PAEDIATRIC SURGERY

Global Objective and Learning Agreement template

ST5/ST6

Programme Director’s Selected Topics
Topics to be selected from the Syllabus
Programme Director’s Supporting Statement
You should appraise yourself fully with the paediatric surgery curriculum as set out on the ISCP website and achieve the targets as set out in that document. In addition to the Paediatric Surgery (2010) curriculum, you should be aware of your requirements in terms of the generic professional skills and behaviour section.
You should closely follow the 7 pillars of practice as set out in the GMC’s ‘Good medical practice’.
You are particularly encouraged to develop skills in leadership, management and medical education.
1. Liaise with your Assigned Educational Supervisor (AES) at the beginning of each placement within 2 weeks of starting. Ensure you receive an appropriate induction from the outset.
2. Start assessments immediately. Identify mini-PAT raters early (in ST5) and get them to register. By the interim mid-term ARCP assessment you should have completed a mini-PAT (in ST5 only), at least 3 CBDs, at least 2 mini-CEXs and 6 PBAs. Your elogbook should be up-to-date and validated. It is critical you complete the minimum number of assessments as above.
3. By the formal ARCP each year, within the placement you should have completed 6 CBDs, 6 mini-CEX, and at least 12 PBAs. You should have completed your yearly audit project and have contributed to your research portfolio. All ARCP paperwork and ISCP documentation must be fully completed or you may fail the assessment.
4. Ensure that all Deanery paper work is up-to-date including Form R. The SAC must be aware of your training position and you should join/continue to be a member of BAPS.
5. By CCT, you will be expected to develop skills in audit and research appraisal/interpretation. At least one structure/process or outcome audit should be completed each year. By CCT you should have a completed research portfolio: This must include evidence of regular critical appraisal of the paediatric surgical literature (e.g. journal club) & presentations at regional and national level together with publications in peer review journals, and may include a higher degree of original work.
6. You should aim to attend national training days and national international meetings arranging this fairly with colleagues and ensuring that NHS work is cancelled/rearranged in advance.
7. All study leave must be approved by your educational supervisor and the Programme Director.
8. Educational support should be with your educational supervisor in the first instance but feel free to contact the Programme Director if there are any problems with your training.

Learning Agreement

Part 1: Topics to focus on during this placement
Please refer to the curriculum - Topics to be selected from the Syllabus
As a guide:
Before ST5
You should have achieved all the competencies as set out in ST3 & ST4 educational plan from previous years. Check if there are gaps.
·  In ST5/ST6: Aim to consolidate experience in core paediatric surgery with an emphasis on making an effective treatment plan.
·  You should concentrate on becoming very familiar with common paediatric surgical elective and emergency problems their investigation/ management including: General Surgery of Childhood, Gastro-intestinal, Neonatal Surgery, Oncology, Thoracic Surgery and Urology.
·  Be pro-active in organising regular appraisals with your AES.
·  Keep an updated educational portfolio containing CV, evidence of achievements and reflective practice
·  By the end of ST5/ST6: You should be able to carry out surgical procedures in the following groups (depending on placements) under supervision or independently:
Laparoscopy / GSC / GI / Neonatal / Thoracic / Oncology / Urology
Fundoplication
Remove gall bladder
Pyloro-myotomy
Gatrostomy insertion / Herniotomy /hydrocoele, Orchidopexy Circumcision Umbilical/epi-gastric hernia repair,
Pyloro-myotomy
Removal of appendix / Fundoplication
Right hemi-colectomy
Subtotal hemi-colectomy
Small bowel resection for Crohns disease / Closure of gastroschisis/ exomphalos
Diaphragmatic hernia repair
Correction of malrotation,
Laparotomy for NEC
Laparotomy for simple meconium ileus
Duodeno-duodenodtomy
Neonatal inguinal herniotomy / Resection of CCAM
Decortication of empyema
Resection of mediastinal mass / Tumour nephrectomy / Cystoscopy
Nephrectomy
Hemi-nephrectomy
Pyeloplasty
Vesicostomy formation/ closure
Repair distal hypospadias
By the end of ST5/ST6:
·  Complete & present at least 1 audit (1 per year)
·  Contribute to your research portfolio
·  Perform the required minimum number of validated WBA (as above)
·  Be able to manage a ward round and most clinic consultations effectively
·  Have a broad understanding of requirements to pass the FRCS Paed and to be consolidating your factual base with regular appropriate reading.
·  Achieved expected operative competency (see table above)
Part 2: Actions required to meet Learning Objectives
Assessments
·  Over the 12-month attachment we will aim to do at least 6 CBD and 12 PBA’s.
·  You should aim to carry out PBAs for the same procedure on several occasions to demonstrate progress
Resources Required
·  Scheduled appraisals
·  Attendance at local/regional Teaching Programme
·  Time set aside for WBA’s with Educational Supervisor
Learning Opportunities
·  Insert timetable, emphasising the best opportunities incl clinics, theatres, WR, admin and MDT’s.
·  A typical WTE weekly timetable may include:
Daily morning WR, some with consultant supervision
3 theatre sessions,
at least 1 general clinic,
1 admin session,
1 study/ teaching session,
Other sessions dependent on training requirements
·  Regional audit/ research meetings
Exams
Courses
See study guidelines above. Limited funding
Useful courses by ST5/6: see TRIPS web site
Operative skills in neonatal and paediatric surgery
Basic Sciences in Paediatric Surgery
BAPS Oncology course
Oxford Neonatal surgery course
Laparoscopy course
Hands-on BSPGHAN Paediatric Basic Ileo-Colonoscopy Course
Contact
Audits/Research/Projects
Part 3: Comments & Sign Off