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The development of a new surgical training pathway is
the culmination of several years of research, planning and
consultation with stakeholders. While there is a continuous
review of all aspects of training as a matter of course, the
transformative initiative came about in response to the need
to ensure that training is closely aligned with the realities of
an increasingly complex healthcare training environment and
to address concerns about the length of the training period.
In particular, it was clear that the duration of surgical training
was contributing to a fall-off in trainee numbers.
The core challenge remains to continue to train surgeons to
the highest level of expertise but within a tighter timeframe
and, indeed, the constraints of the full implementation of
the EWTD. The new surgical training programme, which
commenced in July 2013, provides comprehensive core
surgical training in two years, eliminates gap years and
establishes a structured six-year framework for specialist
training. Specifically, it consists of: one year of core training
(six months in General Surgery and six months in Trauma &
Orthopaedics), ST1; and one year of core specialty training,
ST2; with subsequent progression to the years ST3 to ST8
based on candidates achieving the necessary competencies,
as well as passing the MRCS and assessment by interview in
the relevant year.
The training programme is highly competitive and demands
an intensity of effort and commitment from trainers and
trainees alike. In addition, trainees are required to make
decisions on their specialty of choice in ST1, ensuring
an immediate focus by each trainee on his or her overall
objectives. There had been some concerns that it might
prove difficult to match trainees to their preferred
specialties, with an expectation of disproportionately
high demand for Trauma and Orthopaedics and General
Surgery. Encouragingly, of 58 trainees who commenced the
programme in July 2013, 90 per cent were accommodated
with their first choice of specialty for the second year of their
training programme.
The elimination of the gap years, while contributing
to shortened training, means that the critical research
competencies are now developed later in training. In the
early years of specialist training, trainees will take modules
equipping them with enhanced academic research skills and
capabilities. They will be given the opportunity to engage
in research work alongside, and informed by, their higher
surgical training choices.
The surgical training programme will have an important role
to play within a new framework of enhanced manpower
planning under development by the HSE Medical Education
and Training (MET) unit, ensuring that training is informed by
a strategic awareness of the critical future demands of the
entirety of the service. The ultimate objective is to establish
a forecasting capability that will facilitate effective matching
of training needs to workforce requirement projections for a
predictive window of, ultimately, up to 10 years.
While there are still challenges ahead, the introduction
of the new surgical training programme has progressed
well, further strengthened by an intake of 55 high quality
candidates into ST1 posts in July 2014. The Department of
Surgical Affairs now looks forward to the next major phase
in the development of the programme, the progression
process from ST2 to ST3, which will take place in spring
RCSI hosted the first National Surgical Skills Competition
at the National Surgical Training Centre in April 2014. This
unique event gave prospective surgeons from Irish medical
schools the opportunity to develop and showcase their
A year of transformation and
innnovation for RCSI Surgical Affairs
The Department of Surgical Affairs, headed up by Eunan Friel, has had a
busy 2014. Significant highlights have included the continued successful
implementation of the new surgical training programme and further
strengthening of its student engagement processes, exemplified by initiatives
such as the National Surgical Skills Competition and SurgiQuiz
Pictured at the July Postgraduate Conferring Ceremony
are: Emma Cashman and Emer Phelan who were awarded
Fellowships of RCSI in Otolaryngology.