The intercollegiate surgical curriculum provides the approved UK framework for surgical training from completion of the foundation years through to consultant level. In the Republic of Ireland it applies from the completion of Core Surgical Training through to consultant level. It achieves this through a syllabus that lays down the standards of specialty-based knowledge, clinical judgement, technical and operative skills and professional skills and behaviour, which must be acquired at each stage in order to progress. The curriculum is web-based and is accessed through www.iscp.ac.uk.
The website contains the most up-to-date version of the curriculum for each of the ten surgical specialties, namely: Cardiothoracic Surgery; General Surgery; Neurosurgery; Oral and Maxillofacial Surgery (OMFS); Otolaryngology (ENT); Paediatric Surgery; Plastic Surgery; Trauma and Orthopaedic Surgery (T&O); Urology and Vascular Surgery. They all share many aspects of the early years of surgical training, but naturally diverge further as training in each discipline becomes more advanced. Each syllabus will emphasise the commonalities and elucidate in detail the discrete requirements for training in the different specialties.
Doctors who will become surgical trainees
After graduating from medical school doctors move onto a mandatory two-year foundation programme in clinical practice (in the UK) or a one-year internship (in the Republic of Ireland). During their final year of medical school students are encouraged to identify the area of medicine they wish to pursue into specialty training. During the foundation programme or internship, recently qualified doctors are under close supervision whilst gaining a wide range of clinical experience and attaining a range of defined competences. Entry into surgery is by open competition and requires applicants to understand, and provide evidence for their suitability to become members of the surgical profession.
Selection into a surgical discipline
The responsibility for setting the curriculum standards for surgery rests with the Royal Colleges of Surgeons which operate through the Joint Committee on Surgical Training (JCST) and its ten Specialty Advisory Committees (SACs) and Core Surgical Training Committee (CSTC). In the UK, each SAC has developed the person specifications for selection into its specialty and the person specification for entry to ST1/CT1 in any discipline. Postgraduate Medical Deaneries and/or Local Education and Training Boards (LETBs) and their Schools of Surgery are responsible for running training programmes, which are approved by the UK’s General Medical Council (GMC), and for aiding the SACs in the recruitment and selection to all levels of pre-certification training. In the Republic of Ireland, these roles are undertaken by the Royal College of Surgeons in Ireland (RCSI) and by Ireland’s Medical Council of Ireland (MCoI).
The critical selection points for surgical training are at initial entry either directly into specialty training in the chosen discipline (ST1) or into a generic training period referred to as core training (CT1). Those who enter core training are then selected into the discipline of their choice after two core years and join the specialty programme at a key competency point (ST3), after which transfer from one discipline to another would be relatively unusual. Selection at both core and higher surgical training takes place via a national selection process overseen by the Deaneries/LETBs and JCST and, in the Republic of Ireland, by the RCSI.
Those who are selected into training programmes will then have to achieve agreed milestones in terms of College examinations and the Annual Review of Competence Progression (ARCP) requirements.
Guidance about the UK recruitment process, application dates and deadlines and links to national person specifications by specialty are available from the NHS Recruitment into Specialty Training website here. The RCSI provides this information for Ireland.