An Introduction to East of England Core Surgical Training

Welcome to the East of England Core Surgical Training Website. We aim to provide one of the best Core surgical training programmes in the whole country through excellent clinical training as well as a novel consistent stage specific educational training programme. The programme will also provide support with portfolio development as you gear towards Specialist Trainee (ST) national interviews.

From August 2018 EoE CST will also be supporting the RCSEng Improving Surgical Training programme.

With many more exciting developments ahead we look forward to welcoming you to our region.

Miss Claire Edwards PhD FRCS

Core Surgery Training Education Director

Consultant Trauma and Orthopaedic Surgeon, Norfolk and Norwich University Hospitals NHS Foundation Trust 

Meet the Trainees

Raees Vanker - Core Surgery Trainee Representative for the North of the region, Norfolk and Norwich University Hospitals NHS Foundation Trust 

My name is Raees and I am one of the core surgical trainee representatives in the East England region. I had not previously worked in the region and found it to be a large and friendly deanery with a mix of district and teaching hospitals, therefore allowing for a varied experience.

I have worked in General surgery, Trauma and Orthopaedics and Urology at the Norfolk and Norwich University hospitals, and the experience has been excellent. There have been many training opportunities including audit, research, teaching, leadership and surgical procedures. I personally have had the opportunity  to teach examination and surgical skills to medical and pharmacy students, foundation doctors, physician associate students and nurses. I've been involved in multiple audits and a research project and have had the opportunity to attend theatre on a weekly basis as part of the SMART criteria for surgical trainees. The seniors have always been extremely helpful and supportive in guiding me towards the next level of my career. The consultants have been very encouraging in surgical training, allowing for many one to one training opportunities intra-operatively.

The training programme director and education lead have been engaging and always available to help when in need. Teaching has been set up to cater for a variety of topics in the core surgical curriculum . These included and not exhaustively,  a hands on cadaveric surgical procedures course, orthopaedic training days, and MRCS topic days.

Overall, I am glad that I came to the region and would strongly recommend choosing the East of England as the place to start your surgical career.

Harriet Cunniffe - James Paget University Hospital NHS Foundation Trust

I am Harriet Cunniffe, I completed my CT2 at James Paget University Hospital, with 6 months of ENT and 6 months of Upper GI surgery, and am about to start as an ST3 in ENT. I have found core training at the James Paget University Hospital to be a fantastic springboard to higher surgical training. There are dedicated training lists, meaning there is plenty of elective operating time but also opportunities to attend the emergency lists. The clinics are treated as learning opportunities for core trainees with space to see the patient yourself and then present to the consultant. There are also timetabled free slots which allow for personal development including completing audits, research projects, WBAs, practicing laparoscopic work in the simulation suite and preparing for exams and interviews. Many of the consultants are interested in research so are able to support and supervise projects and most are involved in examining and interviewing for national selection so are able to help with preparation. The on calls are busy but the registrar and consultant are very proactive and available to help with the acute take as the emergency operating is done by a different team.

The James Paget University Hospital has a friendly atmosphere with a very social doctor’s mess. I would highly recommend this hospital to anyone considering it for core surgical training.  

 

Lauren Bolton - Core Surgery Trainee Representative for the South of the region, Colchester Hospital

My name is Lauren Bolton and I am one of the core surgical training representatives in the East of England region. I had not worked in this part of the country prior to starting and I have found it extremely welcoming and friendly. I have learnt a lot and had lots of training opportunities both inside and out of the operating theatre.

I have worked in ENT and Breast Surgery at Colchester Hospital. For CT2 I will be based at Broomfield working in ENT and Plastic Surgery. In CT1 I have had a wealth of training opportunities with excellent teams. In theatre, I have easily met my logbook requirements in both jobs and I have completed all the procedures required for ST3 application (ENT). The seniors provide a lot of one on one teaching in the operating theatre which has made a big difference to my surgical skills.

On calls give good experience in managing emergencies – allowing for independent decision making where you are confident and good senior support if required. Again, this has made it easy to complete all the required workplace based assessments for portfolio. Night on calls cross cover ENT with orthopaedics which, initially was daunting having no previous orthopaedic experience, but the seniors were all friendly and happy to be contacted for advice.

I have taught medical students on surgical skills courses run at Colchester, I have completed multiple audit and research projects, presented my work at conferences. I have found it easy to get study leave to attend courses/conferences and to study for and complete exams. The seniors have provided excellent advice for career progression. In ENT, there are registrars in the training programme so they can give excellent advice in preparation for ST3 application.

I would highly recommend Colchester and East of England to anyone considering this region!

 

Stephen Crockett - East and North Hertfordshire NHS Foundation Hospital Trust, Lister Hospital

Working as a core surgical trainee at Lister Hospital has been a great experience. It is a centre with a large plastics, urology and orthopaedics unit, with an ever increasing general surgery and vascular service which means that you see a huge range of interesting elective and emergency work. There are a number of very good trainers who are supportive and provide trainees with exposure to different operative techniques, and work towards more independent operating. It is definitely a place where the more you put into your work, the more you will get out of it, and thus it has been extremely rewarding. As a trainee, you get a lot of responsibilities, and these have really prepared me well for attending further registrar training in vascular surgery.

 

Awaiting trainee photograph - Barnaby Farquharson, East and North Hertfordshire NHS Foundation Trust, Lister Hospital

Lister hospital is a large, busy DGH with a high quality surgical department. Surgical specialities available at Lister are General Surgery, Vascular, Urology, T+O, Plastics, ENT. This provides an strong platform for training and opportunity to sample a wide breadth of surgical pathology. There is a keen focus on training within the surgical department and trainees are actively encouraged to attend theatre where possible. The large volume of patient turnover leads to significant elogbooks and no concerns completing ISCP WBA quotas. On calls can be busy and challenging but with senior support readily available they come with many learning opportunities. Lister is an ideal place to begin surgical training if hoping to get into theatre and be trained. 

 

Brianda Ripoll - Royal Papworth Hospital NHS Foundation Trust

Working as a junior doctor at Royal Papworth Hospital has been a wonderful experience for me. The UK’s first successful heart transplant was performed here, and since then Papworth has become the UK’s leading heart and lung hospital. Here you will enjoy excellent opportunities in research and innovation. There are six theatres running Cardiac and Thoracic surgery every day, full of surgeons willing to teach you and guide you in your surgical career in a friendly and enthusiastic environment. This is the only centre in the UK for a number of specialist services including Pulmonary Endarterectomy and Balloon Pulmonary Angioplasty. Here you can see Frozen elephant trunks, transplants, VADs, LVRS, subxiphoid and other VATS, and a huge range of elective and emergency procedures. Our ICU is a cutting edge ECMO centre, where you can train in a wide range of skills including FICE. This is a centre that will offer the trainee a global perspective of Medicine and a deep insight of the operative and perioperative management of the Cardiothoracic Surgical patient.

 

Fang Yi Cheung – Bedford Hospital NHS Trust

I was a core surgical trainee at Bedford Hospital for 2 years and am now an ST3 in General Surgery.

There are plenty of training opportunities at Bedford for those who are proactive. I found my time at Bedford to be a great step towards Higher Surgical Training.

I completed 6 months each in Vascular, Colorectal, Breast & Upper GI Surgery, and Urology. There isn’t a rigid structure to the week, however this meant that I was able to choose and structure my time around what was most beneficial for my own learning, with opportunities to attend elective and emergency theatres, clinics and training endoscopy lists.

There are several enthusiastic trainers who are keen to build trainee confidence and operating skills, including very experienced staff grade surgeons who have their own lists with cases perfect for core trainees.

There are also regular opportunities to take a lead on teaching and training roles with all years of clinical students from Cambridge University regularly rotating into Bedford Hospital, as well as a weekly Friday morning surgical teaching, well attended by foundation doctors to consultants.

The day on calls are not too busy and inter-departmental relationships, are for the most part, very friendly, so I found there was space for me to “step up” and make decisions of a registrar on call. Night on calls also require ENT and Orthopaedic cross-cover, however, Registrars understood that I had never done these jobs before and so were supportive and came in when I needed to be in.

Bedford is definitely a place where you can grow at your own pace into the surgeon you want to be; where the more you put in, the more you will get from it.

 

Awaiting trainee photograph - Wayne Ng, Ipswich Hospital East Suffolk and North Essex NHS Foundation Trust

My name is Wayne and I am currently a year two core surgical trainee in the East of England deanery predominantly based in Ipswich hospital. I have found Ipswich hospital to be a friendly place to work with a good team. From a day job point of view I am given a structured timetable which fulfils the SMART criteria but at the same time have the freedom and flexibility to be involved in the clinical work that will benefit me the most. I was allowed adequate time to revise for my MRCS part B at the beginning of my rotation which I have since completed. I have also been given the opportunity to work closely with the registrars and the juniors. It is a unique opportunity to be able to offer support to the more junior members of the team but at the same time trying to learn the trade of being a registrar and making that transition smoother. I have been given opportunities to step up as a registrar in certain situations but I have always been supported by my supervising consultants. I have plenty of opportunities in fracture clinic and found that to be an incredible valuable learning space. I am also free to join most of the trauma lists that go on every day to get my hands on some of the more common operations, namely DHS, MUA + K-wiring of wrists, ORIF of ankles etc. From an audit point of view, I have been involved in two audits thus far and they are both pending re-audits which will take place at some point down the line. All in all I will recommend this training opportunity to any trainee who is interested to do trauma and orthopaedics and will be more than happy to come back for higher training in the future.

 

  

Will Hughes, CT1, Broomfield Hospital, Mid Essex Hospitals NHS Trust

Core Training at Broomfield

Broomfield is a great hospital to be a Core Trainee. The team here are great; we have 6 colorectal consultants, and 4 Upper GI consultants, excellent registrars and enthusiastic foundation doctors. There are two core trainees, a CT1 and a CT2.

I’ve been based with the colorectal team; most days consist of consenting the elective patients prior to the 1-1h30 ward round of between 10-30 patients. There’s normally a good cohort of juniors around to share the jobs which gives the rest of the day up to theatre/clinic time, then catch up with the team in the afternoon. I’ve been scrubbing in for the elective cancer work, hernias and other routine lower GI stuff, and the team let you get really involved in theatre. Additionally there are plenty of appendixes that I’ve been allowed to remove, and the breast team here have no juniors so are very keen to get us involved, at least until their registrar arrived! The training here is great, the registrars are keen to teach and pass on their surgical skills.

On-calls can be variably busy but as the SHO you get supported by 2 registrars during the day, and two F1s, and we always get through it together. We cover vascular, urology and general surgery on-calls during the day, and urology and general surgery at night so you get to see a huge variety of disease.

Chelmsford as a city is also very nice, it’s only 30 mins from London by train going the opposite way to commuter traffic, and it’s even got a John Lewis and an Everyman. There’s also plenty of beautiful surrounding countryside which is great to get away to. The new Anglia Ruskin University has only been running its MBChB programme for 2 years, so we’ve got an abundance of medical students who are keen to be taught.

 

Will Wakeford - Bedfordshire Hospitals NHS Foundation Trust, Luton & Dunstable University Hospital (CT1 ENT & OMFS) 

I am currently a CT2, but spent the first year of core surgical training at the Luton & Dunstable Hospital where I spent 6 months in Oral and Maxillofacial Surgery and 6 months in ENT. As a regional centre for head and neck surgery there are an abundance of interesting surgical cases, many of which bring the ENT and OMFS departments closely together. I was the first core trainee to rotate through OMFS and was unsure what to expect, but I found the department extremely welcoming and was surprised by the diversity of the work taken on by the team. There are emergency cases most days – often for facial fractures – and daily theatre lists ranging from teeth extractions to extensive cancer resections with free flap reconstruction. I felt welcome everywhere and found that, as an aspiring ENT trainee, there was a great deal of learning that will be very useful in my intended career.

Similarly, the ENT department was very welcoming and there were plenty of opportunities to get involved across all aspects of the specialty. Clinical and educational supervision was particularly strong with helpful guidance around professional development. The night shift rota for ENT is combined with general surgery meaning that the nights come around relatively infrequently, but require cross covering general surgery and urology. I was well supported in general surgery at night and was able to get involved with several emergency operations with the on-call registrars.

I did not have difficulty meeting CT1 requirements for the year, despite the massive reduction in services with COVID-19. I also did not have difficulty getting funding from the deanery for training courses, including ‘aspirational’ courses. Overall I would highly recommend this placement for those interested in ENT or OMFS.