wall reconstruction: <5
• Laparoscopic parastomal hernias: <10
• Day case LGI surgery: 75
• Emergency colorectal surgery: 40
• Colonoscopy: >50

Based at: Swansea Bay University Healthboard

Surgical Specialty Association approving: ACPGBI & BAPRAS - This Senior Clinical Fellowship programme has been chosen and supported by The Association of Coloproctology of Great Britain and Ireland, following a competitive selection process, as meeting the specific Fellowship training criteria of the Association, for approval under a joint partnership with the RCS England Senior Clinical Fellowship Scheme.

Approval period: April 2016 - March 2019; reapproved September 2019 - November 2022

Supervisor / Lead Consultant: Mr Martyn Evans Consultant Colorectal Surgeon and Associate Professor of Surgery

Fellowship duration: 6 or 12 months (12 months from 2021)

Stated learning outcomes:

• Operative exposure to at least 15 multi-visceral resections and exenterations in a 6 month fellowship. This would include total pelvic exenteration, cystectomy, radical hysterectomy and vulvectomy and sacretomy.
• Experience working with a plastic surgeon with interest in perineal reconstruction following surgery for advanced malignancy / IBD and chronic perineal sinus.
• Proficiency in laparoscopic and open low rectal cancer surgery.
• Experience in the assessment, operative planning and perio-operative care of patients undergoing surgery beyond the TME plane.
• Participate in research and audit within the department with an expectation of peer-reviewed publications.
• Operative exposure to at least 20 major gynaecological debulking procedures involving total abdominal hysterectomy and bilateral salpingoophorectomy with or without contiguous organ resection.
• Contribute to the pelvic oncology MDT.
• Participate in a busy emergency general surgical on call rota with exposure to a high number of emergency laparotomies.

Clinical competencies to be achieved:

• Have performed or assisted with approximately 150 major laparoscopic and open procedures, including approximately 10 total pelvic exenterations.
• Improve laparoscopic and open operating skills in lower rectal cancer - exposure to at least 25 laparoscopic and 30 open rectal resections
• Exposure to at least 30 major gynaecological debulking procedures involving bilateral salpingoophorectomy and total abdominal hysterectomy in connection with other multivisceral resections
• Participate in on-call rota in a busy unit with over 300 emergency laparotomies performed per annum

Number of main operations the fellow could expect to be involved in: see Learning Outcomes above.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Jeffrey Lim (Oct 16 - Mar 17)
• Gregory Taylor (Oct 16 - Oct 17)
• Kenneth Keogh (Oct 17 - Jun 18)
• Matthew Bedford (Oct 19 - Apr 20)
  

Fellows' feedback

A summary of final feedback from the four most recent completing Fellows providing full feedback:

1. Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x  x

2. Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x
More training than service |  x  x
Mostly training |  x

3. Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x  x
No |

Based at: Yeovil District Hospital NHS Foundation Trust

Surgical Specialty Association approving: ACPGBI

Approval period: October 2018 - December 2021

Supervisor / Lead Consultant: Prof Nader Francis, Consultant General, Colorectal and Laparoscopic Surgeon, with Mr Jonathan Ockrim, Consultant General Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• PBA assessment level 4 throughout all index operative scenarios (manifested as level 5 in the GAS forms in the curriculum).
• Audit projects completed.
• Research publication completed.

Clinical competencies to be achieved:

• PBA assessment level 4 throughout all index operative scenarios.
• Operative logbook to have achieved a minimum of 40 right and left sided resections and 10 rectal resections. 
  

Number of main operations the fellow could expect to be involved in:

Target Logbook per annum

The unit offers a range of colorectal operations and this will be reflected in the logbook of the Fellow.

• Laparoscopic colonic resections: Total: 50; Performed: 15
• Laparoscopic rectal resections: Total: 30; Performed: 10
• Laparoscopic hernia surgery (ventral and inguinal): Total: 10; Performed: 5
• Major abdominal Reconstruction and component separation surgery: Total 10; Performed: 3
• Diagnostic and therapeutic endoscopy: Total: 150; Performed: depends on the level of the candidate

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Manish Chowdhary (Oct 19 - Dec 20)

*** March 2020: this Fellowship programme is not recruiting Fellows until further notice, because of the current situation in the NHS in Northern Ireland ***

Based at: Belfast Health and Social Care Trust

Surgical Specialty Association approving: BAETS

Approval period: June 2019 – August 2022

Supervisor / Lead Consultant: Dr Fiona Eatock, Consultant Endocrine Surgeon, with Mr Titus Cvasciuc, Consultant Endocrine Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Competency in peri-operative management of the adrenal disease.
• Competency in the multidisciplinary management of hereditary endocrine syndromes.
• Competency in the management of benign and malignant thyroid and parathyroid disease.

Clinical competencies to be achieved:

• To gain experience in rare genetic endocrine disease
• To be capable of independent thyroidectomy and gain experience in cervical lymph node surgery
• To be capable of independent parathyroidectomy
• To be capable of independent open adrenalectomy
• To be capable of independent laparoscopic adrenalectomy
  

Number of main operations the fellow could expect to be involved in:

In a 12-month period:

• Laparoscopic Adrenalectomy (Performed: 15)
• Open Adrenalectomy (Performed: 5)
• Thyroidectomy (Performed: 50)
• Parathyroidectomy (Performed: 50)

Fellows awarded Fellowship Certificate (dates of Fellowship):

Based at: HealthCare Global (HCG) Cancer Centre, Bangalore, India

Surgical Specialty Association approving: AUGIS

Approval period: December 2021 - November 2024

Supervisor / Lead Consultant: Dr. Basant Mahadevappa, Senior Consultant and current head of Department of HPB Oncologic and Robotic Surgery and Transplantation, HCG Bangalore

Fellowship duration: 12 months

Stated learning outcomes:

• To evaluate the transplant recipients preoperatively.
• To contribute to their surgery and care for them postoperatively.
• To take part in all of the activities relating to HPB surgery.
• To participate in the preoperative evaluation, assessment, treatment planning, and postoperative ambulatory care of patients in whose surgery they participate.
• To provide comprehensive, state-of-the-art medical and surgical care to patients with surgical diseases/disorders of the liver.
• To be skilled in HPB procedures, endoscopic procedures, interpretation of radiological images as well as the pre-operative assessment, operative timing, management of intra-operative complications and post-operative patient care.

Clinical competencies to be achieved:

• To be competent in the evaluation and diagnosis of Liver, Pancreatic and Pancreatic cancer patients.
• To be competent in the standard surgical and ablative procedures for the treatment of HPB cancers
• To be competent in evaluating pre-operatively patients requiring liver transplantation
• To manage patients in post-operative phase of liver transplantation
• To understand the surgical procedure of liver transplantation.

Number of main operations the fellow could expect to be involved in:

• Whipple’s Pancreaticoduodenectomy: 20
• Distal Pancreatectomy (Lap/Robotic): 10
• Major Hepatectomies: 20
• Minor Hepatectomies: 10
• Radical Cholecystectomy: 10
• Hepaticojejunostomy: 15
• Liver Transplant: 5

Based at: Imperial College and The Royal Marsden Hospital, London

Surgical Specialty Association approving: AUGIS

Approval period: Initially approved January 2019 - March 2022; reapproved October 2022 - September 2025

Supervisor / Lead Consultant: Professor Long Jiao, Professor of Surgery and Chair in Hepaticopancreaticobiliary Surgery at Imperial College and The Royal Marsden Hospital, London

Fellowship duration: 12 months

Stated learning outcomes:

• Safe understanding of the equipment.
• Safe and independent Robotic surgeon for primary HPB procedures.
• Understood and carried out robotic audit research and peer reviewed presentations and publications.
• Can perform pre-operative patient seminars, assessments and counselling independently.
• Accurately recognise and manage post-operative complications.
• Accurately recognise and optimise pre-operative co-morbidities.
• Patient selection and guiding patients through the various surgical procedures.
• Patient safety and development and adherence to peri-operative protocols.
• Can establish and lead a Robotic HPB unit including setting up a multi-disciplinary team, establishing pathways and protocols, seek accreditation of unit and other regulatory procedures to establish a centre of excellence in HPB surgery.

Clinical competencies to be achieved:

• Independent competent performance of primary HPB procedures
• Supervised performance of emergency and revision HPB procedures
• Case selection and optimisation of patients in the pre-operative period
  

Number of main operations the fellow could expect to be involved in:

Level*   |  A    |  PA  |   P

Level 1  |  2/5  |  2/5  |  10/25

Level 2  |  5/5  |  5/5  |   2/5

Level 3  |  5/5  |  5/5  |   1/1

Level 4  |  5/5  |  5/5  |   1/1

Level 5  |  5/5  |  5/5  |   0/0

* liver, pancreas, GB

A- Assisted

PA- Performed with Assistance 

P- Performed 

Example: Assisted 2/5 = assisted in 2 out of 5 operations involved in

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Tamara MH Gall (Oct 2018 - Oct 2019)

Based at: Guy’s and St Thomas’ NHS Foundation Trust

Surgical Specialty Association approving: AUGIS

Approval period: First approved July 2017; reapproved March 2021 - February 2024

Supervisor / Lead Consultant: Mr Andrew Davies, Upper GI Surgeon & Honorary Senior Lecturer, with Mr James Gossage, Ms Cara Baker and Mr Mark Kelly (all Upper GI Surgeons)

Fellowship duration: 12 months

Stated learning outcomes:

• Understanding of clinical issues during work-up, in-hospital and post-discharge care in patients undergoing oesophagogastric resection.
• Understanding of indications and extent of lymph node dissection for oesophagogastric cancer.
• Understanding of techniques used for lymphadenectomy in the abdomen and thorax.
• Appreciating different operative strategies for OG cancer.
• Endoscopy exposure (including interventional / surgical endoscopy e.g. dilatations).
• Consultant-level decision-making in complex upper GI cases.

Clinical competencies to be achieved:

• Competency in staging laparoscopy including endoscopy and peritoneal cytology
• Competency in performing D2 lymphadenectomy for gastric cancer
• Competency in performing two-field lymphadenectomy for oesophageal cancer
• Use of laparoscopic surgery
• Appreciation of different operations for OG cancer

Number of main operations the fellow could expect to be involved in:

Supervisor: “For Completion of training the criteria state that the trainee needs to complete 30 major cases (throughout their entire training period) which includes cancer resections but also benign work such as anti-reflux surgery. For JAG accreditation 200 endoscopies are the requirement. The current fellow has performed over 50 cancer resections in the last 12 months (not including other major cases) and performed over 250 endoscopies, meaning that within 1 year they would have 150% of the numbers required for CCT level. Beyond surgical exposure, a strong emphasis is made on reaching consultant level decision-making and utilizing multi-disciplinary expertise.”

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Dan Foley (Apr 18 - Mar 19)
• Ben Byrne (Apr 19 - Apr 20)
• Philip Pucher (Jun 20 - Mar 21)

Fellows' feedback

A summary of final feedback from the three most recent completing Fellows providing full feedback:

Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |  x  x  x

Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |
More training than service |  x  x
Mostly training |  x

Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4
5  x  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x
No |

Based at: Portsmouth Hospitals NHS Trust

Surgical Specialty Association approving: AUGIS

Approval period: June 2020 – May 2023

Supervisor / Lead Consultant: Mr Gijs van Boxel, Robotic Oesophago-gastric Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• Be involved in 5-15 gastrectomies (distal/total).
• Be involved in 20-30 oesophagectomies (1st assistant, supervised operator).
• Perform gastric mobilisation and lymphadenectomy robotic/laparoscopically under supervision.
• Perform Roux-en-Y reconstruction under supervision.
• Develop a structured, step-by-step protocol to train surgeons with no previous experience in robotic surgery in conjunction with UGIRA.
• Gain experience in positioning patients and equipment to set up for RAMIE.
• Gain competence as the first assistant for the thoracic phase (by the end of Month 4).
• Basic robotic cadaveric course (Intuitive Surgical) as a console surgeon.
• Gain experience in performing part of the robotic dissection of the abdominal and thoracic phase of RAMIE on a dual console robot under close supervision.
• Perform neck dissection for cervical join under supervision when required.
• Robotic/Laparoscopic Benign Surgery.
• Complete mandatory simulation requirements (by the end of Month 2).
• Gain competence as first assistant for hiatal surgery (by the end of Month 3).
• Modular console training for hiatal surgery in line with developing a structured pathway in conjunction with UGIRA.
• Help manage the waiting list, perform virtual follow up and manage complications.

Number of main operations the fellow could expect to be involved in:

The reasonably expected total number of the Fellowship’s main operations, and those to be independently performed (equating to the ‘P’ Performed eLogbook Supervision codes category) by the Fellow during their 12-month Fellowship:

• Robotic anti-reflux surgery (RARS): Total: 30; Performed: 15-20
• Robotic common bile duct explorations: Total: 5; Performed: 2-3
• Robotic Giant hiatus hernia repair: Total: 10; Performed: 5
• Robotic Revisional hiatal surgery: Total: 5-10; Performed: 3-6
• Robotic Gastrectomy (partial/total): Total: 5; Performed: 2-3
• Minimally invasive oesophagectomy (RAMIE/MIO): Total: 20-30; Performed: 10 in parts
• Minimally invasive gastrectomy (total/distal) Total: 5; Performed: 2-3 in parts
• Laparoscopic day case Upper GI surgery: Total: 150; Performed: 100-150
• Emergency/unplanned OG surgery: Total: >15; Performed: >10

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Khalid Akbari (Nov 20 - Oct 21)

Based at: Torbay and South Devon NHS Foundation Trust

Surgical Specialty Association approving: AUGIS

Approval period: October 2019 – December 2022

Supervisor / Lead Consultant: Mr Stuart Andrews, Consultant Upper GI Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• documented evidence of service development either through management change or through implementation of research findings;
• publication/s in peer reviewed journal;
• presentation in national / international meetings.

Clinical competencies to be achieved:

• Achieve Level 4 in Laparoscopic Fundoplication
• Achieve Level 4 in Laparoscopic Hot Gall bladder Surgery
• Achieve Level 4 in Laparoscopic CBD exploration
• Achieve Level 4 in Laparoscopic Herniae repair
• Achieve JAG accreditation in diagnostic OGD

Number of main operations the Fellow could expect to be involved in:

• Laparoscopic Bile Duct Exploration (Performed: 20)
• Laparoscopic Fundoplication/hiatal hernia repair / Hellers myotomy (Performed: 25)
• Acute laparoscopic cholecystectomy (Performed: 30)

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Alexandros Karentzos (Mar 20 - Apr 21)

Based at: St Mary's Hospital, London

Surgical Specialty Association approving: AUGIS

Approval period: Initially approved August 2015; reapproved December 2019 - February 2023

Supervisor / Lead Consultant: Mr Krishna Moorthy, Consultant Surgeon and Senior Lecturer, with Prof George Hanna, Consultant Upper Gastrointestinal Surgeon

Fellowship duration: 12 months

Stated learning outcomes:

• To effectively manage patients undergoing upper gastrointestinal resection on the wards, critical care and out-patient settings.
• To effectively perform radical lymphadenectomy for oesophagogastric cancer resection.

• Understanding of clinical issues during work-up, in-hospital and post-discharge care in patients undergoing oesophagogastric resection.
• Understanding of indications and extent of lymph node dissection for oesophagogastric cancer.
• Understanding of techniques used for lymphadenectomy in the abdomen and thorax.

Clinical competencies to be achieved:

• Competency in staging laparoscopy including endoscopy and peritoneal cytology.
• Competency in performing D2 lymphadenectomy for gastric cancer.
• Competency in performing two-field lymphadenectomy for oesophageal cancer.
• Competency in performed benign oesophageal surgery for hiatus hernia, GORD, achalasia
  

Number of main operations the fellow could expect to be involved in:

• Oesophagectomy: number to be independently performed: 15
• Gastrectomy: number to be independently performed: 15
• Laparoscopic fundoplication: number to be independently performed: 20
  

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Mohamed Ibrahim (Mar 17 - Feb 19)
• Frans Van Workum (Jan 20 - Jan 21)

Based at: MARSU, University Hospitals Birmingham NHS Foundation Trust

Surgical Specialty Association approving: BASO – The Association for Cancer Surgery

Approval period: Initially approved October 2013; reapproved July 2017; reapproved June 2021 - May 2024

Supervisor / Lead Consultant: Mr Max Almond, Consultant Surgeon (Sarcoma and General Surgery)

Fellowship duration: 12 months

Stated learning outcomes:

“The Fellowship has been designed to allow the appointee to gain surgical experience in areas not generally covered by conventional specialty training. This will give greater confidence in recognising the type of surgery needed for these patients and ensuring they are referred to an appropriate centre. At a time of increased surgical specialisation, this Sarcoma Fellowship is almost unique in providing a surgical trainee such a wide surgical experience within a single surgical unit.”

Clinical competencies to be achieved:

• At the end of 6 months, the Fellow should have seen and gained experience in the management of patients with extremity and abdominal/retroperitoneal sarcomas. The Fellow should be confident in the investigation of these tumours and have been involved in their surgery, though not necessarily competent with resectional surgery.
• By 12 months the Fellow should have consolidated the above experience and be capable of describing fully developed management plans for the majority of patients including identification of the range of disciplines necessary for optimum management.
• The Fellow should be expected to have some experience as the primary surgeon and be confident to undertake some multi-visceral resections, all supervised with the consultant as an assistant.

Number of main operations the fellow could expect to be involved in:

• Multivisceral resection for retroperitoneal sarcoma: Total: 30; 1st operator: 5 **
• Small/large bowel resection for NET: Total: 20; 1st operator: 10
• Small bowel/stomach resection for GIST: Total: 15; 1st operator: 10
• Resection of recurrent retroperitoneal sarcoma: Total: 15; 1st operator: 5
• Wide excision for soft tissue sarcoma of the abdominal/extremities: Total: 25; 1st operator: 5
• Sacrectomy: Total: 5; 1st operator: 1

**Depending of the level of training, considering the complexity of the procedure.

Fellows awarded Fellowship Certificate (dates of Fellowship):

• Sam Ford (Oct 14 - Jan 16)
• Max Almond (Oct 16 - Oct 17)
• Vrettos Ierodiakonou (Jul 18 - Sept 19)

Fellows' feedback

A summary of final feedback from the three most recent completing Fellows providing full feedback

Learning Outcomes

“I achieved all of the learning outcomes as specified in my learning agreement”

Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |  x
Strongly agree |  x  x

Service: Training Balance

Please indicate the balance between service and training in your clinical activities:

Mostly service |
More service than training |
About equal |  x  x
More training than service |  x
Mostly training |

Overall rating

How would you rate the Fellowship post overall, from 1-5? (1=very poor, 5=very good)

1
2
3
4  x
5  x  x

Would you recommend this post to a colleague?

Yes |  x  x  x
No |