Speciality Training Committee Meeting Report – March 2019

By | 25/03/2019

19th March 2019

Arman & I met with the STC to report back from a trainees perspective on current issues (positive and negative) within the training program.  We asked all trainees to complete the trainee survey in order to help guide this conversation and also asked for trainees to contact us directly with any issues, concerns, or comments.

Community

With the move to monthly teaching and the increased number of trainees on the rotation there is the loss of the community feel to the program.  This also is a barrier to the shared practice and dissemination of experience based learning (i.e. top tips of where to work, what to avoid, and advice on sitting the exam).

This may also have a knock on effect at teaching attendance as people do not know each other (unless they have worked together previously) and therefore feel less compelled to attend teaching.

We have suggested that as part of the teaching program a team building / informal day could be held essentially to build the community back up.

This was well received and Mr Wimhurst told us how the Urology trainees do this annually, as do the GP trainees.  They did a cooking master class this year which was very well received.

There may be the opportunity of visiting implant factories in the coming year for a limited number of keen registrars; this could be the start of something good to come in the future.

If anyone has any great ideas or desire to drive this forwards please get in touch.

Training Hospital of the Year Survey

48 responses, each with 2 x different hospitals over a 6 months period. – 75% response rate.

The results of the survey have not yet been fully analysed.  The results will be presented at the up coming CTOC meeting / dinner on the 29th March 2019.

From the early analysis notable improvements have been made:

  • Peterborough Hospital
    • Responded to poor educational scores for the clinics by removing trainees from the clinics that offered little educational value
  • Colchester Hospital
    • Increase in the score for the teaching offered locally – new program established with weekly metal work review meeting
  • Harlow
    • Changes made to improve the educational and research experience, however trainees not allocated to many operating sessions per week,

Negatives

  • Broomfield, Ipswich and Queen Elizabeth (Kings Lynn) hospitals are the three lowest scoring hospitals this year.  The AES from each of these hospitals would like to receive a break down of the scores to be able to identify where the issues lie and areas for improvement.

It was raised that the trainee survey provides evidence for the AES to be able to make changes within the trust. Unless they are made aware of issues within the department they are unable to make changes to improve training.  All AESs present would like to know of any issues to help improve training in their departments. If you do not feel able to raise concerns directly then you can escalate to Mr Johnston / Mr Hopgood, or you can remain anonymous and contact Arman and Mike.

Educational Program

Generally the educational program is well received.


There are comments from trainees that the training days can be viva heavy, and that more teaching would be helpful.  This was discussed, and it was felt that the groups for the viva sessions should be split into more junior years and then more senior years.  The junior years would be more focused towards teaching, whereas the exam years more towards a viva as for the FRCS to prepare people for the exam.

In order for trainees to get the most out of the session we need to have done the work prior to attending the day.  Some topics (such as basic science) can only be taught to a certain point. Most of the knowledge however will come from reading a basic science book and then discussing this further with consultants at work, or on the teaching days.  It is impossible to didactically teach the whole of basic sciences in a couple of days. If this is what you want there are excellent basic sciences courses that cover this content over 6 days.

There is a growing program of activity which now covers all sub speciality areas. The program is evolving and requires trainee feedback and engagement to help it progress further.

Teaching attendance

Concerns have been raised about the low attendance at some of the teaching sessions.  In the trainee survey a significant number of people report being oncall or post oncall as the reason for not attending.  Where possible daytime oncall commitments should be covered locally, and you are encouraged to swap oncalls to facilitate attendance.

A log of attendance will be sent back to the AES at each trust to correlate with those who took leave to attend, and to identify those who did not attend to seek clarification as to why not.  This should assist trusts in identifying local issues preventing trainees from attending.

FRCS Exam

Several trainees have recently had difficulty with the FRCS Part 1.

UKITE

Trainees are encouraged to share their scores with the TPD.  In doing so you will not be judged.  This helps the TPD identify those who are ready to sit the exam, and also to offer support and help to those they feel are at risk.

Guidance on how to prepare for the FRCS

This is covered on the trainees website in detail http://www.eoeortho.com/frcs/ .  In summary, it is a major life event.  It takes 6 months of reading your chosen text (i.e. Miller) before the first part.  This builds a library of knowledge for the MCQs. You need to practice the MCQs & EMQs by doing all of the available resources (orthobullets / books etc) .  It then takes several weeks to index the library to be able to access it and vocalise it for the Part B viva.

Trainees are encouraged to discuss plans to sit the FRCS with their AES and highlight any concerns (such as difficulty with sitting exams previously) with them.  A plan can then be formulated to help trainees to prepare for the exam. If your AES & TPD are unaware of any issues they cannon help you.

HEEoE Professional Support Unit (PSU) – https://heeoe.hee.nhs.uk/psu

The PSU are there to help and have lot’s of information and resources on the above website.

The PSU offers an exam workshop and a 1:1 sessions to support trainees with exams. https://heeoe.hee.nhs.uk/psu/support-available/exam-support

Workshops: Trainees can self refer to the exam workshops (run 4 times a year) if there is a pattern of failed attempts in two or more exams previously.

1:1 sessions: Trainees are eligible where there has been 2 or more attempts on the same exam, however where trainees demonstrate a trend of unsuccessful attempts on more than one exam, consideration may be given.

If you have struggled with exams then you could consider discussing this with your AES / TPD.

This information has been added to the eoeortho.com/frcs website.

Study Budget

Frustration at the process raised.  

There are clear guidelines & deadlines on the HEEoE website.

Areas to highlight

  • It is a prospective process
  • Any courses need to be in your PDP and cannot be retrospectively added therefore you need to plan ahead
  • AES support and approval of <£600
  • >£600 needs TPD approval for Aspirational Activity

https://heeoe.hee.nhs.uk/faculty-educators/study-leave

Splitting the region

The AES asked if there was a plan to split the region into two areas i.e. a Norwich and a Cambridge rotation.  Also with a plan for the junior years to work in specific units to cover specific jobs to cover all the sub specialties over a 4 year period.  PHJ and PH report that they do not intend to move towards this at present with multiple reasons to explain why.

It was also mentioned that trainees need to do 4 months minimum of subspecialities for the new CCT guidelines (valid from 5th August 2020). Infomration on CCT guidance can be found on the JCST website – https://www.jcst.org/quality-assurance/certification-guidelines-and-checklists/

Other Issues:

Poor performing hospitals of THOTY survey

  • Broomfield – Lead AES left the meeting before we could address this.
  • Queen Elizabeth Hospital – Will review the feedback from THOTY survey to see what changes they can make
  • Ipswich
    • Trainees do not want to go there
    • High number of trainees considering poor performance and above comment
    • Mr Myers (lead AES) reported
      • A change to the oncall daytime commitments has been implemented to try to address some of the concerns
      • Local audit of the effect of this due soon
      • However pointed out that the score on THOTY is still poor so this clearly not addressed despite what a re-audit may show.
      • Keen to receive a more detailed report form THOTY survey and he will investigate further.

AES’s feedback to us

Often small issues frustrate trainees. These are often easily addressed locally.  However unless we as trainees tell the AESs then they may be unaware or unable to act.  The THOTY survey should provide ammunition to the AES to take to hospital management to make changes to improve training.

Suggested questions to add to the THOTY survey

  • What sub-speciality are you working in – this would help the indative numbers make sense
  • How many consultants do you work for