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Cardio-thoracic Surgery

 |  Study and Training  |  ARCP Information  |  Programme Description  |

Contact Details   |   ARCP Dates  |  Further Information  |

 

The Wessex and Oxford Training Consortium was formed under SAC guidance in 2010 and is based at University Hospital Southampton NHS Foundation Trust ( UHS ) and John Radcliffe Hospital, Oxford ( JRH ). Both units have a long tradition of training NTNs , UK and overseas fellows. The Training Consortium was set up in 2010 to address geographical issues of previous rotations and enhance training opportunities via the synergy available from the two centres.The first jointly appointed trainee started the programme in August 2010.

The primary strength of both units has been based on clinical and operative exposure in both adult and congenital cardiac surgery, this includes the full range of standard and advance operative techniques. These include off pump surgery, the use of minimal extracorporeal circulatory support ( MEC ), minimally invasive surgery, valve repair and sparing surgery, and aortic surgery including thoraco-abdominal aneurysm surgery. Surgery for routine and complex congenital conditions such as AVSDs , TGAs and HLHS are routinely undertaken. In addition, at both sites transcatheter aortic valve implantation ( TAVI) is undertaken for high-risk aortic valve patients. UHS is a national referral centre for Fontan conversion surgery and JRH has an international reputation for mechanical assist devices in heart failure surgery. There is also a comprehensive thoracic surgery programme with six dedicated thoracic surgeons offering a full range of exposure. This programme provides comprehensive training in minimally invasive thoracic surgery, including thoracoscopic lung resection, with an opportunity to have exposure to oesophageal surgery at UHS .

The academic profile of the Consortium is now very strong. Members include two professors of cardiac surgery and a recent past-president for the SCTS and Chairman of the SAC . two MDs and two PhDs have been awarded and over 140 publications published in peer-reviewed journals within the last three years.

The training programme has been strengthened over the last three years with the appointment of four consultants actively providing training in Oxford and a new thoracic surgeon at Southampton. NTNs appointed to the rotation would expect to rotate between Oxford and Southampton, spending at least two years in each centre according to training needs and special interests.

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Programme Description

Cardiothoracic Surgery ST3 Programme Description (pdf)

The training programme is curriculum based as described by the ISCP website: ISCP Cardiothoracic Surgery Curriculum (pdf).

There is a strong training ethos within the programme with a commitment to train whenever possible. For example at UHS , over the last four years the trainees have performed an increasing number of the operations despite an increase in the overall risk profile of the cases, with 53% of all operations (including emergency work) being undertaken by trainees in the last 12 months (these are entire cases undertaken by the trainee not included are components of a case).

Trainees all currently start at ST3 level although a pilot at ST1 is about to commence.

Trainees are taken through all aspects of cardiac and thoracic surgery. At ST5 level, they are encouraged to take the FRCSCTh examination. During ST6/7 the training is tailored toward the trainee’s ambition and sub-specialist interest for example, mitral reconstruction, congenital or transplantation. A new programme has commenced which may provide an opportunity for a trainee to exchange for a French Trainee from Renne in France. This latter programme is ideally suited for more senior trainees who have the FRCSCTh .

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Study and Training

  • There is a wet and dry lab facility at both centres which is used for formal teaching twice a year. 
  • A homograft bank is available at Oxford and a dry lab facility is accessible by trainees on 24/7 basis at Southampton.
  • At both centres, there are weekly MDT meetings to discuss complex cases and all clinical activity is stopped so trainees can attend. There are also weekly TAVI MDT meetings where trainees can attend if available. An Oxford journal club for thoracic and cardiac surgery is run on a fortnightly basis. Both centres have weekly grand rounds.
  • There are monthly didactic/interactive curriculum based teaching which alternates between Oxford and Southampton and the whole curriculum is covered over a two-year period. This programme has been running since January 2010.
  • Frequent informal tutorials and mock exams are arranged for trainees approaching the FRCSCTh exam.
  • At both centres, new and follow-up patients are seen by trainees in the outpatient clinics. At Southampton 50% of all new referrals are initially seen by trainees who then discuss these cases with the consultant.
  • If the trainees wish to undertake academic work there is an active research programme, both clinical and basic science. A number of trainees have gone on to undertake full time research and successfully completed higher degrees such as an  MD & PhD .
  • In the last 12 months trainees have attended: the Birmingham Review course; the national SCTS meeting; as well as EACTS (European Association of Cardiothoracic Surgery); and the annual meeting of the SCTS (Society for Cardiothoracic Surgery for GB & Ireland). They have also been sponsored to attend specialist meetings such as the Brussels Aortic Reconstruction course and the Milan SVR course when appropriate. All trainees also encouraged to attend the Birmingham review course prior to undertaking their FRCSCTh .

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ARCP

The annual ARCPs are undertaken in July of each year and are web-based. It is therefore vital that all trainees fully engage with the ISCP website and record all their training data with evidence supporting their training progress through validated work based assessments.

An ARCP  six needs to be awarded before a CCT can be awarded to a trainee. The JCST have outlined requirements for CCT in the Quality Assurance section of their website: CCT Guidelines.

Specific requirements which need to be achieved by ARCP date are clearly stated in your global objectives and include:

  • 1 MSF at least once every two years
  • 40 WBAs per year
  • Topics as required
  • Up to date CV on system
  • An Assigned educational supervisor ( AES ) report. At least one clinical supervisors report by someone other than your AES for each learning agreement.
  • An evidence section and logbook that are completed contemporaneously

 

The only paperwork required for ARCPs is:

  • Enhanced Form R (for revalidation)
  • Validated (signed) consolidated logbook for that training year

 

To find out the date of your next ARCP please follow this link

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