Dear all,

There are a number of important issues that came up at the last SAC
meeting. Please read this email and pass on relevant bits to SHOs
and colleagues who do not access the Yahoo group.

1. BELFAST/DUBLIN
a. Due to the implementation of PMETB, which has a remit for
the UK only, the Belfast/Dublin programme is effectively dead, as
PMETB will not recognise training in Dublin for the award of CCT.
b. That this fact only came to light recently is deplorable,
and I have expressed the disappointment of trainees who have yet
again suffered thanks to the MMC fiasco. However, that does not
change the situation on the ground.
c. The current proposal is that: Belfast will integrate into
the UK consortia/programme scheme, but for the foreseeable future no
formal link will be established. This essentially means that the
Belfast trainees must sort out their own rotation to a different
unit.
d. Again, this is unsatisfactory. The links will not be
formalised (although hopefully close links with Glasgow can be
established) because yet again there is talk of changing the
consortia structure – this is to do with the issue of Schools of
Surgery and Deanery arrangements, and has not been addressed yet.
e. There is also talk of Belfast becoming a single centre
training site (with an OOPE elsewhere) but again this has not been
decided. One option would be for a Belfast trainee to spend 5 years
in Belfast and 1 year OOPE in Dublin (which would be recognised).
If you want to consider this, get prospective approval from the SAC
and get it in writing that this will be acceptable for your CCT.
f. Similarly, Dublin trainees may apply for an OOPE in Belfast
or elsewhere in the UK. I have again stated that it is unfair to
expect trainees to arrange their split sites in this way and
especially that funding for the OOPE is not guaranteed, so that a
significant financial penalty may be incurred. The SAC will
hopefully strongly recommend that formalised OOPE arrangements in
Dublin should be established.
g. All in all I think this is a mess. It may work out well for
people if they arrange satisfactory rotations for themselves, but
please let me know if you are encountering problems.
2. THE EXAM
a. I will have more details for you after the meeting in July.
In the meantime:
b. The new FRCS(paeds) exit exam comes into force 18th Nov
2006. From this date, the format of the exam will be as follows:
i. There will be two parts – Part 1 MCQs and Part 2 clinical
and viva
ii. Part 2 will sit March and Sept every year. I do not know
dates for the MCQs yet.
iii. Part 1 will consist of 150 MCQs (single best answer from 5)
and 135 EMQs. I will hopefully have some sample questions for you
in the next couple of months. Part 1 will have unlimited attempts
within a 3 year period.
iv. Part 2 will consist of
1. a 1 hour clinical exam with 5 structured cases
2. 6 30min vivas in urology, more urology, oncology/endocrine,
neonates, GI/general and emergency/trauma.
v. You will have 3 goes at passing part 2.
c. THE SPOT TEST WILL DISAPPEAR
d. More to follow…
3. MMC
a. This information will be of relevance to your SHOs, but will
not affect SpRs directly.
b. From Aug 2007 the SHO grade will be closed (no new posts
will be appointed). No SpR numbers should be recruited to after 1st
Jan 2007. LATS can still be appointed but will not extend beyond
end July 2007.
c. Anyone without a number at this time will have to get on the
MMC programme – ST1, ST2 or ST3. Experienced SHOs will be aiming
for ST3.
d. The number of ST3 posts available will be equal to the
number of posts created by SpRs leaving the rotation (for consultant
posts) as no extra funding will be available. (NOTE – I am awaiting
clarification on this as I have heard some contrasting things).
This would cause problems accommodating the SHO "bulge".
e. Some SHOs will therefore need to apply for ST2 posts as well.
f. In order to increase their chances of getting a post, ASiT
is encouraging SHOs to enhance their CVs as much as possible, for
instance with papers, presentations and by undertaking the same
assessments that F2/ST1 trainees will. They will have to up to date
on the Curruculum and try to get signed off for various DOPs,
miniCEXs etc. If they do not know what this means, they must find
out and soon!
g. Trainees shunted into "one year training contracts" will, I
think, find it very hard to get back into mainstream run-through
training. Try to avoid this if at all possible.
h. Finally, eventually selection in paediatric surgery at ST3
level will be done nationally, as it is envisaged that between 10-20
posts will become available every year.
i. DO NOT WORRY about all of the above if you already have a
number. You are immune. Although we may have to pick up the pieces
as consultants in the future…
4. NUMBERS OF CONSULTANT PAEDIATRIC SURGEONS
a. Are not enough, and the situation will worsen as more and
more general surgeons stop operating on children.
b. It is envisaged that more and more paed surgery will be done
by specialists (us) in specialist centres. This is good as it means
that in theory we will all get jobs at the end of training.
c. However, as the NHS funding crisis gets worse, trusts may
not recruit enough surgeons.
d. Hopefully, the prospect of little Johnny dying because no-
one was available to operate on his perfed appendix as the local DGH
refused and the local tertiary centre was full will be a sufficient
spur for the Dept of Health to make funding this a priority. Keep
you fingers crossed!

You will be glad to know that that's all, folks. I would just like
to add that the committee room I sat in for 5 hours on Friday was
boiling hot on a lovely sunny day, and that I missed the kick off of
the opening World Cup game. This is not exactly a training issue,
but I feel better for getting it off my chest.

Please post comments or email me with questions/clarifications.

Best wishes

Richard