The GMC has published new guidance that sets out doctors’ role and responsibilities towards children and young people. The guidance will come into effect on 15 October 2007.
All doctors have a duty to safeguard and protect the health and well-being of children and young people.
0-18 years: guidance for all doctors provides advice on many of the sensitive and complex issues that doctors may face with dealing with children and young people. It also provides links to sources of further information or guidance.

“Grid” training for HPB surgery.
This has been agreed in principle by BAPS and passed to the SAC for further agreement and for the practicalities to be addressed. This will mean a system, similar to urology training, where sub-specialty posts are nationally controlled and advertised.

College statement on General Paediatric Surgery provision in DGHs.
Seems likely our specialty will end up as monopoly General Paediatric Surgery providers as general surgeons who had previously done this work retire and no trainees come through to replace them. This could be viewed as a threat to our specialty in that it would dilute our “specialist” practices but could also be seen a major opportunity to claim a good deal more work, raise the profile of our specialty and increase our influence. Whether to resist or embrace this is unclear but would have major implications for consultant jobs and training in the future.

BAPS Congress 2008, Salamanca. - The symposium topic will be AVMs.

BAPS Winter meeting. Joint Feto-maternal meeting, RCSEng 16th Nov 2007.
It was emphasized that this is not just a consultants meeting and trainees are very welcome, ideally at least one trainee and one consultant from each centre would attend.

Syllabus for Surgical Care Practitioners in General Neonatal and Paediatric Surgery.
The authors of this document will be invited to the Winter meeting to provide some clarity as to what role these practitioners may be envisaged taking in the future.

USB keys.
Trainees have been asked to ensure that all USB keys with presentations or other work documents are encrypted or password protected in some way. This follows an incident at the BAPS Congress in Edinburgh regarding a trainee’s USB key containing a Powerpoint presentation going missing.

Trainee representative.
Jonathon Sutcliffe is standing down. Nominations for his successor are invited.

MRCS and evaluation of progress

The role and future structure of the MRCS and its integration with “work-place assessment” is currently being discussed. It seems possible that it will take some time for the new types of assessment to bed in, so again further change is likely.

ST2 Progression

The number of ST3 posts available next year will depend very much on whether ST2 trainees go on to run through training. It seems the ability of non-ST2 trainees to apply for ST3 posts will vary with deanery. The views of Paediatric Surgical trainees were again canvassed (“Appointments to ST1/2”-below)

PMETB Survey

There will be a national survey of trainees in all specialties in December. Due to the size of our specialty, it is particularly important there is a complete response and some consortia have made it a requirement of the RITA process. Accurate responses will produce information that is likely to improve our training. So it is intrinsically worth doing.

Intercollegiate Exam

The year in which the exam can be taken is no longer defined. The standard is said to be high and there was a recommendation from some of the examiners that sitting in year 5 of SpR training is appropriate.
The syllabus has recently been updated in printed form. There is also a URL

General Surgery of Childhood
This document summarises the management of “surgery of childhood”. Click on the image opposite to download the document. It might be useful for interviews…




Jonathan Sutcliffe
Iain Yardley

Appointments to ST1/2 in Surgery
Paediatric Surgical Trainees Perspective

It has been proposed by the RCSEng that all appointments to surgical training schemes at ST level 1 or 2 be FTSTAs, meaning that there would be no guaranteed progression to higher levels of training and that an additional competitive selection process would occur prior to ST 3. This would be broadly similar to the previous situation with SHO grades seeking progression to SpR training. In the MTAS process, however, there were appointments made at ST2 level in paediatric surgery that were not FTSTAs, with the understanding of the trainee that they had been appointed to “run-through” training.

It is not clear to us how this situation has arisen, and this must be addressed. Nevertheless, in considering how to take things forward, we have been asked to give comments on the views of Paediatric Surgical SpRs. We have drafted this response and would be grateful for your comments. We would also welcome the comments of non-SpRs. Please could you could state your current grade with your comments and e-mail them to us or post them on the forum. Additionally, there will be time to discuss this at the SpR Training Day in Oct in Nottingham.

Current Situation

* Trainees have been appointed to ST2 posts in paediatric surgery with the expectation that this will be a “run-through” appointment and, assuming satisfactory progress and assessments, they will arrive at a CCT without further selection.
* There remain trainees committed to the specialty who are seeking ST3 level appointments having failed to secure posts in the MTAS round 1 or 2. It is unclear how many ST3 level posts will be available in future years.

Firstly the situation as exists currently needs to be addressed and then a consideration of how things may be arranged in the future can be undertaken.

Currently

We feel that two separate groups of trainees need to be considered and that it is important to try to act fairly to both those seeking ST3 posts and those already appointed to ST2 posts, regrettably this may not be possible.

Offers of “run-through” training should be honoured as these trainees will have made personal plans such as housing around these offers and to move the goal-posts once more at this stage would be grossly unfair. There should however be a proper assessment of these trainees prior to moving into an ST3 post. It is possible some may not be able to progress to later years of training. Any ST3 posts coming available due to non-progression of trainees should be then made available to open competition.

Additional ST3 posts should only be created where there is a reasonable expectation that consultant jobs will be available at the end of their training. Extra posts without this expectation will only delay a problem emerging and seriously dilute training experience in the meantime.

Advice and support should be given to those trainees who are unlikely to be able to obtain training posts in paediatric surgery.

Future

In the long-term many trainees have doubts that future consultant surgeons can be identified and selected only 2 years post-graduation and consequently would favour a competitive selection at ST3 level.

What all trainees would value most highly is clarity and the ability to make long term plans for their future careers.

Iain Yardley and Jonathan Sutcliffe