General Surgery Training Programme

About

The HEE KSS training programme in General Surgery is a six year programme, leading to CCT accreditation in General Surgery or other specialties depending on the candidate’s choice, Breast, Upper GI or Colorectal. The programme is led by Humphrey Scott, Head of School, and Ayman Hamade and Will Hawkins, Training Programme Directors, to find out more about their roles visit the Meet the Team webpage.

By choosing KSS as your training region, trainees will have the opportunity to develop a broad base of specialty experience in the friendly and supportive units within the region. And depending of trainees future specialty of choice, they will have the opportunity to widen their knowledge in the world-class centres of expertise within London teaching hospitals.

The rotation trainees will be allocated to help you become a well-rounded and confident General surgeon and an excellent specialist if a sub specialty is chosen. There are many fantastic training opportunities within the region and KSS have excellent Colorectal, Upper GI and Breast Oncoplastic centres.

KSS teaching university hospital is in Brighton, which is shared between east and west trainees. KSS trainees have access to tertiary centres in London at King’s, St George’s, The Royal Marsden, and St Thomas’ hospitals.

Curriculum

The 2013 general surgery curriculum does contain the guidelines and so trainees on that curriculum will have them enforced when they come to CCT application.

Balancing the JCST view with the GMC regulations on transferring to the latest curriculum, the SAC decided to assess all CCT applications against the guidelines after 30 Sept 2014 (two years after they were introduced) unless they are informed by the trainee, their Training Programme Director, Head of School, or Postgraduate Dean that the trainee has remained on the 2010 curriculum. After 31 Dec 2015, all trainees (with only one small excepted group) will be on the latest curriculum and so will have to be assessed against the 2013 curriculum and the guidelines.

The updated surgical syllabus is due to start for Higher Surgical Training in October 2020 and the detail of this will alter the structure of training to a degree but the full detail is not available at the time of writing.

Where do trainees train?

KSS posts are organised into two geographical sub-rotations east or west and National Training Numbers (NTNs) will be advertised without specifying East or West. Exact hospital placements and overall rotation through the programme being confirmed with the trainee by the Training Programme Directors.

KSS give trainees the opportunity to stay in one location for at least two years, i.e. provide ‘mini rotations’.  Trainees will be invited to give their preferences for placements at recruitment and at the annual interim review, but the Training Programme Directors will need to ensure above all that placements meet trainees individual training needs, while at the same time maintaining overall programme balance.

There are many fantastic training opportunities within the region which are based in the following locations:

West placements

Surrey

– St Peter’s Hospital, Chertsey – Ashford and St. Peter’s Hospitals NHS Foundation Trust

– Frimley Park Hospital, Frimley – Frimley Health NHS Foundation Trust

– Royal Surrey County Hospital, Guildford – Royal Surrey NHS Foundation Trust 

– East Surrey Hospital, Redhill – Surrey and Sussex Healthcare NHS Trust

Sussex

– Worthing Hospital, Worthing – Western Sussex Hospitals NHS Foundation Trust

– St Richard’s Hospital, Chichester – Western Sussex Hospitals NHS Foundation Trust

East placements

Kent

– William Harvey Hospital, Ashford – East Kent Hospitals University Foundation Trust

– Queen Elizabeth and Queen Mother Hospital, Margate – East Kent Hospitals University Foundation Trust

– Medway Maritime Hospital, Medway – Medway NHS Foundation Trust

– Darent Valley Hospital, Dartford – Dartford and Gravesham NHS Trust

– Maidstone Hospital, Maidstone – Maidstone and Tunbridge Wells NHS Trust

– Tunbridge Wells Hospital, Pembury – Maidstone and Tunbridge Wells NHS Trust

– Kent and Canterbury Hospital, Canterbury – East Kent Hospitals University Foundation Trust

Sussex

– Conquest Hospital, St. Leonards-on-Sea – East Sussex Healthcare NHS Foundation Trust

– Eastbourne District General Hospital, Eastbourne – East Sussex Healthcare NHS Foundation Trust

To find out more about each training location, please visit the Local Education Provider webpage.

Tertiary placements

Senior and sub-specialties placements

Once trainees have declared their specialty of interest, they will be guided through training placements that will help them build those specialist skills. This will be in the years ST7 & ST8 and if declared earlier ST6 as well.

Colorectal

  • All west and east placement providers

Benign UGl

West

– All west placement providers

East

– Maidstone Hospital, Maidstone – Maidstone and Tunbridge Wells NHS Trust

– William Harvey Hospital, Ashford – East Kent Hospitals University Foundation Trust

– Queen Elizabeth and Queen Mother Hospital, Margate – East Kent Hospitals University Foundation Trust

Upper GI Resections

  • Royal Sussex County Hospital, Brighton – Brighton and Sussex University Hospitals NHS Trust
  • Royal Surrey County Hospital, Guildford – Royal Surrey NHS Foundation Trust 

Hepato-biliary (HPB) 

  • Royal Surrey County Hospital, Guildford – Royal Surrey NHS Foundation Trust (covers east and west placements)

Breast Oncoplasty

West

– All west placement providers

East

– Conquest Hospital, St. Leonards-on-Sea – East Sussex Healthcare NHS Foundation Trust

– Eastbourne District General Hospital, Eastbourne – East Sussex Healthcare NHS Foundation Trust

– Darent Valley Hospital, Dartford – Dartford and Gravesham NHS Trust

– Maidstone Hospital, Maidstone – Maidstone and Tunbridge Wells NHS Trust

Bariatrics

  • St Richard’s Hospital, Chichester – Western Sussex Hospitals NHS Foundation Trust
  • St Peter’s Hospital, Chertsey – Ashford and St. Peter’s Hospitals NHS Foundation Trust

Vascular

West

– St Peter’s Hospital, Chertsey – Ashford and St. Peter’s Hospitals NHS Foundation Trust

– Frimley Park Hospital, Frimley – Frimley Health NHS Foundation Trust

– Royal Sussex County Hospital, Brighton – Brighton and Sussex University Hospitals NHS Trust

East

– Royal Sussex County Hospital, Brighton – Brighton and Sussex University Hospitals NHS Trust

– Kent and Canterbury Hospital, Canterbury – East Kent Hospitals University Foundation Trust

– Medway Maritime Hospital, Medway – Medway NHS Foundation Trust

Teaching and Learning

Induction

At the beginning of the academic year, trainees are invited to attend an induction meeting over two days which takes place at the Mattu, Guildford.  The course covers all aspects of your training over the next six years or more, including advice on research, ARCP, CCT, professionalism, etc.

FRCS exam

Trainees will be supported to prepare and pass their exams wherever they are working. You will not be signed off to do the exam until you are in ST7 training year.

The Surgical Training Committee (STC)

The STC is composed of Surgical Consultant leads from each Trust, the Head of School, Healthcare Education Team administrative staff, the two Training Programme Directors, an SAC liaison member and trainee representatives from the east and west placements.  We feel this is a responsive committee and feedback from trainees is encouraged. 

In the past, this has led to various changes, which we think has improved the standard of training. The Head of School has also set up a shadow board, composed of trainee representatives from each Trust.  This has been warmly welcomed by trainees and is another means of ensuring that problems and ideas for improving training are fed back to the highest levels of the Postgraduate Medical and Dental Education department.

Training courses

Trainees are expected to attend a monthly training day, which is rotated between KSS trusts.  There is a rolling two year course, which covers the general surgery curriculum and includes some surgical simulation training. 

A separate simulation course is held at Imperial College in London and trainees are expected to attend this course, this is the best simulation course in the country.  Teaching is given by expert consultant trainers and includes an assessment of each module. Sub-specialty modules are available for senior trainees.

Audit and Research

There are opportunities for out-of-programme research experience within KSS at the Royal Surrey County Hospital, as it is integrated with the University of Surrey, with opportunities for Specialist Trainees to get involved in research. Opportunities are also available in London hospitals for interested candidates who will have to compete with other National trainees.

Overseas fellowships are permitted subject to authorisation from the Training Programme Director or Head of School. These fellowships may or may not be counted towards your training and require authorisation from the JCST.

Collaborative research among trainees has developed across the country as a way of running high quality research projects by collecting data from many departments across departments, regions and internationally. Participation in these projects at a data collection level is a good introduction into how to organise research project and getting names associated with the papers that come from it (all participants in the collaboratives are usually index linked to any papers that are published as a result). Taking a leadership role in one of these research projects offers the opportunity to produce papers that will count towards CCT with the support of the collaborative.

The KSS Surgeons Research Collaborative website also has rich and valuable sources of information for all surgical trainees who are wishing to participate in audit and research activities within KSS. All trainees on the rotation are encouraged to get involved with this
collaborative to support their work and the work of other collaboratives across the country.

Trainee support

The transition to Higher Speciality Training can often be quite daunting. Overnight trainees change from being an experienced core trainee, competent in dealing with all aspects of surgery at this level of training to being a junior registrar. The difference between the two grades is significant and can be challenging, especially at the start. Trainees may feel that there is an expectation from some of your senior colleagues regarding your ability to perform surgical procedures. Trainees may find that decision making and leadership of the firm can be a vastly more testing experience than you have previously been exposed to. The learning curve is steep and requires hard work, but can be extremely rewarding.

ST3s starting KSS will be paired with a senior trainee at the same hospital who will be available to act as a mentor. Mentors will be available as a source of advice regarding all aspects of surgical training including ISCP assessments, elogbook queries (how you should be logging cases) and in preparation for the ARCP. This is an informal arrangement that has been welcomed by previous ST3s starting within the region.

To improve communication amongst trainees we have developed a trainee WhatsApp
group. It is appreciated among the registrars on the rotation that communication with other trainees across the region is key in order to share important and relevant information about training (such as teaching events, courses, conferences and research projects) as well as more logistical issues (such as finding out who is on call at a particular hospital on a certain day). Trainees have the option to be added to this once they start. This will usually be done at the Registrar Ready Day or at the first Regional Training Day.