BSG TRAINING COMMITTE
TIG representatives: Christopher Lamb/Talal Valliani


UPDATES:

These notes are taken by the trainee rep on the committee and are not an accurate verbatim minutes of the meeting.


Update: June 9, 2010 (Talal Valliani)

Workforce

There is now to be a strict freeze on national training numbers across the country. This is because expansion of the work force (increase of 8% in trainee numbers) is currently greater than expansion in consultant posts (5.9%). As purpose trained Acute Medicine trainees are growing in number, the prospect of posts with Acute Med & Gastro are becoming less.  Some deaneries have continued to allocate numbers despite this freeze but this will now stop. Trainees on OOP E-C-R-T should be replaced by LAT posts. We did bring up the issue of how the specialty may become less popular as there is no incentive to do LAT posts if there is no training number to then pursue. The TC are aware of this concern. In theory, the problem should not be as great as one may anticipate as trainees going out on OOP should be replaced by those coming back to training. Filling in gaps on medical rotas is not a trainee issue and should be brought up locally with trusts and individual deaneries.

Hepatology curriculum

All trainees will now have to spend 6 months in a level 2 centre as defined for hepatology training. This is compulsory for all trainees in Gastroenterology. A level 2 centre is one which has 24 hour endoscopic/radiological facility for variceal bleeding, TJ liver biopsy facilities, access to TIPSS, Viral Hepatitis clinics, ITU with facility for liver patients needing renal support and HPB MDT’s. In order to become a gastroenterologist with an interest in hepatology, one needs to spend a further 6 months in a level 3 centre (transplant centre). As for a true CCT in hepatology, one will have to spend a further 12 months in a centre which offers the training needed to obtain this CCT.

National recruitment

In 2010, there were 490 applications for 72 Gastro ST posts. The process is still on going for allocating posts but there is unlikely to be a round 2 this year

SAC report

The 2010 curriculum is to be rolled out in August of this year. This includes more defined competencies for nutrition & hepatology as well as 3 new assessment tools (audit observation, patient survey, teaching observation). This curriculum will be only for trainees commencing in August 2010. Please note that if a LAT starts his/her training numbered post on or after Augist 2010, then he/she will also follow this curriculum.

E portfolio

JETS e portfolio is going to become compulsory from 2010.

JAG

Summative assessment requirements have become less stringent and please refer to JAG website for further details.

Update: February 10, 2010 (Adam Haycock)

Medical manpower

5.2% increase in consultant posts over the last year – 1,,041 total (1 per 60,000 pop, but wide disparity). Need 850 more to meet target 1,700 (expansion of 7% per annum) but issues re NHS budget. Retirement age 62 – stable.

Approx 800 trainees – increase in 4% over the last year. Approx 7.2 years to reach CCT. Predicted CCT dates – 100 per year over the next 4 years, but only 20 retirements per year. If consultant expansion continues at 7%, then there will only be 20 CCT holders without a job. Acute medicine posts are likely to dry up as Acute Medicine CCT holders come through.

Best employment option over the next few years is in hepatology.

JAG

1. DOPS now validated as an assessment tool. Can now change format. Need 4 assessed cases within a month, but no longer 2 assessors.  Your primary endoscopic trainer shouldn’t be an assessor.

If you fail one of the four, do you have do re-do all 4 cases? Not stated yet, but will check!

Do the assessors have to have TTT? Not stated yet, but will come out with guidelines.

2. New JAG website now live and very different.

3. Will be advertising for new JAG Chair. Will be open to all comers and interview appointment.

Hepatology

There is now an official hepatology training lead, who will be representative on the training committee. Centres will now be graded into 3 grades depending on what level of liver training is available there. There is likely to be more need for supervisors to confirm that trainees have actually done specific aspects of hepatology. BSG liver committee and BASL are joining to form one committee to give a single voice in hepatology.

National recruitment

Now with 5 specialities nationally. Can apply to 2 deaneries per speciality, but should state 4 deaneries to have a choice for cascade 2nd round. If selected, candidates will book their own interviews (within 48h). There will be 3 interview stations of 10-15mins each. They can accept an offer, reject it, or hold one offer until final date. Then local clearing round, followed by national clearing process.

Adverts 15 Feb. Opens 26 Feb-26 Mar. Shortlisting 29 March, then invitations 19 April. Interviews 29 April – 17 May. Offers 18-26 May. 1st June holding period ends.

SAC

New curriculum 2010 in progress. Curriculum and methods of assessment should be approved by PMETB. Need to ensure deliverability, esp in hepatology and nutrition.

Penny Nield said that training in nutrition should be deliverable. Minimum standards of centre are trying to be determined (e.g. nutrition team).

KBA

108 took part in second round. 61% passed. It was clear a lot of trainees had done very little preparation. Seemed like most trainees who were
expected to pass did. Lots of pictures e.g. histology, radiology. Next date registration 26 June - 26 July.

Should the BSG run training courses on the KBA? Perhaps… but realistically trainees should be adult learners and find the information for themselves. Charlie Murray has been put in charge of a project looking at the possibility of an e-learning module specifically for the KBA.

Trainee issues:

1) Compulsory endoscopy courses

We were reassured that trainees who started before 2007 and have already demonstrated competence in endoscopy will not have to do ‘mandatory’ JAG courses. They can invoke the unofficial ‘Grandfather’ clause! Advice is to talk to their programme director first and then any further queries should be directed to the BSG secretary. Ian Forgacs has said they will not make anyone do a course who is already clearly competent.

2) Sengstaken survey

This was raised as Edwin Swarbrick wanted to do a survey looking at experience in this. The 2010 curriculum will now state:

Can place safely and manage a Sengstaken tube in refractory variceal bleeding" This skill is assessed by DOPS and is in the core curriculum for all trainees.”

The training committee thought that it was inappropriate to DOPS such emergency procedures, but that training should be done using simulation on a model, with DOPS to confirm competency. However, they would expect trainees to have experience in real life, but not to have DOPS on them.