Standards for Surgical Trainers

As surgeons, we are all aware of how important good surgical training is to the quality and safety of the care we can deliver for the benefit of our future patients.

As trainers, we face significant challenges to maintaining the high quality of training and we must now strive to deliver training in less time and in a far more distributed environment than before.

To date, there has been no stipulation of the standard needed to become a surgical trainer. This situation differs in primary care where there is a recognised and rigorous selection and training process to be recognised as a GP trainer. It also means that GP trainers are properly recognised and remunerated for their role, whereas in surgery the training role is rarely rewarded. The Faculty of Surgical Trainers has now produced a set of Standards for Surgical Trainers.

Download the latest version of the standards

Recognition and Approval of Trainers

In 2016 the GMC put in place a system of trainer approval for all trainers in secondary care. All those with a named training role (i.e. educational and clinical supervisors) now go through this process in order to maintain their training role. In effect, this brings secondary care trainers into line with primary care trainers, who already have to be approved by the GMC. Further details can be found on the GMC website.

This GMC process of trainer recognition will entail demonstrating your activity as a trainer. The GMC has chosen a framework originally devised by the Academy of Medical Educators (AoME). This framework consists of seven domains (see below) in the field of education and training. These domains will be used to ensure that you carry out your job as a trainer effectively.

This framework, however, lacks a surgical context and so the Faculty of Surgical Trainers has devised a set of specific Standards for Surgical Trainers. The evolution of these surgical standards can be found in this accompanying short webinar presentation. Our standards contain an explicit set of surgical trainer behaviours mapped to the AoME domains, which will enable surgical trainers to comply with the GMC approval process.

The seven domains:

1. Ensuring safe and effective patient care through training
2. Establishing and maintaining an environment for learning
3. Teaching and facilitating learning
4. Enhancing learning through assessment
5. Supporting and monitoring educational progress
6. Guiding personal and professional development
7. Continuing professional development as an educator

Bringing the Framework to Life

In this video, the framework of standards are brought to life by future trainers. Watch as David O’Regan, former Director of FST, poses a series of questions taken directly from the FST framework to panellists Mohamed Abdelrahman, Kelsey Mills and Arjun Nathan.

Development of the Standards for Surgical Trainers

The Faculty has adapted the existing AoME standards and rewritten them with the surgical trainer in mind. Rather than a simple and superficial rewrite, an in depth process of analysis and adaptation has been carried out.

Retention of the original domain headings has ensured that this process will satisfy the GMC trainer approval process. This adaptation process has also taken care to accurately depict what an effective surgical trainer actually does in their day to day training job. Detailed and multiple sources of evidence have been compiled that can be used to demonstrate that a trainer meets the GMC trainer approval standard. Throughout all this process an emphasis was kept on being practical and not turning into an onerous burden of paperwork for the trainer.

Although the original domain headings, and the concept of the effective and excellent trainer were retained, all the descriptors were altered to ensure that they reflected real world surgical training practice. These descriptors all describe behaviours that any surgical trainer would recognise and would carry out in their training role. For each descriptor time was spent detailing a list of sources of possible evidence that could be used by that trainer to prove that they satisfy that particular descriptor and can map to that domain.

A complex list of descriptors was drawn up for each domain, and then were distilled down into a smaller set of behaviours that were indicative of effective surgical training. This forms our Standards for Surgical Trainers. This document will make it easier for surgical trainers to fulfil the GMC trainer approval process. While the faculty welcome efforts to enhance the quality of training, it is important to ensure that dedicated trainers will not relinquish their training role in light of this impending legislation. The production of a dedicated set of standards for a surgical trainer, rather than the generic AoME standards, should help support surgeons to remain as recognised trainers.

These standards have been presented to the Joint Committee on Surgical Training, who hope to adapt these as the UK standard for surgical trainers. The Faculty are currently working with ISCP to integrate both these standards and the method of proving that you meet these standards into ISCP version 10.