Surgical trainer roles should be reserved for the best consultants, college says

Only the best consultants should take up surgical trainer roles, the Royal College of Surgeons of Edinburgh has said, as it launched a set of standards for consultant surgical trainers across the UK, developed by its Faculty of Surgical Training.

Many aspects of the current surgical training system were outdated and must be changed to safeguard standards and ensure the safety of patients, the college said.

Speaking to The BMJ, Craig McIlhenny, the faculty’s surgical director, said, “Training at the moment by surgeons and for surgeons is really a default position. When you become a consultant, by default you often become a trainer. We know there are some excellent trainers out there, and we also know there are some trainers who are not excellent. Certainly what I would like in the future is that being a trainer is a badge reserved for the very best—those who are very good at their job.”

The standards (http://bit.ly/1upFVoG) are divided into seven “framework” areas, five of which apply to a named clinical supervisor, and all seven of which apply to a named educational supervisor.

The college said that the standards would help ensure that consultants who provided surgical training were able to prioritise patient care, challenge poor practice, promote improvements, and support underperforming trainees.

The standards have been approved by the General Medical Council, and consultants will be able to use the standards to revalidate themselves as trainers. Evidence to prove that consultants are meeting the standards will be gathered in a “trainer’s journal.” This will initially be on paper but could become an app or website in the future, the college said.

McIlhenny said, “Part of the problem is that at the moment trainers don’t really get any recognition or reward for their role. The other thing that our standards will hopefully fulfil is that by collecting this evidence trainers will start to say to their employers, ‘This is what I do on a regular basis; this is the amount of time it takes me to train people effectively,’ which hopefully will mean they get increased recognition in their job plans and professionally for the role they provide.”

Commenting on the launch of the standards, Ian Ritchie, president of the Royal College of Surgeons of Edinburgh, said, “This can only help to address concerns around the effects of the European Working Time Directive, which has capped the number of hours a surgeon can work.”

He added that the old-style apprenticeship model of training no longer met the needs of a changing NHS. “Training has to be delivered in a more structured, consistent, and educationally sound way, focused on patient care. The end product of training, after all, must be a surgeon who provides first class, safe patient care,” he said.