Dear Fellow Trainers

As most of you will know, new ISCP HST curricula were introduced in July 2021 which once again emphasised the importance of emergency surgical competencies (trauma and non-trauma) for practitioners on general emergency take. It was pointed out that emergency surgery ‘is not simply elective surgery performed out of hours’. The patients are different in that they may be shocked and thus physiologically compromised, the inflammatory cascade may have been activated, their medical history may be unknown etc. In addition, by its nature, trauma often occurs out-of-hours, isn’t always consultant supervised and there may be considerable interpersonal and inter-institutional variability in outcomes. While huge progress had been made in management of the cancer patient, it is generally agreed that management of the trauma patient has lagged considerably behind.

One of the other fundamental changes in the 2021 General Surgery curriculum was that training was no longer time-based but rather competency-based with ultimate responsibility resting with supervisory trainers only to sign a trainee off when they are satisfied that the trainee ‘is capable of managing the breadth of undifferentiated emergency take as a Day-1 Consultant’.

In 2018, the Irish Government launched a blueprint for the roll-out of an Irish trauma network entitled ‘A Trauma System for Ireland’ which envisaged the establishment of two Major Trauma Centres (MTCs) and ten Trauma Units (TUs).

Against this background, the College set about establishing a comprehensive foundational surgical trauma training programme to be made available in the first instance to all General Surgery HSTs. It comprises

1. A series of didactic lectures (videos) on the College’s Moodle platform covering

• The New Context (ISCP Curriculum, A Trauma System for Ireland, Sláintecare)
• A walk through the Trauma Management Algorithm
• Emergency Surgical Airway (Emergency Cricothyroidotomy)
• Thoracic surgery for the General Surgeon
• Trauma laparotomy – access and packing
• Hepatic and Diaphragmatic trauma
• Splenic trauma
• GI (hollow viscus) trauma
• Vascular trauma for the General Surgeon

2. A course eHandbook which exactly mirrors the Moodle lectures and which, in addition, contains a series of Trauma Management Algorithms and a chapter on the Physiology of Trauma

3. An intensive one-day, hands-on course in either the Wet Lab at 26 York St or in the College’s equivalent facility on the Beaumont campus.

The course has proved a huge success and while the Moodle lectures and eHandbook cannot be taken in isolation from the hands-on session as all three components comprise the training package, they can however be viewed as providing either a foretaste of the principles of surgical trauma management or for those already experienced, an aide memoire or refresher module. 

I have recently retired from all surgical activity including the role of General Surgery Lead – Trauma Education and Training and have handed on the baton to the next generation (hopefully) of surgical practitioner who will build on the foundations laid down in recent years. Mr, Sean Johnston, GSTC Chair, is holding the fort until a new Lead is appointed.

Click here to register your interest in this course.

Prof. Paul Balfe MD, FRCSI