Welcome to our first Trainers eZine. The formation of the RCSI Faculty of Surgical Trainers is a very important development for us and we are grateful for the commitment from our Chair, Ms Bridget Egan and all members of the Faculty Committee. The impact of COVID 19 on surgical training has been very significant. It has not affected all trainees and all specialties in the same way. In some cases trainees were redeployed to other services, others only saw emergency surgery and others attended private hospital sector. However, as always, Irish Surgical trainers remained committed to training and supporting their trainees. Trainers innovated with local online teaching, specialties re-organised and identified high quality webinars to support all. We are grateful for the flexibility and patience shown by all our trainers in adapting to new processes but at the same time upholding high quality and standards.

At the moment, the RCSI, through the National Clinical Programmes (Surgery, T&O, Emergency Medicine) is engaged with the HSE in the reinstatement of surgical services. We face many uncertainties on the exact structure of surgical services and we envisage that we will have to work very hard with local trainers to optimise surgical training and balance it with the huge unmet service need that has built up over the last few months.  RCSI will need your advice, guidance and leadership in the delivery of the training curriculae in new and unfamiliar formats. The team in Surgical Affairs will work with you to develop a suite of education resources, material and courses in the coming months. I just want to acknowledge my team in surgical affairs who have tirelessly maintained their commitment to RCSI and surgical training, The teams across education & training, administration, IT and quality assurance have just been wonderful.

I hope you find this e-zine useful and see it as a way of signposting important information to support your role as a Surgical Trainers. I wish you and your families and colleagues good health and as always, if you have any queries, comments or concerns, please do not hesitate to contact myself or anyone in the team in surgical affairs.

With kind regards

Kieran.

The current pandemic poses challenges that no surgeon has experienced previously and as a community of dedicated professionals surgeons throughout the county have demonstrated selfless commitment to their patients by adapting to the new reality that now exists and continuing each day to devise new ways of working that will lead to improvements in patient care. Undoubtedly this dedication will be the surgical community’s legacy as we move forward.

RCSI is responding to this situation by ensuring that a system of robust supports are in place for surgeons throughout the country, this initiative led by the Department of Surgical Affairs includes a series of resources for surgeons in practice, trainees and other professionals involved in front line patient care.

As the situation evolves the advice is being updated so do continue to check in with us at Coronavirus - COVID-19 Surgical Practice or Clinical Guidance for Surgeons

As part of the suite of resources, RCSI are hosting a weekly, 40-minute webinar series which aims to update surgical teams on the latest developments and what it means for them. These webinars are free to attend and take place every Wednesday at 6pm, for further details can be found here

Following an online application process interviews for the Core Surgical Training programme July 2020 intake took place on Tuesday 4th February in RCSI.  The interviews were preceded by an address from the Postgraduate Dean Professor Oscar Traynor and a briefing from a member of the RCSI HR Team. 130 candidates were interviewed over the course of the day in a morning and afternoon sessions. Using our online application portal 56 Consultant Trainers & members of RCSI faculty carried out the interviews with separate panels for the two sessions. 

The rotation of surgical trainees is due to take place this July as planned. The rotations have been circulated to all trainees and each hospital site will be in contact directly with regard to induction and PPE training.

The return to surgical services is just beginning and the only thing that is certain is that it won’t be the same as before for quite some time. Trainees are moving to their designated rotation location. However, with the continued use of the private hospital network they may be working in alternative locations.  The College will continue to update trainers on developments in this area.

Over the past number of years annual Bootcamp has become an established first step on the surgical training path. This year, Bootcamp will go ahead but in a different format due to restrictions. Surgical Affairs hopes to run a “virtual” based Bootcamp to all new trainees due to commence in July 2020 and this will be followed up by technical skills teaching later in the summer based on a smaller hybrid model of teaching for small groups adapting to the social norms of today but ensuring the best in technical skills teaching and supporting the new trainees for practice. The details are currently being developed and we will update you shortly.

In light of COV-19 Higher Specialist Training successfully moved the selection process for ST3, 3 weeks earlier than advertised. With the support of all the surgical specialties the team managed the delivery of 7 interview panels across 3 days to ensure candidate appointments to Specialist Training Programmes were competed on time and under the normal process to ensure transparency to all candidates. In total the process was supported by 90 panel members and Chairs. A total of 62 candidates where interviewed and 42 appointed to Specialist Training programmes for July 2020.  Without the collaborative working by with the respective trainers, Surgical Affairs staff and Chairs (RCSI Council members), who willingly engaged in the process understanding the urgency required to ensure its success. 

With the onset of Cov-19 and the inability to run the normal training days in the college and limited theatre work for our trainees, many of the specialties have now embraced the new norm “webinar” style lectures, ground rounds and case based discussions to ensure continued interaction and teaching at some level across the training years from Core Surgical Training to Specialist Training.

We will continue to work with each specialty over the coming months to build on this format for the future and to ensure continued supported learning for our trainees as we work back towards the reintroduction of training days in the College. However it is increasingly becoming an acceptable method of delivering didactic training sessions to our Trainees and we will also start to work towards a supported learning for our Trainers on how too delivery these sessions efficiently and effectively to our trainees. In the meantime, the college and surgical affairs our working closely to understand how we can recommence on-site training in no 26 in a safe manner for both our Trainers and trainees in the future.

The College recognises that the role of a Surgical Trainer is a voluntary one and the skill and dedication of surgical trainers throughout the country continues to ensure surgical trainer standards are kept at a high level.

The College has committed to supporting trainers in their role and in order to do this effectively the national survey was undertaken and was designed to be a listening process that would give greater insight and understanding of the training environment.

This survey was devised in a way that it was short, precise and focussed on a number of key areas including, trainer education, support, College IT platforms and communication.

Our innovative part-time postgraduate programme in Human Factors in Patient Safety is now available to complete in one year as a Postgraduate Diploma or over two years as a Postgraduate Master’s Degree. The programme brochure can be viewed here.

This programme supports candidates who wish to become experts in delivering patient safety and quality improvement initiatives in acute hospitals. The programme is positioned at level 9 on the NFQ and is a fully inter-professional programme developed to meet the needs of Surgeons, Anaesthetists, EM doctors, Acute Care Nurses, Nurse Educationalists and other health care professionals. In the past it has attracted both NCHDs and Consultants.

The programme is now open for enrolment and will commence as scheduled in September 2020.  If COVID-19 restrictions apply in the autumn that impact onsite delivery then the programme is ready to commence with online delivery.  First-round applications will be reviewed after 20th June 2020 and successful applicants will be allocated places on a first come first served bases.

You can find out more on its website to register your interest, request a call or read testimonials from graduates of the programme. The Human Factors team would be delighted to hear further from you at MScHumanFactorsPS@rcsi.ie if you should have any queries or questions. 

The College, in consultation with both trainers and trainees, has developed a mentoring programme which aims to ensure every surgical trainee has the opportunity and access to the benefits that structured mentoring by an experienced surgeon can offer. 

The key participants are the mentors and mentees with support and oversight from individual specialty committees under the governance and stewardship of the Department of Surgical Affairs at the RCSI. 

The mentor’s role will be to act as an advisor to their trainee on areas as follows:

1) Current difficulties/problems

2) Future career planning and development  

Trainees are expected to fully engage with mentorship and in particular to focus on any of the issues identified under the defined headings.

Although mentorship is a voluntary exercise and participants should not be compelled to participate in the programme.  It is intended that if this initiative is successful and beneficial, it will be extended to all trainees which will necessitate a corresponding increase in participation.

This programme will be rolled out in July 2020 and further information will be circulated in the coming weeks.

The NDTP Aspire (Post CSCST) Fellowships are fully funded supernumerary posts.

These fellowships are designed to address the need to provide the specific post CSCST training opportunities required for a range of roles and skill sets at consultant level in the Acute Hospital system at present and into the future.

The RCSI Surgical Trainees have been successful in the recent past attaining a number of scholarships in specialities such as; General Surgery,

Applications are assessed by an expert advisory panel, and NDTP may seek specific advice from relevant experts, Clinical Directors etc. as required. Fellowship proposals are assessed on the basis of quality of the proposal, identifying an unmet patient need, specialty and service priorities, the unavailability of such training in Ireland and the potential benefits to the Irish health service and patients. Other factors may include specialty spread, geographical distribution and other considerations.

The College is acutely aware of how the ARCP process is impacted by the current situation.  For some trainees these are critical times in the training journey and we conscious of the need to provide guidance and support to trainers in this matter. 

This JCST document provides direction and support for the process.

The HSE National Health Library and Knowledge Service (NHLKS) have now made the BMJ’s decision support tool BMJ Best Practice available to healthcare professionals and patients across the Republic of Ireland.

BMJ Best Practice provides healthcare professionals with quick, easy access to the latest information and evidence for diagnosis and treatment decisions. Its content is updated daily and draws on the latest evidence-based research, guidelines and expert opinion to offer step-by-step guidance on diagnosis, prognosis, treatment and prevention.

Access is automatically enabled via the national IP address. BMJ Best Practice can also be accessed anytime via the mobile responsive website or the app. 

Further information is available at www.hselibrary.ie.

In April the HSE has announced there will be an increase in the annual intake of medical interns this year, from 734 to approximately 1,100.

The medical interns recruited have now taken up their posts in hospitals throughout the country.  Each post begins with an intern induction week, followed by assignment to clinical posts one week later, for an internship until July 2021.

The HSE International Medical Graduates (IMG) Recruitment programme which has been running for a number of years and is now an established part of the training landscape in Ireland.

Plans are underway for the incoming group to start as planned on 13 July 2020, it is expected that 16 surgical trainees from Pakistan will arrive in early July.

The group under the direction of the HSE will self-isolate for 14 days before their arrival to local clinical sites at the HSE City West Campus.

Hospitals are been asked to provide the doctors with access to any online tools/library they have available that the doctors can avail of during their self-isolation period in addition to HSEland. 

The Spark Innovation Programme is an initiative that encourages healthcare providers to develop and implement their ideas so that we can improve our health service.

National Doctors Training and Planning (NDTP) established Spark in July 2017 as a national programme to encourage, support and recognise innovation among doctors in Ireland. The programme is now also being supported by the National Quality Improvement Team with the goal of encouraging innovation across our health service

As our patient cohort becomes more complex, providing high standards of care becomes more challenging. Frontline members of staff are ideally placed to recognise the issues faced by their patients and colleagues and implement creative solutions to these issues. NDTP and the Spark programme aim to support projects that make our health service a better place to work and receive care. 

The first Spark Ignite event took place in Galway in 2018. Applications were open to all healthcare staff working in the Galway region. Entrants were asked to plan, perfect and then pitch their ideas at the event.  The winners of the competition were given funding to further develop their ideas and are getting on-going support and mentorship from Health Innovation Hub Ireland. 

One of the first winners of the Spark Ignite competition was Professor Derke O’Keefe, consultant physician in GUH, and his team members Brendan Tuohy, Clinical Engineer UHG, Frank Kirrane, Clinical Engineer UHG, Michael Kerin Consultant Surgeon, UHG, Peter McCarthy Consultant Radiologist, UHG. Prof O’Keefe and his team proposed to develop an inexpensive handheld medical electronic device that will accurately tell if a Naso-Gastric (NG) tube has been placed correctly in the stomach before NG feeding commences.

The winners of the competition will be given funding to further develop their ideas and will receive on-going support and mentorship from Health Innovation Hub.

The College is committed to supporting our Surgical Trainers and is now working on developing a Trainer’s portal on mSurgery.

This will be a resource for surgical trainers to support them in their role and will include online courses, up to date information on training and links to access further information when challenges in training occur.

The content will be driven by the needs of the training community and we would like to hear from trainers as to what supports they envisage will be required.