Training in Cardiothoracic Surgery: Information for Overseas Doctors
An explanation by The Cardiothoracic Dean, Mr Leslie Hamilton
Thank you for your interest in
undertaking postgraduate training in cardiothoracic surgery in the
United Kingdom. I have
compiled this guide in my role as the Cardiothoracic Dean for the
Society of Cardiothoracic Surgeons it is my function to liaise
with current and prospective trainees, both within the UK and from
other countries. Our specialty is one of combined cardiac and
thoracic surgery, rather than cardiovascular surgery as in some
other countries. All
surgeons belong to one of the four Royal Colleges the Royal
College of Surgeons of England (based in London), the Royal College
of Surgeons of Edinburgh, the Royal College of Physicians and
Surgeons of Glasgow or the Royal College of Surgeons in Ireland. Training is supervised by the Joint Committee for Higher
Surgical Training (JCHST),
which is a sub-committee of the combined Royal Colleges of surgery
in the United Kingdom and Ireland. Each specialty then has a sub-committee, known as the
Specialist Advisory Committee (SAC), which organises and supervises
training. To be eligible for
entry to higher surgical training, all trainees (Type 1 and Type 2
posts see below) must have done a minimum of two years of basic
surgical training, including at least six months in cardiothoracic
surgery. You will need
formal documentation of this period of training. There are two types
of training posts and although they vary in duration and entry requirements, the training provided in each is the same:
| Type 1 post: |
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This is a six-year
programme (see curriculum), leading to the award of a Certificate of
Completion of Surgical Training (CCST), which is granted by the Specialist Training Authority
(STA). Those wishing to enter a Type 1 programme must have acquired
membership of one of the Royal Colleges of Surgeons by examination,
i.e. the MRCS (previously FRCS or AFRCS). These posts are obtained by competitive interview and are
advertised when vacant in the British Medical Journal and the Lancet
(available on their websites). There is great competition for these posts and trainees will
often have spent more than the minimum time in the specialty at SHO
level. Many trainees
will have undertaken a period of research, and all would be expected
to have peer-reviewed publications. In view of these formal regulations and requirements, it is
in practice, quite difficult for trainees from overseas to obtain a
Type 1 post. Appointees
are given a six-year contract which is reviewed annually a
formal meeting is held (attended by the Programme Director,
representatives from the subspecialty and the Postgraduate Dean)
known as the RITA (Record of In-Training Assessment) process.After a minimum of four years, the examination for the
Fellowship of the Royal College of Surgeons in Cardiothoracic
Surgery (FRCS C/Th) may be taken under the auspices of the
Intercollegiate Exam Board.
When the full six years are completed satisfactorily and the
examination passed, the trainee is recommended for a Certificate of
Completion of Specialist Training (CCST) by the JCHST. Once the
Specialist Training Authority grants the
CCST application may be made to the General Medical Council for
inclusion in the Specialist Register.
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| Type 2 post (This does not lead to a CCST) |
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An alternative for overseas
doctors who wish to come to the United Kingdom for a short period of
specific training. Recognising
this, these posts are normally reserved for doctors from outside the
European Community. However,
it may be possible for a European doctor who is in a recognised
training programme in their own country to come for specific
training in a Type 2 post. The
posts are appointed usually, but not necessarily, after an interview
and are not as competitive as Type 1 posts. Again, trainees must have done a period of basic surgical
training, as described above, and formal documentation has to be
provided. The posts are
normally for two years although they can, in some circumstances, be
extended to four, which would enable the appointee to undertake the
examination in cardiothoracic surgery. For further information
regarding the regulations for entry, please see visit The Intercollegiate Board website.
However, it must be stressed that if the successful candidate
does not hold the MRCS, then they will be awarded a Certificate of
Success in the examination, rather than being granted the FRCS C/Th. Overseas doctors who have acquired right of residence in the UK cannot be appointed to Type
2/FTTN
posts. |
| Additional Considerations |
| Trainees appointed
to either of these posts are given a training number and registered
by the JCHST. Those
appointed to a Type 1 post are differentiated, depending on whether
or not they have right of residence in the United Kingdom if
they do, they are giving a National Training Number (NTN) and if
not, they are given a Visiting Training Number (VTN).
Those appointed to a Type 2 post are given a Fixed Term
Training Number (FTTN) thus, these posts are advertised as
fixed-term training appointments (FTTAs).
All doctors practising in the United Kingdom must be registered with the General Medical Council and information is available on their website. If appointed to a post which has been granted educational approval by the SAC, then limited registration is usually provided. Further details of the regulations for basic and higher surgical training can be obtained from the Joint Committee on Higher Surgical Training. In addition, The Royal College of Surgeons of Edinburgh runs a sponsorship scheme for those overseas trainees coming to the UK for basic surgical training. A similar scheme, known as the Overseas Doctors Training Scheme (ODTS), is operated by the Royal College of Surgeons of England, for higher surgical trainees. There is a rather complex structure for organisation and management of postgraduate training in the United Kingdom, and further details can be obtained from the website www.copmed.org.com. If you are successful in obtaining a training post (or indeed if you are coming to the United Kingdom for an initial period of basic surgical training), then I would strongly advise you to attend a two-day overseas doctors induction course for non-UK graduates new to the NHS, which is run by the Professional Recruitment Section of the National Health Service (NHS). Details can be obtained by telephone on (0114) 290 0930. A further, very
useful site is the National Advice Centre for Postgraduate Medical
Education
which gives further information and a host of useful links.
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