RCS England Learning and Assessment Meeting and RCS 13th June 2019

Royal College of Surgeons, England

I had the opportunity to represent BOTA at the most recent Royal College of Surgeons of England (RCSEng) Learning and Appraisal Committee meeting and Council Meeting

Various interesting topics were raised at today’s meeting. The most pertinent to T&O trainees is the slow rollout of RCSEng branded Fellowships for the peri-CCT trainee. Currently accounting for less than 10% of Fellowships available to surgical trainees across the board, the RCSEng hopes to expand its scope and create more Fellowship opportunities for trainees across the breadth of surgical subspecialties. The College recognises that Fellowship opportunities are diverse from a range of providers including Colleges, Trusts, and specific Health Boards. This can lead to a variety of Fellowship experiences of varying quality to the peri-CCT trainee. The principal aims are to improve the quality and quantity of trainee Fellowship posts available and aim for a “gold standard” of Fellowship. There was agreement with these aims however I raised concerns that this shouldn’t evolve into a tiered system of Fellowships where some, although not necessarily RCSEng branded, may be perceived as lower quality. Furthermore ASIT/BOTA also resisted the notion that national recruitment is used to apply for these posts. The issue of types and quality of Fellowship opportunity will be discussed at future BOTA committee meetings and we will be following these RCSEng developments closely.

The rollout of a ATLS-equivalent qualification called ATNC was generally welcomed by BOTA/ASIT and we were given reassurance by the committee that this wouldn’t be at the expense of trainees currently on waiting lists for ATLS courses. The Learning and Assessment Committee echoes sentiments raised by the JCST regarding the timescale of the IST training programme and agrees that the current timescales are unrealistic.

Further topics discussed included the formal introduction of a document relating to examiner code of conduct which was scrutinised. The introduction of innovative ways of both learning and examining candidates on anatomical knowledge using 3D printable models and computer software was discussed and represent an exciting development. The trialling and standardisation of these novel methods are still to be determined however we will continue to monitor these at the relevant committees including ICBSE.

The RCS Council meeting commenced with the presentation of the Gilbert Blane medal. Additional topics of discussion included expanding the surgeon’s role within the multidisciplinary environment of the perioperative patient and the redevelopment of the new RCSEng building. ASIT/BOTA voiced that designated Fellows/Members areas be an integral part of the new building plans with concerns raised regarding the size of area available to members and fellows. The RCSEng Vice President provided this reassurance and the intention of the new building would be to create a new mixed use space with two designated areas for members/fellows with flexibility on some of the other spaces. We will continue to monitor these developments with interest.

NHS Access Standards for Elective care which is relevant to the NHS in England related to target waiting times for elective surgical care. ASIT/BOTA voiced concerns regarding the possible increased use of the private sector for cases that would be suitable for training. The RCSEng President Professor Derek Alderson shared these concerns and we were reassured by several other committee members that trainee interests were aligned. 

Finally, the RCSEng position on IST was documented and echoes the current views held by BOTA/ASIT and the JCST.