Paediatric surgery is a small specialty in the UK with currently approximately 120 consultants, confined largely to regional centres. The specialty deals with the surgical diseases of childhood from newborns to the teenage years. The workload has a very general focus with most consultants developing experience and skills across the breadth of surgery. A substantial part of the paediatric surgical workload is urgent or acute.
The Training Pathway:
Specialty training programmes are the route to gaining a Certificate of Completion of Training (CCT) in Paediatric Surgery. The training programme in paediatric surgery is currently an indicative 8 years’ duration. Programmes are designed to provide exposure to a wide range of surgical problems in children during training. The training program comprises four stages: initial, intermediate, final and special interest.
- The initial stage (ST1 and 2) is the early phase and comprises training in surgery in general.
- The intermediate stage (ST3 and 4) introduces specialist paediatric surgical skills.
- The final stage (ST5 and 6) develops these specialist skills further.
- The special interest (ST7 and 8) stage enables further development of paediatric specialisation and consolidation of specialist skills and forms the transition to CCT.
It is highly likely that entry into specialty training will be by competitive selection at ST3 level, although the precise details are yet to be resolved.
Currently specialist training in paediatric surgery in the UK is organised into six consortia. Trainees will gain experience in two centres in one consortium. The consortia are currently:
The Department of Paediatric Surgery in Leeds
The regional department of paediatric and neonatal surgery in Leeds provides an acute and elective surgical service for children up to the age of 16 years. The department serves a population of approximately 4 million in the Northern and Yorkshire Region. The service is staffed by nine paediatric surgeons. Leeds is one of three national Children’s Liver Disease Centres (NSCAG), and the current paediatric liver surgeon remains closely allied to the rest of the paediatric surgical service. The paediatric surgical unit produces over 3,500 FCEs per annum.
Paediatric surgery training in Leeds is currently on two sites: the Clarendon wing of the Leeds General Infirmary and at St James’s Hospital. There are plans to transfer all childrens services to the Clarendon wing in the near future. At present acute surgery, neonatal surgery, GI surgery and thoracic surgery are based in the Clarendon wing. Hepatobiliary and paediatric liver transplantation surgery, urology, oncology and robotic surgery are based at St James’s Hospital.
There are currently 23 paediatric surgical theatre sessions across the two sites, including paediatric liver surgery and paediatric urology. There is an afternoon emergency theatre available in the Clarendon Wing theatre suite.
Mr DCG Crabbe (Thoracic & upper GI)
Mr AS Najmaldin (Urology & minimally invasive surgery)
Mr BR Squire (Oncology)
Prof DFM Thomas (Urology)
Mr ID Sugarman (Lower Gastrointestinal)
Mr MR Powis (Oncology & GI, College Tutor and Programme Director)
Mr RA Subramaniam (Urology)
Mr NK Alizai (Hepatobiliary and GI)
Currently we have a middle grade tier comprising nine specialist registrars. There is a junior tier comprising one FY-1, two FY-2 and 6 ST1/2/ Trust Fellow doctors. The specialist registrars are currently working a partial shift rota which is EWTD compliant at Band 2B and approximately 1:8. The junior tier is currently working a full shift rota.
Teaching and Learning:
Comprehensive training in all aspects of paediatric surgery is available in Leeds. The majority of teaching and training takes place in the operating theatre, outpatient clinic and on the wards. In addition the following academic meetings are held on a weekly basis:
- Thursday morning CW
- Tuesday lunchtime SJUH (renal/urology)
- Friday lunchtime CW (general)
- Friday pm SJUH (renal/urology)
- Thursday pm SJUH (oncology)
- Friday pm CW
Twice yearly national training meetings are organised by the BAPS Education and Training Committee for SpRs and other trainees in Paediatric Surgery. The meetings are held at different venues around the country.
Leeds/Leicester/ Nottingham/Sheffield/Newcastle consortium Training Committee meetings also take place twice a year.
ARCP meetings for the Consortium trainees are generally held in May and November in either Leeds or Sheffield. The trainees are appraised and assessed with the consultants and plans are made for training in the forthcoming year.
Study leave is allocated according to the educational needs of the trainee.