Certificate of Completion of Training in Trauma & Orthopaedics


The British Orthopaedic Association produce the orthopaedic training curriculum. This is then endorsed by the Joint Committee on Surgical Training (JCST) and Speciality Advisory Committee (SAC).  The curriculum is then approved by the GMC.  This last occurred in 2014 and is due for review in 2017.

It is worth reading the curriculum and guidelines for CCT reguallry throughout your training to ensure you are working towards all standards.

At your final ARCP you will be expected to have logged evidence against each domain and fulfil the criteria for CCT.

This is a checklist of what is required for CCT (excluding passing FRCS). Penultimate Year Checklist

Clinical experience:

  • Evidence of the breadth of clinical experience defined in the specialty syllabus
  • Trainees must provide evidence of participation in annual scheduled
    (i.e. timetabled) minimum of three operating lists per week and two
    outpatient clinics per week (including fracture clinic).
  • Trainees should provide an annual statement of “no probity issues” to
    meet future enhanced appraisal and revalidation criteria as
    documented in GMP Domain 4. – FORM R
  • Multi-Source Feedback – completed NHS: LQF 360 and/or clinical 360 and /or miniPAT every 2 years.

Operative experience:

  • Consolidated logbook evidence of the breadth of operative experience defined in the specialty syllabus
  • Trainees should be seeking to have logbooks validated electronically through the eLogbook each year and move away from a signed summary sheet.
  • Minimum total operations = 1800 [A, STS, STU, P or T]
    • Must be supported by evidence from PBAs over a range of trainers and periods of time.
      • Carpal Tunnel Decompression: 30
      • Arthroscopy & simple arthroscopic procedures: 40 (any joint)
      • Total Knee Replacement: 40
      • First Ray Surgery (Foot): 20
      • Total Hip Replacement: 40
      • CHS for Intertrochanteric Fracture Neck of Femur: 40
      • Hemiarthroplasty for Intracapsular Fracture Neck of Femur: 40
      • Application of Limb External Fixator: 5
      • Operative Fixation of Fracture of Ankle: 40
      • Tension Band Wiring of patella and olecranon fractures: 10
      • Intramedullary Nailing for Femoral or Tibial Shaft Fractures: 30
      • Tendon Repair (extensor , Achilles etc): 20

Operative competence:

  • Evidence of competence in indicative operative procedures to level 4 (evidenced by PBAs defined by the specialty)


  • Evidence of an understanding of, and participation in, research as defined by the specialty
  • Trainees should undertake research during training and provide
    evidence recorded on the ISCP of a minimum of:

    • Author of two peer reviewed publications from research (or
      instructional notes or literature review) performed during training
      (ST3 onwards) in print or accepted for publication at the time of award of CCT.
    • Evidence of the screening/recruitment of 5 patients to an Research Ethics Committee approved study.
    • Completion of a Good Clinical Practice course in Research Governance within 3 years of award of CCT.
    • Evidence of critical analysis of publications (i.e. journal club activity).
    • Author of two presentations (podium or poster) at national meetings from research performed during the period of training (ST3 onwards).

Quality Improvement :

  • Audit
    • Minimum of one audit per year of training, and two of these audits to have progressed through the full audit cycle
  • Service improvement project

Medical Education and training:

  • ‘Training the Trainers’ (or a similar course)
  • Minimum of one lecture/presentation per year on a teaching programme with structured (written) feedback.

Management and leadership

  • Evidence of an understanding of management structures and challenges of the NHS in the training jurisdiction
  • Evidence of leadership and management e.g. attendance on a management course, change management etc.

Courses / qualifications:

  • Valid ATLS® provider or instructor credential at the time of CCT.

Educational conferences:

  • Attended appropriate educational conferences and meetings


  • JCST secretariat to notify:
    • The GMC of trainees approaching the end of their training six months ahead of their expected completion dates.
    • The SAC Liason Member that trainee is due for final ARCP. They will then review the trainees ISCP with attention paid to the following:
    • The Training Programme Director (TPD), and LETB/Deanery Administrators, to advise him/her that all parties have been informed and they should therefore advise the LM of the date of the ARCP meeting
    • Trainee that he/she will be contacted directly by the GMC