1. Overview and Objectives of the General Surgery Curriculum
Revised General Surgery curriculum
The updated General Surgery curriculum came into effect in 2013 but has since been revised and re-dated 2016 owing to the addition of the TIG Fellowship. The changes engendered in the 2013 curriculum are described below.
Trainees entering ST3 must follow the new curriculum. The formal regulations on transfer to the latest curriculum are on the GMC website. The General Surgery SAC's view, supported by the GMC, is that trainees already in specialty training and whose CCT is after 30 September 2014 should transfer to the 2013 curriculum. Trainees with a CCT before that date do not need to transfer (see table below).
| Level of training being entered in August or October 2013 |
| ST3 |
ST4 |
ST5 |
ST6 |
ST7 |
ST8 |
| Must use the August 2013 curriculum |
May remain on old curriculum but GMC encourages transfer to August 2013 curriculum |
Please note that downloading 2013 syllabus topics in the learning agreement will automatically transfer progress recorded against 2010 syllabus topics.
VASCULAR Special Interest topics (2010 curriculum)
The August 2013 syllabus does not include the full range of skills required by a vascular specialist. General Surgery trainees (appointed to an NTN before 1 January 2013) will be able to continue full training in Vascular Surgery alongside their General Surgery if they choose Vascular Surgery as their special interest. In order to accommodate this, the complete vascular section of the 2010 curriculum is appended to the special interest section. Trainees appointed to General Surgery in the 2013 selection process and thereafter will not have the option of following the 2010 vascular section.
Trainees in general surgery will undergo Core Surgical Training (CT1 and CT2) followed by a period of 6 indicative years of specialty training (ST3 to ST8).
The aim is to train general surgeons who will be able to work independently to the standard of a consultant in elective and emergency general surgery and who have started developing an interest in one or more of the components of general surgery as defined in the curriculum.
In order to gain the CCT in general surgery all trainees will gain knowledge, clinical and technical skills to the competency levels defined for ST8 in elective and emergency general surgery. They will all gain knowledge, clinical and technical skills to the competency levels defined for ST6 in gastrointestinal surgery (upper and lower). They will all gain knowledge, clinical and technical skills to the competency levels defined for ST4 in breast, transplant, vascular and endocrine surgery. In addition, knowledge, clinical and technical skills are defined for ST8 in the special interest components of general surgery.
During ST3 and ST4 all trainees will complete one year in gastrointestinal surgery (mixture of upper and lower), six months in vascular surgery and a further six months in either breast, transplant or gastrointestinal surgery.
During ST5 and ST6 all trainees will complete one year in gastrointestinal surgery (either upper, lower or a mixture) and one year in their special interest.
During ST7 and ST8 trainees will consolidate their training opting, where possible to further develop their special interest.
Emergency general surgery training will continue for all trainees throughout the six years. Working within EWTR, rotas in emergency and elective general surgery should aim to give trainees the opportunity to learn continuity of care, judgement, decision making, prioritisation and to see how symptoms, signs and associated pathology develop over time.
Trainees may have the opportunity to gain competencies to ST8 level in the general surgery of childhood or in endocrine, advanced trauma or remote and rural surgery.
Assessment will be monitored by the Annual Review of Competence Progression (ARCP) system and carried out by Workplace Based Assessment and by the FRCS examination.
The award of a CCT by the GMC indicates successful completion of a training programme but it is recognised and expected that all doctors continue to develop and gain new skills throughout their careers.