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.

Stand up for standards

Voices from across the profession give their views on the importance of clear guidance for trainers

The launch of the Faculty of Surgical Trainers’ (FST) standards and GMC accreditation of trainers will have ramifications across the profession – from training programmes, to CPD and daily clinical practice. We spoke to representatives from different sides of training about what the standards can offer in an era when both time and financial pressures on the NHS seem to be greater than ever.

Time to innovate

bruce keoghThe 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.

Assessment issues sliced and diced

fst1‘Assessment drives learning’ was a key message at the Faculty of Surgical Trainers’ conference ‘Who Makes the Cut? Assessment in Surgical Training’, held in Edinburgh on 22 October

The Surgical Trainers’ meeting was opened by RCSEd president Ian Ritchie, who introduced Professor John Norcini as the first keynote speaker of the well-attended event. Professor Norcini is president and CEO of the Foundation for Advancement of International Medical Education and Research and is one of the world’s leading experts in workplace-based assessment (WBA).

Formative assessment in postgraduate medical education is vital and depends on the quality of feedback given to the trainee, said Professor Norcini. He addressed the issue of whether national training programmes improve the quality of care; reassuringly, the evidence suggests that they do.

Chair of the Intercollegiate Surgical Curriculum Programme (ISCP) Professor Bill Allum discussed the state of trainee assessment in the UK, concentrating on data from the ISCP website. This provided an insight into the current usage of the ISCP and highlighted that, although engagement with the ISCP portfolio has increased over time, the quality of assessments and reports remains variable.

Healing power

Sept14-250pxA campaign is under way to make basic surgical care a component of universal healthcare for one-third of the world’s population

As it stands today, an estimated 2 billion people lack access to the most basic surgical services that prevent premature death and severe disability. As a result, easily treatable surgical conditions can lead to devastating lifelong disability, social exclusion, economic hardship and even death. This situation has remained largely unknown and unrecognised by the global health community well into the last 30 years. Even less recognition is given to viable and simple solutions available to address these neglected surgical diseases in low and moderate-income settings. Thus, ‘essential surgery’, the thesis of defining these conditions and setting practical and realistic goals in alleviating the enormous burden of disease in many low-income countries, has become the primary goal of the International Collaboration for Essential Surgery (ICES).

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