The MMC T&O 8 Year

“Mixed Economy” Training Project

The Project to dateThe Project to date

Professor W Angus WallaceChair, Specialist Advisory Committee (SAC)

in Trauma and Orthopaedic Surgery

Prof W Angus WallaceProf W Angus WallaceChair, SAC in Trauma and Orthopaedic SurgeryChair, SAC in Trauma and Orthopaedic Surgery

Presented to the Regional Advisers Meeting,Presented to the Regional Advisers Meeting,RCSEng on 7RCSEng on 7thth May May 2009 2009

Slide No 1

The Aims of the Study

• To explore if a “mixed economy” intake of young surgeons into T&O could be carried out successfully

• To establish if this format for T&O Training will work over a 2 year period (2009 and 2010)

• Approved by MMC on 24th September 2008

Slide No 2

A Proposal for a Study of a A Proposal for a Study of a

““Mixed Economy” intake of Mixed Economy” intake of

T&O Trainees from 2009 - 2011T&O Trainees from 2009 - 2011Prof W Angus WallaceProf W Angus Wallace

Chair, SAC in Trauma and Orthopaedic SurgeryChair, SAC in Trauma and Orthopaedic SurgeryPresented to the MMC Programme Board Presented to the MMC Programme Board

On 24On 24thth September 2008 September 2008

Professor W Angus WallaceChair, Specialist Advisory Committee (SAC)

in Trauma and Orthopaedic Surgery

MMC Presentation 24th September 2008 Slide No 3

The Requirements for Orthopaedic Trauma Training

• Essential to have exposure to at least 10 months, and preferably 12 months of Orthopaedic Trauma in order to meet the Curriculum requirements – Workplace Based Assessments etc. (WBAs) DOPs etc.

• The BOA Curriculum Committee has advised that 2 of each of the following assessments are undertaken for each post at ST1 and ST2: DOPs, CBD, Minicex, PBA Minipat.

• By the end of ST2 the curriculum demands that in order for them to progress, must have achieved supervised operative experience of hemiarthroplasty, DHS and ankle fixation.

MMC Presentation 24th September 2008 Slide No 4

The Organisation of the Study

• Four Deaneries volunteered to take part

• Yorkshire & Humber; Northern; North Western; West Midlands

• The Study was led by the Chair of the T&O SAC

• The Lead Deanery was Yorkshire & Humber

• Each Deanery appointed a Lead Member to coordinate their Deaneries appointments

Slide No 5

Managing the Applications

• One Advertisement was published on 5th January 2009

• The ICATs system was used for managing the applications

• Applicants were asked to apply for one preferred Deanery but could apply to all but would only be interviewed by their preferred Deanery

Slide No 6

Applicants completed a Ready Reckoner Form

Slide No 7

Applicants completed a Ready Reckoner Form

Slide No 8

The Ready Reckoner Form produced a Score for each applicant

• The Score was entered into ICATS system

• The number of months in Surgery was entered into the ICATS

• The Scores were tabulated

• An adjustment factor was calculated for those who were applying from FY2

• Those candidates who scored in the top group were interviewed

Slide No 9

The Ready Reckoner Form accuracy

• Form Checked against evidence at the Selection Centre

• We introduced a Station 8 to do this

• There were some dishonest applicants – one has been reported to his employers and to the GMC

Slide No 10

Selection Centres

• Four Selection Centres:-Northern – Newcastle 13 FebNorth Western – Bolton 23 FebYorkshire & Humber – 24 FebWest Midlands –Birmingham – 24-26 Feb

• 7 Stations at each Centre 13+2 Minutes each

• All 4 Centres Quality Controlled

Slide No 11

Selection Centre Stations

• Interview station 1 - Probing of the portfolio = 3 Selectors

• Interview station 2 – an Acute Emergency Scenario + a Probity Scenario = 2 Selectors

• Interview station 3 – Commitment to the Specialty of T&O and to the Deanery = 2 Selectors

Slide No 12

Selection Centre Stations

• Station 4 – Skills assessment station – Suturing + communication = 1 Actor + 1 Selector

• Station 5 - Telephone Communication with a Consultant at night on a clinical problem = 1 Selector

• Station 6 – Discharge Summary from a Patient’s Case-notes = 1 Selector

• Station 7 – Communication with relatives = 1 Actor + 1 Selector

• Station 8 - Validation of Shortlisting Tool Slide No 13

The Scheme was very Popular

• 491 Applicants for 67 posts

• Trainees want run-through training

Slide No 14

Number of ST1/CT1 Appointments

Slide No 15

Deanery

No of ST1 (run-through)

posts

No of CT1 (un-coupled)

posts

Total No of ST1 and CT1

posts

Approx No of Short-listed Candidates

(3x No of posts)

Yorkshire & Humber 9 10 19 57North Western 6 6 12 36

Northern 4 5 9 18West Midlands 11 16 27 81

Total 30 37 67 192

Number of posts by Deanery586015334223234212532293683

619

Number of CT1 Appointments 2008

Surgical Specialty

Total Nos in post in 2008 ST3 to SpR6

Nos per year

Cardio-Thoracic 131 22General Surgery 902 150ENT 260 43Paediatric 60 10Plastic Surgery 173 29Trauma & Orthopaedic 833 139Urology 228 38

TOTALS served by “Core Surgical Training” 2587 431

Number of Surgical ST3 Posts 2008

Number of CT1 Posts 2008

619

The New Lost tribe ?

• This means we have a new lost tribe between CT2 and ST3 of 187 (21%) in “official” surgical training at present.

• This does not take into account LAT posts

The EndThe End

Slide No 19