Faculty of radiologists 2015

New Surgical Training Pathway

2015

Faculty of Radiologists

1

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

TRADITIONAL MODEL OF SURGICAL TRAINING

HST

n=100+ n30+

BST

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MCh

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

PhD?

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

PhD?

Reg

BSpT

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

Reg

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

Reg Fellowship

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

Reg Fellowship

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

Reg

13+ years

Fellowship

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST

MD

Reg

13+ years

• Very experienced staff– Middle grade level– At SpR

• Highly successful in FRCS exams

• Research productivity• Competitive Internationally• Depth of experience at

Consultant appointment

ADVANTAGES

PROBLEMS

• Duration– Graduate entry– Feminisation– Other specialties– Other countries

• Uncertainty• Poor experience (early

years)– Opportunist

• Unstandardised • Time rather than

competence based

REFORM

• Selection– Fair– Transparent– Standardised– Earlier

• Progression– Competence-based

• Structure– Clinical/operative– Other competencies

• Data driven

ST 1 ST 2 ST 3-6 ST 7-8

CORE TRAINING SPECIALTY TRAINING SUBSPECIALTY

CCSTFRCS

PHASED SELECTION

Selection

Competitive reselection

Matching

MRCS

SELECTION

MB Ranking 15%

SELECTION

MB Ranking

Aptitudes 15%

15%

SELECTION

MB Ranking

Aptitudes

15%

Professional Development

Clinical Judgement

Suitability

Inte

rvie

w

15%

15%

15%

15%

MB Ranking

Aptitudes

Professional development

Clinical Judgement

Suitability

Communicationskills

Inte

rvie

w

15%

15%

15%

15%

15%

25%

Professional development

Clinical Judgement

Suitability

Communicationskills

Inte

rvie

w

15%

15%

15%

25%

• Structured scoring• Scripted scenarios• Rotating invigilator

STANDARDISATION

• Structured scoring• Scripted scenarios• Rotating invigilator

• Results– tabulated– standardised– normalised

STANDARDISATION

1

2

3

4

5

51

52

53

54

55

56

RANKING• 10 base hospitals• HbDCST

1

2

3

4

5

51

52

53

54

55

56

MATCHING

YEAR 1

ST1

N=55

Boo

t cam

p T&O Surgery(6mo)General Surgery

(6mo)

Rotation 1 Rotation 2

RANKING FOR SPECIALITY YEAR

RCSI Hospital

Operative skills

Human factors

Knowledge & Judgement

SSAOP SSAOPSSAOP

SCA SCA SCA

Trainers report

Logbook

OSATS

OSATS

OSCE

OSCE

SFS

• www.elogbook.org

E LOGBOOK

E LOGBOOK SCORING

ParticipationComplexity

Weighting

www.rcsi-stat.ie

ASSESSMENTS

PROGRESSION

ST1

N=55

Boo

t ca

mp

T&O Surgery(6mo)C

APA

CAPA

HF

Skills

General Surgery(6mo)

Rotation 1 Rotation 2

Speciality matching

SPECIALITY MATCHING

ST 1 Interview rank/score

SSAOP

Trainers report

Online CBD

Logbook

SSAOPSSAOP

SCASCASCA C

APA+

Score = rank

MATCHING – YEAR 21

2

3

4

5

51

52

53

54

55

Urology

General Surgery

T&O

ENT

Plastics

CardioTh

Paediatric

OMF

Neuro

?? Vascular ??

• Trainee preference

• * 2 HST posts• February Year 1• Limited COM

YEAR 2 ASSESSMENT

Common Core

Speciality…

ST1 ST2

Rigorous selection

Matching - performance - preference Competitive selection

N=55 N=55

YEAR 2 (SPECIALITY) - ASSESSMENT

RCSI Hospital

Operative skills

Human factors

Knowledge & Judgement

SSAOP SSAOPSSAOP

SCA SCA SCA

Trainers report

Logbook

OSATS

OSATS

OSCE

OSCE

SFS

MRCSI*

PROGRESSION TO HST

5 structured Interviews+

Speciality specificFebruary/March Year 2

SELECTION FOR ST3 A. Performance during Core Surgical Training: 650 marks  Workplace Assessments: 130 marks x 3 = 390 marks The following assessments are performed in each of the first 3 rotations during Core Surgical Training: SSAOP x3 ( 15 marks each ): 45 marks SCA x 3 ( 10 marks each ): 30 marks E logbook: 30 marks Trainer reports: 25 marks  Total: 130 marks ( x3 rotations )  RCSI Assessments: 260 marks Case Based Discussions (SCHOOLforSurgeons): 60 marks Technical Skills Assessments: (ST1 x4/ST2 x4) 100 marks Human Factors OSCEs: (ST1 x4/ST2 x4) 100 marks   Must have passed all parts of MRCS examination in order to participate in Interview.  B. Specialty Interview: (5 x 70 marks) 350 marks Multiple Mini Interview format: 5 stations/5 themes:

– Quality and Safety in Surgical Healthcare– Commitment to Academic Advancement and Lifelong Learning– Knowledge of Current Issues Relevant to Surgical Practice – Decision Making and Judgement in Surgery– Professionalism and Probity in Surgical Practice

Grand Total: 1000 marks

HST

• No further selection• Continuous assessment

– JCST– JCIE – FRCS examination

• Research• Fellowship• Sub-speciality training

https://hcldr.wordpress.com

#looklikeasurgeon

Sucesses

• Early selection• Certainty• Focus on trainee

“experience”

• Transparency• Fairness• Robust

• CST Manual

Challenges

• Early speciality choice• Limited 2nd chance• Service

• Standardisation of assessment

• Trainer buy-in• Speciality specific issues• Validity• Research