Dear All,

Just a few things to say about recent developments.

1. Firstly, some good news (I think). Many of us have been worried
about what will happen when the current SpRs are integrated into the
MMC framework when it comes on line. This will certainly affect the
year 1-3 trainees at least.

The main concern has been whether we will get our full (6 year)
training or whether we would be expected to get 4 years as the new
trainees would do. The answer seems to be that there are no plans
to shorten our training. [Although this is all back corridor stuff
and nothing is in writing]. In fact, people are more worried that we
will demand a shorter training time (!).

The reason is that when MMC comes on line RITA assessments will be
competency based. If you can tick the boxes, you progress
regardless of numbers. In theory, some of the old style SpRs may
well fulfil all the MMC competencies early and be eligible for CCT
before their 6 years are up. If you do not want to finish early
then do not push for all your competencies to be signed off or for
your CCT once they are.

So, there will be no official drive to accelerate existing SpRs
through the process. This will however mean that some of the year
1/2 SpRs may see their current SHOs who get onto MMC qualifying
alongside/ahead of them!

2. Who will perform the general surgery of childhood?

This is a potentially big problem. At BAPS it was mentioned twice
(Council and lecture by Prof Craft, president RCPCH) that plans are
afoot to give all adult general surgery SpRs 6 months paed surgery
training so that there will be surgeons based at DGHs in the future
who can do inguinal surgery and simple emergency surgery on
children. This may be limited to surgeons who want to work in a
DGH, but who will say say that at the start of their career?

My problem with this is the potential impact this will have on out
training lists, as we are outnumbered badly by the adult surgery
SpRs, and there are already concerns about the operative exposure we
are getting compared to historical counterparts.

3. How will we therefore work in the future if very few "adult"
surgeons operate on children?

This is something for you to think about; hopefully I can put some
more concrete options together later...

In the meantime, all thoughts gratefully received...

Cheers

Richard