Framework for excellence

Dec14 250pxThe Faculty of Surgical Trainers (FST) has published new standards, setting out the criteria for training excellence in the health service

As surgeons, we are all aware of how important good surgical training is to the quality and safety of the care we can deliver for the benefit of our future patients. While we still recognise Dr William Halsted’s maxim “See one, Do one, Teach one”, I am sure we all now realise that this paradigm is no longer fit for purpose in our modern NHS. Shorter working hours and more fragmented working patterns have decreased the face-to-face time we once had with our trainees.

We must now strive to provide high-quality training in less time and in a far more distributed environment than before. This shift is not unique to surgical practice, and affects medical education and training as a whole, but surgery feels these changes most acutely because it is a craft specialty with a breadth of knowledge, skills and attitudes.

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Blood brother

Blood brother

Chronicling the work of Canadian surgeon Norman Bethune who travelled to Spain in the 1930s to help in the fight against fascism

Norman Bethune FRCSEd (1890–1939) was the Canadian surgeon whose political and humanitarian convictions led him to join the Spanish Civil War, on the side of the Republican (Loyalist) forces in 1936. In Bethune in Spain, authors Roderick Stewart and Jesús Majada describe how Bethune became deeply involved in the anti-fascist effort and chronicled events through his writings and talks. The following excerpts, taken from Bethune’s own letters and reports, cover his creation and operation of a blood transfusion service, the commitment of the International Brigades and the rescue of fleeing Loyalist civilians during the Málaga–Almeria road tragedy.

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Mapping cancer care in the USA

Mapping cancer care in the USA

Professor Timothy J Eberlein is an expert in the delivery of cancer care and has held surgical chairs at Harvard and now at Washington University. Here he speaks to Professor Robert Steele about the state of oncology services in a country as large and diverse as the USA


What are the main challenges in providing uniformly high-quality cancer care across the US?
The main challenges are twofold. Physicians in the United States tend to be independent practitioners. Adapting multidisciplinary care that is patient focused, and making recommendations with the patient’s best interest in mind, would improve quality. The second issue in the United States is access to cancer care. Patients without insurance or poor-quality insurance tend not to avail themselves of routine preventative care. They do not undergo screenings and, therefore, are more likely to present with more advanced cancer. Alleviation of these two issues would dramatically improve the quality of cancer care in the United States.

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Time to innovate

Time to innovate

The new surgical training standards from the College’s FST are vital to seven-day service innovation, writes Professor Sir Bruce Keogh

Initially conceived in 1940s America to respect Christian and Jewish practices, the weekend has been universally adopted in Western countries as protected personal time.

In the UK, challenges from high-street retailers resulted in a change to the Sunday trading law in 1994. Since then, social behaviour has changed profoundly. Public expectations of service provision for customer convenience have resulted in routine services being available seven days a week in many industries – but not healthcare.

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Fighting the odds

Fighting the odds

College Fellow Mr Tim Hargreave tells Mark Baillie  about his close involvement with the world’s largest surgical public health drive – to reduce the spread of HIV in Africa by circumcising 20 million men

“This is all about numbers; I’m sort of metamorphosing from a surgeon into a public-health doctor, and the point is that if you’re doing something for public health, it has to be cost-effective. So you don’t want to have to treat thousands of people to prevent one case.” Tim Hargreave launches into our interview with a level of enthusiasm that must be a valuable trait in one of the most ambitious projects for tackling the HIV pandemic.

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20 years of support for surgical research

20 years of support for surgical research

Latest Research Report marks two decades of support for research during which time over £7m has been awarded to support surgeons across the world

As the Research Report shows, the RCSEd is continuing its support for surgical research, from those in the earliest training years to renowned career academics. The report includes prestigious awards such as the Robertson Trust Fellowship, the Cutner Travelling Fellowship in Orthopaedics and the John Steyn Travelling Fellowship in Urology.

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From one Dental Dean to another

Past dean Richard Ibbetson quizzes Bill Saunders as he steps into the role of leader of the College’s Dental Faculty

Bill, I’m delighted that you have taken over the role of dean, which I’m sure you’ll discharge with your usual skill and style. Can you tell me about when you first became involved with the Facul…

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The President writes - December 2014

Ian Ritchie  provides his regular update

Politicians direct healthcare policy and allocate budgets, but health service managers provide the mechanisms and infrastructure to allow healthcare to be delivered. Managers in the health service have a difficult job because they are subject to a degree of political control a…

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The Lister Project

Director of Heritage Chris Henry provides an update on the project to restore the College’s ‘Playfair’ Building

Anyone visiting the RCSEd at the moment will notice that the College’s main building – the Playfair – is encased in a new skin of steel poles and nylon netting. This is the strongest evidence yet that the L…

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Time to even the score?

Crisis after crisis, complaint after complaint, concern after concern. Is it really the case that healthcare in the UK is more notable for its problems than its successes? Sometimes it does feel that way. One element of improving a service for patients is top-quality training. This is essential to develop younge…

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Soldiers, surgeons and a speaker

In the second part of our series on the Monro dynasty,   follows the family into the 19th century

he saga of the anatomist Monros took an imperial turn in the first half of the 19th century. David Monro (1813–77) son of , graduated in medicine from Edinburgh, but then migrated in 1…

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Measuring up trainee needs

Contrary to the findings of the Greenaway Report, more flexibility is required for future doctors to gain the skills necessary for consultant careers – so argues the Association of Surgeons in Training

he final report of the independent review led by Professor David Greenaway made recommendations regarding th…

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