History

The Young Cardiac Surgeons' Club was founded in 1986 by Martin Elliott and B. Sethia. At that time it was known as the Senior Registrars' and Young Consultants' Club, and was open to all senior registrars and consultants of less than five years standing in the specialty. The aim was to provide a scientific and social meeting for friendly debate, complaint and discussion of matters of mutual interest without the potentially oppressive influence of senior consultants. A particular aim was to provide a unified voice for trainees and to increase junior representation within the cardiothoracic establishment at a time when there was growing concern among senior registrars over the heterogeneity of cardiothoracic surgical training. Against this background the Club became the forum for the nomination and election of a senior registrar representative to the Executive of the Society of Cardiothoracic Surgeons of Great Britain and Ireland. Traditionally on appointment to a substantive consultant post this representative moves on to become the Young Consultants' Representative on the Executive of the Society, until he in turn is displaced by the appointment of the next senior registrar representative to a consultant post. More recently the club has also been responsible for electing a representative onto the cardiothoracic Specialist Advisory Committee (SAC) on Higher Surgical Training.

With the introduction of career grade registrars, and the inevitable implication that a career grade registrar was destined to become a consultant within the specialty, the club expanded to include "numbered" career grade registrars, and in order to avoid an unwieldy title changed its name in 1992 to The Young Cardiothoracic Surgeons' Club.

Each Annual Meeting is held over a week-end. The first part of the Saturday is given over to scientific presentations for which there is a prize of a sponsored trip to the next European Association of Cardiothoracic Surgery. This is then followed by an invited speaker(s) to discuss topics of mutual interest. The final session of the day constitutes a Business Meeting which is primarily aimed at allowing trainees to exchange views with Consultants in an open an uninhibited forum and where necessary for these views to be formalised and presented to more senior members of the specialty either personally or through the senior registrar representative to the Executive of the society. In addition if requested the Chairman will arrange for an additional topical session with invited speaker(s) at the annual meeting of the Society. The annual meeting and prize were originally sponsored by Shiley (UK) but this mantle has now passed on to Sorin Biomedica (UK).

Issues in 1995

Historically, surgical trainees had always worried about the adequacy and quality of training and their future employment. However, with so many changes afoot over the preceding couple of years certain concerns had become particularly relevant. With respect to adequacy, there was growing concern over the conflict between the reduction in junior hospital doctors' hours and adequate surgical exposure, particularly towards the end of training. Furthermore, whilst the impending continuum training was regarded as a move in the right direction since it provided an improved degree of security during training, there was concern over job availability and security at the end of the training. There were two specific angles to these concerns. Firstly, since the continuum was an escalator programme with new trainees regularly entering and progressing, the system demanded that trainees leave the scheme at the completion of their proscribed training period. This effectively removed the existing senior registrar buffering zone which traditionally allowed senior registrars to remain in post until they had found a consultant post. To ensure that there was not a surplus of well trained, unemployed cardiothoracic surgeons the club argued for extremely careful manpower planning for six years in advance. There was considerable doubt that such planning was possible: who would undertake the task, and how would input into the regional continuum programmes be policed in the face of changing national manpower requirements? There was substantial concern that if a surplus of trained cardiothoracic surgeons developed this would encourage the development of a sub-consultant grade which might, by necessity, be filled by well trained individuals of consultant standard. There was also concern that the development of such a grade (or even worse temporary posts) might be facilitated and fuelled by a surfeit of European specialists. These concerns were highlighted by the fact that it was still clearly possible to be appointed a consultant without specialty accreditation.

Given that an exit exam (Cardiothoracic Fellowship) had become mandatory, bringing us into line with Australasia and the United States there was broad agreement that a defined curriculum was long overdue. The lack of a defined curriculum combined with widespread anecdotal reports from candidates contributed to the unfortunate perception among potential candidates of an unstructured examination. the club argued that credibility and enthusiasm for the exam would be enhanced by the rapid dissemination of a "curriculum", and it would help if the Society, in conjunction with the colleges, explored the possibility of establishing reciprocity with other countries to enable trainees (and consultants) the option of undertaking clinical duties in other countries once in possession of the intercollegiate fellowship.

With respect to the year's research envisaged in the new continuum schemes there was a growing feeling that pure surgical or biological research did not suit everyone and some individuals may benefit more, and subsequently have more to offer to the specialty, if they spent a year doing some alternative form of study, for example health service management diploma, an MBA or a defined MSc.

The views and concerns outlined above represent some of the issues raised at meetings in the early 1990's and were published in the Bulletin by Bruce Keogh to stimulate debate and, in some areas, seek reassurance.

Current Issues