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Supporting Surgical Trainees From Junior Level

Supporting Surgical Trainees From Junior Level

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24 September 2024

RCSEd Communications Team

General

Ahead of the 2024 Future Surgery Show (1-2 October), Kiran Saini (Core Surgical Trainee, Royal Berkshire Hospital, founder and President of the Core Trainee Forum) and Mike Silva (Consultant HBP at Oxford University Hospitals NHS Foundation Trust & former Director of RCSEd's Surgical Advisory Network in the UK) provide a sneak peek of their talk, 'How to Engage and Support the Core Trainees' (1 October, Theatre 2, 10:40-11:10).

The RCSEd national Foundation Trainees Surgical Society

The Foundation Trainees Surgical Societies (FTSS) are part of the College’s ongoing commitments to excellence in surgical education, maximising access to surgical careers and supporting trainees at all stages of their surgical careers. Closely aligned with the College’s Regional Surgical Ambassador (RSA) network, the FTSS initiative offers a platform for foundation doctors and medical students considering surgical careers to attend educational events, develop their understanding of surgical training pathways and interact with the College prior to membership. The first FTSS originated in Oxford in 2014 under the supervision of Michael Silva (Consultant HPB Surgeon Oxford, then director of the RSA network) and Miss Katie Hurst - then a foundation doctor, now Specialty Registrar in General Surgery, RCSEd Trainee Representative on Council and RCSEd Sustainability Champions Chair. In 2020, the Foundation Trainees Surgical Societies became a national initiative with the College now proud to support sixteen FTSS covering the breadth of England, Wales, Scotland, and Northern Ireland.

Each regional FTSS is run by Foundation doctors, supported by the College’s Regional Surgical Ambassadors, consultant surgeons who have taken responsibility for acting as mentors and conduits between the College and trainees in their region. The College is pleased to point to the blossoming success of the FTSS as a testament to the commitment of College members to developing and nurturing the next generation of surgeons.

With RSA support, in the past years FTSS have run surgical skills events, careers advice evenings, taster sessions and mentorships schemes in numerous specialities. Several FTSS have run revision courses for the MRCS Part A examination. A glowing example is the Oxford and Cambridge FTSSs collaborating to run an online MRCS course run through College’s e-learning platform, which saw a national and international audience with over 2000 viewers across its 12 episodes. This content remains online for College associate and full members to access, free of charge.

The National FTSS Conferences

The end of each academic year is marked by the Foundation Trainee Surgical Societies Conference, a national event organised collaboratively by foundation doctors from each FTSS. This is now an annual event at the College in Edinburgh. The conference is open to medical students and foundation doctors, and aims to provide information for those interested in pursuing a surgical careers, and inspiration for those considering surgery. Trainees are also offered the chance to present work via oral and poster presentations, along with the opportunity to network amongst like-minded colleague and to hear about research & innovation from across the country. This year’s conference had over 170 participants from all corners of the UK and was a roaring success.

Building upon the success of the National FTSS movement Michael Silva, who now is the director of FTSS UK, has spearheaded the formations of a National Core Trainee Forum.

The RCSEd National Core Trainee Forum

“By trainees, for trainees…”

Embedded within the Royal College of Surgeons of Edinburgh (RCSEd), the Core Trainee Forum (CTF) seeks to elevate the standard of surgical education and trainee satisfaction for those undertaking Core Surgical Training.

Why Does the Core Trainee Forum Exist?

Core surgical training is a pivotal time where the foundations of a surgical career are built, and trainees are preparing for higher surgical training.

Unfortunately, despite years of educational initiatives, the general satisfaction of trainees with their surgical training is declining; with some evidence that core surgical trainees (CSTs) are the least satisfied group of all[1].

There is no trainee body currently focused on the needs of CSTs despite it representing one of the largest single groups of surgical trainees.

This is where the CTF aims to step in. We are the first organisation solely focused on improving the training experience of CSTs. This is a trainee-led initiative, supported by senior colleagues and RCSEd faculty, aiming to drive real change for CSTs. Our goal is to establish a culture in which junior surgical trainees can thrive.

There are clearly a multitude of issues facing CSTs today, with increasing clinical pressures, reduced operating exposure, and proportionately more service provision. This is on top of the significant pressures that trainees already face, including increasing competition for CST jobs, the financial and time costs to passing membership examinations, and stressful applications for higher surgical training. Many of these challenges are faced during the two short CST years. We believe that there should be an organised body for CSTs to have their voices heard and to provide them with resources and opportunities tailored to their unique position.

As well as advocating for the current concerns of CSTs, the CTF will think strategically about shaping the longer-term trends to ensure all trainees enter higher surgical training with the skills to be a confident and capable registrar. We will achieve this through research, teaching, mentoring, peer-to-peer support and learning, and targeted advocacy. Our aim is to propose meaningful, cost-effective, and reasonable solutions to the issues facing CSTs today.

What is the Core Trainee Forum?

The Core Trainee Forum is an initiative designed to serve as a national platform for core surgical trainees, representing the whole of the UK. It is primarily focused on fostering educational excellence by delivering trainee-led initiatives. The forum is envisioned as a space where trainees can engage in discussions, share knowledge, build mentorship, and contribute to initiatives that enhance their early surgical training experience.

The forum is structured to empower core surgical trainees by providing them with the tools, resources, and support necessary to succeed in their careers. It aims to create a robust network of engaged trainees who are actively involved in shaping the future of surgical education and training; attached to and supported by RCSEd. Trainees within the forum will undertake targeted research, setup pilot initiatives, engage discussions with senior stakeholders across every level of surgical education, and produce policy papers that improve the long-term quality of core surgical training, junior clinical fellowships and other SHO surgical roles across the NHS.

What is the Core Trainee Forum Trying to Achieve?

The Core Trainee Forum has several key objectives that align with its mission to enhance surgical training and foster a supportive community for trainees. These objectives can be categorised into three main areas:

Educational activities:

The forum aims to deliver trainee-led educational initiatives, with an emphasis on aiming for excellence, which are specifically tailored to the needs of core surgical trainees. These initiatives include revision courses for the Membership of the Royal Colleges of Surgeons (MRCS) exam, preparation series for higher surgical training interviews (ST3), and teaching sessions focused on basic surgical procedures. In providing these, the forum seeks to enhance the clinical competence of trainees and ensure that they are well-prepared for the next stages of their careers.

Community Building

The Core Trainee Forum (CTF) aims to build a supportive community of core surgical trainees by establishing local networks for discussion, collaboration, and experience-sharing.

Advocacy

The CTF will serve as an advocacy platform, representing trainees' interests and collaborating with bodies like RCSEd and NHSE to improve training standards whilst predicting and addressing emerging challenges. We need low-cost, more efficient ways to build the foundational surgical skills required for higher surgical training which are easily accessible or implementable at all hospital sites within existing workflows. A core goal of the CTF is to help design these methods whilst simultaneously pushing for even higher quality and standards. While no small task, we hope that as a nationwide collaboration with the backing of the resources and faculty of RCSEd, we can succeed. We will highlight areas of local excellence and share lessons across our network. This follows our bottom-up philosophy for change in surgical training as a powerful force; and overcomes principal-agent problems.

Conclusion

The Core Trainee Forum is an exciting, newly formed initiative to enhance the early years surgical training landscape and promote the interests of CSTs. By providing a platform for peer-led education, community building, and advocacy, the CTF seeks to enhance and create a lasting impact on the training experience for UK CSTs and SHOs.

References

[1] Donald, N. and Lindsay, T. (2024). Surgical trainee experiences from 2013 to 2023 within the United Kingdom as reported by the General Medical Council National Training Survey. The Surgeon, 22(2), pp.74–79. doi:https://doi.org/10.1016/j.surge.2023.11.005.

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