JCST Multi-Specialty Committee Meeting 21th January 2020

[vc_row][vc_column][vc_separator][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Report on the JCST Multi-Specialty Committee meeting

21st Jan 2020

Ran Wei  – BOTA Vice President

I attended the first JCST meeting of the decade on 21st January 2020. During this multi-specialty meeting many important issues around surgical training were discussed.

My main aim during this meeting was to inform the JCST about concerns raised by trainees regarding delivery of the new T&O Curriculum and ISCP assessments. At the BOTA congress, trainees from various regions of the UK raised their concerns regarding trainers who do not currently engage with the ISCP assessments. It is therefore assumed that these trainers are unlikely to engage with the new ISCP assessments (CiPs & GPC via the MCR). These trainers form a minority of the cohort, but the effects of their disengagement can be significant. The JCST took onboard these concerns. They also recognised that there will likely be some teething issues when the new curriculum and new ISCP assessments go live. The curriculum lead (Mr Jon Lund) is currently running champion days for trainers and will soon be extending the remit of champion day to trainees. I informed the JCST that BOTA would like to ensure that trainees do not become casualties of the inevitable teething issues of the new curriculum and ISCP assessments. The JCST would like to re-iterate that there are robust local mechanisms that allow trainees to raise issues with inadequate supervision. As such, trainees who encounter issues regarding disengaged trainers should continue to use local mechanisms by informing his/her AES and/or TPD. The JCST maintain that mechanisms need to remain local and cannot be policed nationally.

Professional Behaviours Framework courses

Mr Adam Farquharson presented ongoing work on the delivery of Professional Behaviours framework in the West Midlands training region. A variety of pan-specialty professional behaviours courses have been made availability within this region. These are aimed to satisfy various aspects of the GMC’s GPC guidelines. Courses are targeted at trainees at various stages of their higher surgical training. I enquired about the possibility of ‘franchising’ some of the novel courses to other training regions. Unfortunately, the novel courses are still being piloted and therefore not ready to go beyond the West Midlands training region. It was inspiring to hear about what the West Midlands region are doing for their trainees.

Less Than Full Time (LTFT) training Pilot

Mr Jon Hossain presented his work on a new category for LTFT training. As it stands, there are 2 categories for trainees considering LTFT training. Category 1 is for caring and health reasons. Categories 2 is for unique opportunities. The new Category 3 will allow trainees to undertake LTFT training without the need to provide a specific reason. This has been piloted successfully in Emergency Medicine trainees. Results from this pilot demonstrated >90% excellent feedback and improved retention to specialty. Retention to specialty is rarely an issue in higher surgical training but the issue of burnout is. On this front, the pilot reported improved results of the Copenhagen Burnout Inventory. Interestingly, the majority of trainees within the LTFT training pilot were male. Members of the JCST highlighted the fact that we do not know whether there is an appetite for LTFT training by male trainees within surgery. The JCST recognises that we must work hard to ensure that established culture does not prevent trainees (male or female) from pursuing this route of training. It is also important to recognise that Emergency Medicine trainee rotas are very different from surgical trainees. The method through which training is delivered is also significantly different. Mr Hossain informed the Committee that Paediatric Medicine and Obstetric & Gynaecological Surgery are both interested in piloting Category 3 LTFT for their trainees. Subsequent discussions regarding LTFT training revealed that LTFT trainees are more likely to become LTFT consultants. The JCST recognise that an increase in LTFT working patterns will have an obvious impact on the delivery of service due to potential rota gaps. I raised the point that trainees can often feel stigmatised if opting for LTFT due to this fact. As such, the JCST accept that trainee numbers may need to increase to compensate for any increasing trend in LTFT working patterns. It was thoroughly encouraging to witness a change in culture within the training body toward trainees choosing LTFT. 

Training Interface Group (TIG) Fellowships

A joint statement between BOTA & ASiT was delivered to the Committee prior to this meeting. This joint statement addressed concerns regarding the discontinuation of TIG Fellowships. Alternative arrangements for future TIG fellowships were discussed. The most likely outcome will be a JCST/parent specialty managed post-certification fellowship with or without GMC regulation. This remains the topic of ongoing debate.

Improving Surgical Training (IST)

The first cohort of IST trainees are due to complete their ST2 this year. As such, much debate has been had regarding the need for benchmarking (i.e. participation in the ST3 selection process). It has been the strong view of BOTA that benchmarking is necessary. Mr Gareth Griffiths informed the Committee that it has been agreed that this first cohort of IST trainees will attend national selection as a means to evaluate the IST pilot. The ST3 interview scores of these IST trainees will not have an impact on their ARCP outcome and therefore no impact on their progression to ST3. With the first cohort of IST trainees in T&O surgery due commence later this year, BOTA will be monitoring this situation closely.

New Curriculum & ISCP Assessments

The new curriculum is still undergoing the final stages of approval by the GMC. The beta version of the Multiple Consultant Report (MCR) is due to go live at the end of February 2020. ISCP have designed and delivered Champions Training days for trainers in various regions to help disseminate the implementation of the new curriculum. They will be extending these to trainees in the coming months. If you are interested in being a trainee champion and attending a Champions Training day (at RCS Eng) then please get in touch with me at vicepresident@bota.org.uk