As the incoming Director of National Surgical Training Programmes, I will be responsible for the efficient and effective provision and co-ordination of postgraduate surgical training across all surgical specialties. This role will involve a high degree of interaction and collaboration with all training programme directors, trainers, HSE management and key senior stakeholders including the Medical Council and the National Doctors Training and Planning Unit. I will transition into this role during the months of September and October in order to formally commence duties on November 1st next, During my tenure of office. I will continue to devote 50 per cent of my time to clinical practice in order to maintain connectivity with the multiple issues that broadly influence surgical practice across Model 3 and Model 4 hospitals.
The role of Director provides for participation in all aspects of the interview, selection and allocation process of trainees within core and higher surgical training programmes across all surgical specialties. RCSI is committed to a significant expansion of the various surgical training programmes in order to meet future Consultant workforce requirements in both the public and private sectors over the next ten years. In that respect, eighty core surgical trainees were appointed in July of this year, to commence phase 1 of surgical training under a new curriculum for each specialty. It is envisaged that from July 2023 onwards, sixty trainees per year will be appointed to the various higher surgical training programmes in order to progress to phases 2 (ST 3- 6) and 3 (ST7-8) of training. By comparison, thirty seven trainees were appointed to higher surgical training programmes in July of this year.
I will also remain centrally involved in the ongoing assessment of trainee performance during core and higher surgical training. I have participated in the Intercollegiate examinations process since 2007 and will continue to do so in order to maintain my familiarity with summative assessment of our trainees as they approach the final years of training. Within the existing structures at RCSI, I will participate in all committees related to surgical training as well as representing the interests of RCSI from a training perspective on external committees at both national and international levels.
The new curriculum requirements as agreed at an Intercollegiate level with the JCST and the SAC are now operational for all surgical trainees with the exception of final year trainees. Within the structures of the new curriculum for each surgical specialty, considerable emphasis is placed on the generality of the specialty including competency in emergency surgical management. This is in line with international best practice as greater focus comes to bear on the outcomes for emergency surgery, and particularly in the context of an ageing population. The end product of training will remain the same- the Day 1 Consultant. The high level outcomes of training that require successful achievement by all trainees and common to all surgical specialties include-
1. Managing the outpatient clinic
2. Managing the unselected emergency take
3. Managing ward rounds and the on-going care of in-patients
4. Managing an operating list
5. Managing multi-disciplinary working
These high level outcomes are known as capabilities in practice and will be assessed within the framework of the Multiple Consultant Report (MCR). The format of the MCR will provide for a more meaningful and holistic assessment of each trainee within the clinical environment by all Consultant trainers within a designated training unit.
Assessment in an outcomes based curriculum through the MCR therefore examines each trainee from the perspective of each of the capabilities in practice. Training is capability based with indicative times in which the majority of trainees will be expected to complete training. There is the potential also for trainees to progress faster through training if they demonstrate the necessary capabilities. In addition , the modular structures of the new curriculum will permit flexibility to respond to changing service demands within our health service in the future. The details of each specialty curriculum are clearly presented on the Intercollegiate Surgical Curriculum Project website and can be accessed at www.iscp.ac.uk