CCT Checklist (please sign each of the 3 pages)

Name:……………………………………………………………......

Year (as of 10/2012):……………………………………………………..

CCT date:……………………………………………………………..

I understand the Guidance of the JCST in relation to minimum requirements before the award of CCT.I acknowledge that it is my responsibility to be aware of any shortfalls in regard to these “targets” and to discuss with my Program Director a means of correcting any deficits in a timely fashion before the end of my 6 year training program.I am providing numbers re Logbook cases and details of publications / presentations, but understand that the other minimum requirements must be met too, and detail any problems in this regard below.

Signature:………………………………………..Date:………………………..

Academic Progress:

National Podium Presentations of work prepared during SpR / StR Training:

1.
2.

Peer review publications of work prepared during SpR / StR Training:

1.
2.

LOGBOOK Summary as per JCST Guidance

Please Note:These operation target numbers do not include Assisted Cases. Categories SS/SU/P and T are the ones that count

Procedure / Target Number / Number Performed
  1. Carpal Tunnel Decompression
/ 30
2. Knee Arthroscopy & simple arthroscopic procedures / 40
  1. Total Knee Replacement
/ 401 within this number other joints can be included
  1. First Ray Surgery (Foot)
/ 20
  1. Total Hip Replacement
/ 40
6. Compression Hip Screw for Intertrochanteric Fracture Neck of Femur / 40
7. Hemiarthroplasty for Intracapsular Fracture Neck of Femur / 40
8. Application of Limb External Fixator / 5
9. Operative Fixation of Weber B Fracture of Ankle / 40As well as Weber B, Weber C fractures can be included
10. Tension Band Wiring of patella and olecranon fractures / 10
11. Intramedullary Nailing for Femoral or Tibial Shaft Fractures / 30
12. Tendon Repair / 20This includes all tendon repairs e.g. tendo
Achilles

TOTAL CASES DURING SpR / StR Training to Date:………………………………………………

Signature:…………………………………………..Date:………………………..

Information that I wish my Program Director to be aware of at this time:
If this section is blank then all targets eg ATLS, Audit etc etc in the JCST Document are assumed to be met.

Signature:…………………………………………..Date:……………………….