Alternative surgical training model will be trialled from 2018

Authors: Abi Rimmer 

Publication date:  13 Apr 2017

A new programme for surgical training will be trialled by trusts and hospitals from August 2018, the Royal College of Surgeons (RCS) has said.

Earlier this month the RCS and Health Education England (HEE) published the names of 18 trusts and hospitals that will be piloting a new training programme for general surgery.[1] Additional sites are planned for Scotland but the locations are yet to be confirmed.

Ian Eardley, vice president of the RCS and chair of its improving surgical training working group, said that the pilots will recruit at core trainee year 1 level. Trainees are likely to join the pilots directly after completing their foundation training.

The programme aims to give trainees a better balance between training and service delivery than the current model, Eardley said. It will also help to develop other members of the extended surgical team so that they can work alongside trainees and help them to get the most out of their training.

Eardley added, “The pilot will produce surgeons with exactly the same set of clinical and technical skills and competencies as current certificate of completion of training holders; the key is that the pilot is trialling an improved delivery method and environment for training.”

HEE has said that the programme would also develop the concept of the modern “firm.” In December last year Jeremy Hunt, England’s health secretary, said that RSC and HEE would work together to explore whether a modern firm structure could make junior doctors feel more valued.[2]

In a 2015 report on improving surgical training, which formed the basis of the new training programme, the RCS said that the dissolution of the firm had “led to the loss of the traditional relationship between trainee and trainer.”[3]

Commenting on the announcement of the pilot sites, Wendy Reid, medical director and director of education and quality at HEE, said, “The pilots incorporate a range of exciting developments for training in general surgery.

“In particular, they provide an excellent opportunity for us to test how different, more multi-disciplinary models of team working can improve the quality of training received by our doctors in training, and the care they then provide to patients.”

Eardley said that the RCS was developing a comprehensive monitoring and evaluation plan for the pilots. “We aim to assess whether trainees have benefited from the changes,” he said. “Assessment of the impact of the pilot will be iterative and will measure a variety of outcomes from trainee satisfaction to service delivery impacts.”

The pilots will initially focus on the two years of core surgical training, Eardley said, and there will be pathways in place to let trainees who want to leave and continue their training in the normal programme to do so.

“We will continuously measure the pilot’s impact,” Eardley added. “If the whole or parts of the project are successful, we’d hope to spread out the changes to other specialties over the full duration of training.”


  1. Royal College of Surgeons. Pilot site announced for new surgical training progamme. 2017. [Link] .
  2. Rimmer A. Return of the “firm” gets a cautious welcome. 2016. [Link] .
  3. Royal College of Surgeons. Improving surgical training. [Link] .

Abi Rimmer BMJ Careers

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