surgical trainingThe teaching of a junior doctor how to be a surgeon. In the UK, the first post-medical school year is as a pre-registration house officer (PRHO, now known as Foundation Year 1—FY1), at the end of which he or she is eligible for full GMC registration. Second-year juniors aspiring to become surgeons apply for a senior house officer (SHO, now known as Foundation Year 2—FY2) post in accident and emergency (A&E) medicine, or in one of the surgical specialties (i.e., working as a PRHO, but in a field of surgery) posts, which are generally of six months duration.
During FY2, the junior applies for an SHO Basic Surgical Training rotation, which lasts 2.5 to 3.0 years, and involves 6-months’ training in each of various surgical specialties, often with more time spent training in intensive care and A&E. During their surgical rotation, juniors are immersed in a formal educational programme and training towards the membership to the Royal College of Surgery (MRCS) examination, facilitated by the Royal College of Surgeons’ educational course (the STEP course), which can be followed at their employing hospital. Junior trainees must take a Basic Surgical Skills course and test and should take both Advanced Trauma Life Support (ATLS) and Care of the Critically Ill Surgical Patient (CCrISP) courses. Most SHOs take the MRCS examination about 3 years into their SHO training.
On passing the MRCS, trainees seek a higher surgical training (HST) post with its national training number (NTN). HST is now a structured, formalised 6-year period of training; the first 3 years are generally undertaken in district general hospitals where trainees gain a wide range of experience covering various sub-specialties. In general surgery, the trainees may work for surgeons with a sub-specialty interest in: breast, endocrine, vascular, upper GI (stomach, small bowel, liver and pancreas), or colorectal surgery. One of the 6 years is designated for research which may have already been fulfilled before obtaining an NTN, and does not need repeating. The final 2 years of HST are usually spent in trainee’s chosen sub-specialty. During the final year the trainee takes the inter-collegiate specialty examination, either in general surgery or in the chosen sub-specialty, which includes neuro-, cardiac, ENT, trauma and orthopaedics (including its sub-specialties), paediatric, urology, and maxillofacial surgery.
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