Hospital Dr News

BMA calls for surgical training to be extended

Surgical training could be extended to overcome problems created by implementation of the European Working Time Regulations, the BMA has agreed.

In a debate at the Association’s annual representatives’ meeting in Harrogate BMA Council chairman Dr Mark Porter challenged college presidents who want to abolish the regulations to instead consider increasing the length of training.

It had been calculated that an extra five weeks was the time required, he said.

Mr Ram Moorthy, an ENT consultant, said juniors who started surgical training in 2009 were are risk of becoming a “lost tribe” because they lacked the experience to gain consultant posts.

“We are hearing reports of insufficiently trained applicants applying for consultant vacancies.  When I applied for a surgical registrar number in ENT I was expected to do 50 tonsillectomies, 50 grommets and be able to do a tracheostomy unsupervised.  Currently my first year registrar is being taught how to do tonsillectomies and adenoidectomies through no fault of his own.  It is the way the Working Time Regulations have been implemented and the training requirements for progression that we need to address.”

He said no solutions that had been proposed to date to protect surgical training were implementable in most hospitals.

“What we have seen is a number of reports with a lot of very aspirational goals but none of them are actually achievable or have incentivised trusts (to protect training).

“We have wasted lot of time trying to overturn the European Working Time Regulations and increase the hours (for training) and what we haven’t done is looked at the number of increasing trainees, the reducing training opportunities and the increasing service demands.

“Aspiring to Excellence (the independent inquiry into Modernising Medical Careers) back in 2008 restated the level of the CCT and the requirements that we need.  Instead what we are now seeing is a reduction in those requirements to allow people to progress to ST3 & to CCT and instead seeing an increase in the demands required and the number of post CCT fellowships – this is now becoming the norm.

“If hours can’t be increased we need to look at length of training we must make sure the CCT standard is maintained,” he said.

The meeting agreed that the BMA should discuss with the Surgical Royal Colleges, Joint Committee on Surgical Training and Surgical Specialty Associations whether the length of the current CCT training programme is fit for purpose in preparing a trainee for appointment as a NHS consultant surgeon.

The motion also expressed concern about the increasing number of surgical trainees undertaking post-CCT fellowship to prepare for consultant appointment.

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