faculty of radiologists 2015

New Surgical Training Pathway

2015

Faculty of Radiologists

1

TRADITIONAL MODEL OF SURGICAL TRAINING

BST HST


HST

n=100+ n30+

BST


BST HST

MCh


BST HST

MD


BST HST

PhD?


BST HST

PhD?

Reg

BSpT


BST HST

MD

Reg


BST HST

MD

Reg Fellowship


BST HST

MD

Reg

13+ years

Fellowship


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

http://www.elogbook.org/

E LOGBOOK SCORING

ParticipationComplexity

Weighting

www.rcsi-stat.ie

ASSESSMENTS

http://www.rcsi-stat.ie/

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