JCST Meeting

RCS Edinburgh, 24th October 2019

I had the privilege of representing BOTA at the recent JCST meeting conducted at the Royal College of Surgeons, Edinburgh. Several important areas were discussed.

The JCST recognised the work of outgoing T&O SAC Chair Mr. Mark Bowditch and we are grateful for his contributions over the years towards both the SAC and JCST. He will be succeeded by Mr. Rob Gregory and we look forward to working with him. There was discussion surrounding JCST-approved fellowships within the surgical subspecialties of cardiothoracics, general surgery and ENT. The issue surrounding how these places are to be funded is still a contentious area that has yet to be determined and as yet there is no scope to expand to within T&O however we will monitor the situation closely. ASIT/BOTA do not support the position that trainees should be obliged to self-fund in order to have the opportunity to go on fellowship despite a number of different funding options being discussed.

The discussion surrounding the possible devolution of Breast Surgery from General Surgery generated interesting debate and although at present not wholly applicable to T&O at this stage, its outcome raises the possibility of something similar happening within the T&O subspecialties. At present we are monitoring these develop closely.

The numbers of CESR applicants is projected to rise and the JCST have signposted that there is an online application form from the GMC that CESR applicants can fill in. There is a mandate that CESR applicants will need to complete a multiple consultant report in future or provide additional evidence. For further information regarding this please consult the GMC website.

The use of ISCP overseas continues to be an ongoing debate with its successful implementation in Iceland. There has been discussion regarding its expansion into Egypt however this has yet to materialise. The potential commercial process involved in ICSP’s overseas expansion is an area we will closely monitor to insure that trainees are getting the best value from this system.

Improving Surgical Training (IST) continues to cause heated discussion. The general consensus is that there is currently a lack of clarity regarding the process of higher specialty training for those trainees already in the pilot. Although assurances were given from the CSTAC lead that these trainees would be not be disadvantaged, the JCST recognised that these trainees haven’t been given the necessary clarity with regards to onward applications. The JCST assured ASIT/BOTA that this would be clarified over the coming months and we will work closely with ASIT and with our CSTAC colleagues to insure that trainees are given this clarity.

ASIT/BOTA welcomed the document drafted by the JCST with regards to advice on trainees requiring maternity leave. It was welcomed as an authoritative guide to help trainees and once the draft of the document is available ASIT/BOTA will insure it is scrutinised. ASIT raised the point regarding the JCST fee for those on maternity leave and JCST stressed that for trainees on maternity leave a reduction of fee is available.

The remainder of the meeting focused on several changes as mandated by the GMC with respect to:

  • Mandatory Courses – the GMC have stated that only a small percentage of courses will be recognised as being essential for training. As yet BOTA do not have a copy of this list however BOTA/ASIT raised the concern regarding the implications of study budget funding of courses. Courses necessary for waypoints will still be stipulated by the relevant subspecialty SAC however we will monitor the situation closely.
  • The need for “generic” core training
    1. This has been an aim of the GMC for the last 3 years resulting in the JCST and CSTAC to consider proposals regarding a restructuring of core surgical training to introduce a possible run-through component from ST2 onwards. It is very important to stress that these ideas are still in the early stages of development and the CSTAC lead will liaise with the rest of CSTAC with regards to how this fits with the current IST model and future surgical training pathways. We are grateful to the CSTAC lead for a copy of any early ideas with relevant annotation.
  • The dissolution of the pre-CCT TIG
    1. The JCST is very disappointed to learn from 2022 onwards the pre-CCT TIG will no longer be available to trainees. ASIT raised the excellent point that the pre-CCT TIG helped give trainees greater flexibility and career planning. Furthermore there was concern raised that this would result in the CCT being diluted. There was unanimous condemnation with regards to this move particularly as the trainee groups weren’t advised on this at an earlier opportunity.

Finally ASIT/BOTA welcomed proposals from the JCST to create a JCST trainee forum for which members of BOTA and ASIT would be welcome to attend. This wouldn’t infringe on the current seat on the JCST that BOTA occupies however it would be an opportunity to give greater dialogue and depth to trainee issues that sometimes cannot be completely addressed at the JCST proper. BOTA will actively engage in this process when this is set up.