Cardiothoracic Surgery Training Programme in HEE South West
The South West regional training scheme in cardiothoracic surgery is based in 4 hospitals – Bristol Royal Infirmary (General Thoracic), Bristol Heart Institute (Cardiac GUCH), Bristol Royal Hospital for Children (Paediatric) all in Bristol (Severn) and Derriford Hospital – Plymouth (Peninsula). Overall supervision of the programme is led through the Severn Postgraduate Medical Education; however the TPD rotates between the two centres. The trainees rotate between the two training hospitals with approximately half their training at either centre.
Appointment to the Cardiothoracic Surgery Training Programme is undertaken by national recruitment and trainees can apply to enter at various levels: ST1, ST3 o ACF.
The ST1 post is based in Plymouth and comprises 2 years at Core Trainee level with 6 months General Surgery, 6 months Vascular Surgery and 12 months Cardiothoracic Surgery before progressing through to the Southwest ST3 rotation. Trainees will attend the Cardiothoracic ARCP during their ST1-2 training. There are a limited number of posts nationalTly (usually 6-10 posts) where trainees can enter the programme from an early stage and receive Core Surgical themed training for two years followed by automatic entry to specialist registrar at ST3 level.
There are approximately 15-20 trainee numbers available nationally annually and a degree of cardiothoracic experience is usually required.
Expected rotation arrangements for this programme are:
- Nationally selected trainees will rotate between Bristol and Plymouth spending 2-4 years in either post
- In both centres trainees will spend 6 months in a firm based (consultant clinical supervisor) arrangement under a single educational supervisor
- Paediatric cardiac surgery is based in Bristol. Trainees will spend at least 6 months in the unit
Registrar rotas at both units are compliant with the EWTD. Features include:
- Non-resident on call registrar
- Day off post on-call (Bristol cardiothoracic trainee workload ranks in the best 5% of UK programs in the GMC survey)
- Firm based training at core training level and beyond
- Structured training for core trainees by SCPs in theatre
- Nurse Practitioner support in ward areas
ACF: Academic Clinical Fellows posts are advertised through Bristol and appointed at national selection. These consist of 3 year academically themed years followed by 3 clinical years.
ACFs will be based in Bristol Heart Institute, linked with the University of Bristol for the first 3 years of their training. Briistol is a Russell Group University, ranked within the top 30 Universities in the world (QS world rankings 2014). The medical academic staff includes:
X1 British Heart Foundation Professor of Cardiac Surgery
X1 Bristol University Professor of Cardiac Surgery
X2 Bristol University Readers of Cardiac Surgery
X1 Research Fellow
There are a large number of high impact papers published by our trainees each year.
There has been a strong interest in separating the two disciplines in Cardiothoracic Surgery with the proposed eventual appointment of either only Thoracic or Cardiac Surgical Consultants. The training will still be combined to a degree Thoracic and Cardiac surgical themed training programmes are due to be developed in the near future and the South West will be able to offer these posts when available nationally.
All aspects of Cardiothoracic Surgery are undertaken in the South West with the exception of heart and lung transplantation. The following subspecialist areas are provided by the two centres:
- Bristol Royal Infirmary: Based in the new £62M Bristol Heart Institute the centre performs around 1400 adult cardiac operations each year as well as adult thoracic surgery. Particular areas of specialisation include off-pump CABG, minimal-access mitral and aortic valve surgery and clinical research. Paediatric cardiac surgery is performed at the adjacent Bristol Royal Hospital for Children. The department has strong links with Bristol Heart Institute research group led by Professor Angelini supported by a further professor, a reader and a senior lecturer in Cardiothoracic Surgery supervising of one to two ACF posts – (http://www.bristol.ac.uk/bhi/). The research group has over £50M worth of research grants and publishes nearly 100 papers annually in clinical and basic science. In the last 7 years 1 trainee won the Fontan Award, 3 the St Jude/SCTS Fellowship and all trainees have undertaken overseas fellowships in prestigious centres in Europe, Australia and America.
- Derriford Hospital Plymouth: Based in the new £30M Terence Lewis Building, the South West Cardiothoracic Centre performs 1300 adult cardiac operations each year with a specialist interest in minimally invasive surgery including minimally invasive aortic and mitral procedures, transcatheter aortic valve replacements (TAVI) and minimal extracorporeal circulation - (MECC). Major aortic surgery is performed including complex stenting of thoracic aortic pathologies. Adult thoracic surgery is performed with all the regional upper gastrointestinal surgery including minimally invasive oesphagectomies.
Trainees can expect a great deal of clinical exposure at the two centres with a reputation of extensive surgical experience with trainees performing a high percentage of cases. Regional training days are arranged biannually with additional wet lab days and mock exam sessions provided. We are proud to have a 100% first time pass rate for the part III exit exam for national trainees from the South West. Both centres offer access to locally arranged training days and simulation classes and there has been very positive feedback from the previous trainees in the region.
Annual Review Competence Progression's take place in July; further interim assessments take place as necessary. The panel includes the Training Programme Director and Deputy Director, Chair of the Specialty Training Committee, a Dean's representative, the SAC Liaison member for the region and a lay person.
The Cardiothoracic Syllabus is outlined in the ISCP website.
By agreement with the Training Programme Directors it may be possible and we would encourage trainees to spend a year out of programme at an overseas training unit (OOPT). Other opportunities exist within the academic departments of surgery for trainees to undertake a period out of programme (OOPR) to do formal research in order to complete a project that would lead to an MD, MS or PhD thesis.
Further details are available on the Severn and Peninsula Postgraduate Medical Education websites.
There are a number of regular teaching sessions and formal study days arranged throughout the year:
- Weekly departmental teaching for trainees in Plymouth and Bristol
- Monthly regional Core Trainee Meetings (Peninsula)
- Regional study days held 3-4 times per year between Severn and Peninsula PGME
- Aortic Valve Study Day
- Aortic Surgical Study Day (Bristol)
- Minimally Invasive Workshop – Bristol
- Mitral Study Day and Wetlab teaching
- Cardiopulmonary Bypass Study Day
- Thoracic Stapling and Airway Anastomosis Course
- Modern Management of Lung Cancer Symposium
Our faculty are actively involved with national educational events, including:
- Specialty Skills Course in Cardiothoracic Surgery
- Intermediate Skills Course
- Professional Development Course
- Birmingham Review Course
- RCSEng Training the Trainer Course
- SCTS University
- Cardiothoracic Trainees National “Boot Camp”
From September 2019 all study leave is administered by the employing Trust. Please refer to the Study Leave pages on the website
Hunaid Vohra - Training Programme Director
Susan House - Education & Programme Manager.
The next ARCP date for 2022 is: Thursday 20th January 2022 . This is for the panel only. Trainees will be given feedback after this date.
Cut off date for ISCP to be updated and all paperwork uploaded and Form R returned to Programme Manager is Thursday 6th January 2022