A new surgical qualification shaped around the needs of today's junior surgeons
31 May 2017
Mr Daniel Ryan, President Elect of the Federation of Orthopaedic Trainees in Europe and Vice President of BOTA
The landscape of surgical training has changed dramatically in recent years. The European Working Time Regulation (EWTR) has provoked a move away from the traditional team-based approach to shift-pattern working, resulting in increased time away from potential training opportunities for junior doctors. How can we tackle this problem?
When I was a fresh-faced, wet-behind-the-ears foundation doctor, toiling away on the wards, a registrar in T&O gave me a great piece of advice: “Fail to prepare, prepare to fail. Know your stuff and you won’t have to stress”. He was right. A great deal of uncertainty and angst as a junior doctor comes from tackling the unknown. Every day you are faced with numerous problems that you have never faced before, particularly when on call, and climbing that sharp learning curve can be daunting.
In the past, the weapon of choice as a foundation doctor or core trainee was the old ‘Cheese and Onion’, or ‘Oxford Handbook of Clinical Medicine’. Often, this tome would be handed from generation to generation, well-thumbed, with a cover battered by the tight-fisted grasp of many a nervous junior. Numerous similar textbooks were available for surgical specialties, but times have changed, and now these books have largely been replaced by the smartphone, with information available at the touch of a screen.
This week sees the launch of the Royal College of Surgeons Postgraduate Certificate in Surgery. Aimed at the junior tier of aspiring surgeons. How is the PGCert in Surgery different? E-learning is nothing new, and the benefits are well-documented: easy to access, available at any time, allowing efficient transfer of information.
Where the PGCert in Surgery stands out is in its design, shaped around the needs of the adult learners who will use it. It covers a broad range of common topics in surgery, providing information on common conditions in both the acute and elective settings. Not only does this help candidates prepare for the intercollegiate Membership examinations, but, more importantly, it helps prepare them for clinical practice through exposure to conditions that they will see every day. Modules cover history taking, clinical examination, diagnosis and, crucially, basic principles of management: the cornerstone of developing decision-making skills as they climb the ladder of seniority.
Learning is further driven by case-based discussion modules, where reflective practice is encouraged, with suggestions for formative assessments, which can be performed with educational supervisors to obtain workplace-based assessments for entry into ISCP. Summative pass/fail multiple choice and extended-matching questions also provide assessment at the end of each module.
In addition, candidates may also attend selected courses held at the RCS adding practical and social aspects to a mixed-method learning experience that is far from passive. With modules written by registrars and consultants together, the PGCert contains the up-to-date information that clinicians feel is important for junior doctors in their day-to-day practice, all in one place. Hopefully junior surgeons will use it to lay a solid foundation of knowledge on which to build their clinical practice and prepare to succeed.