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New training scheme for surgeons of the future gets underway

01 Aug 2018

The first cohort of surgical trainees to take part in the Improving Surgical Training (IST) pilot will take up their posts today (1 August 2018).  The pilot training programme, developed by the Royal College of Surgeons (RCS) and Health Education England (HEE), will trial innovative improvements in the quality of training, a better balance between service and training for trainees, and professionalisation of the role of surgical trainers.

The programme is being piloted in general surgery at over 30 different trusts across England, Scotland and Wales from today, with 80 surgical trainees taking part. From August 2019, trainees in urology and vascular surgery will also join the pilot. Applications for posts in all pilot specialties will open in November 2018. Applications will be made through the Core surgery national selection process, via Oriel

The programme was commissioned following a review of surgical training, which found high dissatisfaction rates among surgical trainees. The review found that many trainees were spending increasing amounts of their time on service provision, and not enough of their time on training. The General Medical Council’s annual trainee survey consistently finds that surgical trainees are the least satisfied of all the medical specialties with their training

Rotas in the IST pilot will provide trainees with 60% elective daytime training activity. Each trainee will also have a minimum of one hour per week to receive feedback from their trainer and reflect on their work. Enhanced training for IST trainers has been developed and delivered by the RCS via dedicated two-day boot camps.

Olivia Spence, a surgical trainee taking part in the pilot, said:

“I feel very privileged to be starting the IST pilot scheme this week and I am excited for the opportunity to embark on a programme that aims to provide better quality and quantity of training to surgical trainees. For me, IST has many advantages including that there is an emphasis on developing a better trainer-trainee relationship, which I believe is essential for aiding the apprenticeship nature of surgical training.” 

In addition to improving surgical training, the pilot will also focus on wider team learning as part of the concept of the ‘modern firm’. This is where members of the wider surgical care team, including physician associates and surgical care practitioners, help support the trainee in a positive and collaborative manner. The Royal College of Surgeons has recently welcomed members of the surgical care team into its membership. 

Dan Beral, Consultant Colorectal and General Surgeon, and RCSEng Surgical Tutor for Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust, said:

“I am really looking forward to the start of the IST Pilot. I think trainers have been aware for some time that Core Surgical trainees often do not get the best deal. The Pilot is looking to address all aspects of training that can have a bearing on trainees' experience and achievement.  

“My focus is the trainers themselves, and I have delivered training for the IST Assigned Educational Supervisors, as faculty for the Trainer Boot Camps. I truly believe that the IST Pilot can improve training, both within the pilot and across the board going forwards.”

Mr Ian Eardley, RCS Council Member and sponsor of the Improving Surgical Training project, said:

“We’re very excited to start training the next generation of surgeons in this new way. To date, too many surgical trainees have found that despite their title, they simply do not have enough time in their day to train. Our general surgery pilot aims to change this and ultimately serve as a model for training in other surgical specialities. 

“To facilitate this, the programme will improve the quality of training posts by professionalising the role of surgical trainers to enable them to dedicate more time to delivering training. It will also adapt different rota designs to allow surgeons to train more during daytime hours.

“Alongside all this, the pilot offers an opportunity to develop the concept of the modern firm, involving the multidisciplinary team within which surgical trainees work. Roles such as surgical care practitioners and physician associates are becoming ever more important in delivering high-quality patient care, and supporting surgical trainees.” 

Professor Wendy Reid, Executive Director of Education and Quality and Medical Director, Health Education England, said:
“I am delighted to see the first Improving Surgical Training pilots going live this week and would like to thank all those that have contributed to this important initiative. Improving Surgical Training provides an exciting opportunity to enhance training in general surgery – and, in due course, training in other surgical specialties - to help improve patient care. We will, of course, be monitoring the pilots closely and HEE will also fund a formal evaluation of the scheme to inform future developments.”


Notes to editors

The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

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