1. The MMC T&O 8 Year “Mixed Economy” Training Project The Project to date Professor W Angus Wallace Chair, Specialist Advisory Committee (SAC) in Trauma and Orthopaedic Surgery Prof W Angus Wallace Chair, SAC in Trauma and Orthopaedic Surgery Presented to the Regional Advisers Meeting, RCSEng on 7 th May 2009 Slide No 1

2. The Aims of the Study To explore if a “mixed economy” intake of young surgeons into T&O could be carried out successfully To establish if this format for T&O Training will work over a 2 year period (2009 and 2010) Approved by MMC on 24 th September 2008 Slide No 2

3. A Proposal for a Study of a A Proposal for a Study of a “Mixed Economy” intake of T&O Trainees from 2009 - 2011 Prof W Angus Wallace Chair, SAC in Trauma and Orthopaedic Surgery Presented to the MMC Programme Board On 24 th September 2008 Professor W Angus Wallace Chair, Specialist Advisory Committee (SAC) in Trauma and Orthopaedic Surgery MMC Presentation 24 th September 2008Slide No 3

4. The Requirements for Orthopaedic Trauma Training Essential to have exposure to at least 10 months, and preferably 12 months of Orthopaedic Trauma in order to meet the Curriculum requirements – Workplace Based Assessments etc. (WBAs) DOPs etc. The BOA Curriculum Committee has advised that 2 of each of the following assessments are undertaken for each post at ST1 and ST2: DOPs, CBD, Minicex, PBA Minipat. By the end of ST2 the curriculum demands that in order for them to progress, must have achieved supervised operative experience of hemiarthroplasty, DHS and ankle fixation. MMC Presentation 24 th September 2008 Slide No 4

5. The Organisation of the Study Four Deaneries volunteered to take part Yorkshire & Humber; Northern; North Western; West Midlands The Study was led by the Chair of the T&O SAC The Lead Deanery was Yorkshire & Humber Each Deanery appointed a Lead Member to coordinate their Deaneries appointments Slide No 5

6. Managing the Applications One Advertisement was published on 5 th January 2009 The ICATs system was used for managing the applications Applicants were asked to apply for one preferred Deanery but could apply to all but would only be interviewed by their preferred Deanery Slide No 6

7. Applicants completed a Ready Reckoner Form Slide No 7

8. Applicants completed a Ready Reckoner Form Slide No 8

9. The Ready Reckoner Form produced a Score for each applicant The Score was entered into ICATS system The number of months in Surgery was entered into the ICATS The Scores were tabulated An adjustment factor was calculated for those who were applying from FY2 Those candidates who scored in the top group were interviewed Slide No 9

10. The Ready Reckoner Form accuracy Form Checked against evidence at the Selection Centre We introduced a Station 8 to do this There were some dishonest applicants – one has been reported to his employers and to the GMC Slide No 10

11. Selection Centres Four Selection Centres:- Northern – Newcastle 13 Feb North Western – Bolton 23 Feb Yorkshire & Humber – 24 Feb West Midlands –Birmingham – 24-26 Feb 7 Stations at each Centre 13+2 Minutes each All 4 Centres Quality Controlled Slide No 11

12. Selection Centre Stations Interview station 1 - Probing of the portfolio = 3 Selectors Interview station 2 – an Acute Emergency Scenario + a Probity Scenario = 2 Selectors Interview station 3 – Commitment to the Specialty of T&O and to the Deanery = 2 Selectors Slide No 12

13. Selection Centre Stations Station 4 – Skills assessment station – Suturing + communication = 1 Actor + 1 Selector Station 5 - Telephone Communication with a Consultant at night on a clinical problem = 1 Selector Station 6 – Discharge Summary from a Patient’s Case-notes = 1 Selector Station 7 – Communication with relatives = 1 Actor + 1 Selector Station 8 - Validation of Shortlisting Tool Slide No 13

14. The Scheme was very Popular 491 Applicants for 67 posts Trainees want run-through training Slide No 14

15. Number of ST1/CT1 Appointments Slide No 15 Deanery No of ST1 (run-through) posts No of CT1 (un-coupled) posts Total No of ST1 and CT1 posts Approx No of Short-listed Candidates (3x No of posts) Yorkshire & Humber 9101957 North Western 661236 Northern 45918 West Midlands 11162781 Total 303767192

16. Number of posts by Deanery 58 60 153 34 22 32 34 21 25 32 29 36 83 619 Number of CT1 Appointments 2008

17. Surgical Specialty Total Nos in post in 2008 ST3 to SpR6 Nos per year Cardio-Thoracic13122 General Surgery902150 ENT26043 Paediatric6010 Plastic Surgery17329 Trauma & Orthopaedic833139 Urology22838 TOTALS served by “Core Surgical Training”2587431 Number of Surgical ST3 Posts 2008 Number of CT1 Posts 2008 619

18. The New Lost tribe ? This means we have a new lost tribe between CT2 and ST3 of 187 (21%) in “official” surgical training at present. This does not take into account LAT posts

19. The End Slide No 19