Chair of the BSG Training Committee The Shape of Gastroenterology Training The many facets of gastroenterology and dont forget the rest of the body My own experience how not to train a gastroenterologist ID: 999107
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1. Dr Matthew CowanConsultant Gastroenterologist at Surrey and Sussex Healthcare NHS TrustChair of the BSG Training CommitteeThe Shape of Gastroenterology Training
2. The many facets of gastroenterology…and don’t forget the rest of the body!
3. My own experience (how not to train a gastroenterologist)Gastro/hepatology House Job 1998Senior SHO post RFH Liver Unit /DGH gastro inc OGDHigh intensity DGH SpR post 2 yrsSubspecialty hepatology 2 yrsNIHR PhD Fellowship 3 yrsMore subspecialty hepatologyIgnored advice to get retrospective JAG approvalNo hepatology consultant jobs…
4. Shape of TrainingPatients and the public need more doctors who are capable of providing general care in broad specialties across a range of different settingsWe will continue to need doctors who are trained in more specialised areas to meet local patient and workforce needsSecuring the future of excellent patient care. Greenaway 2013
5. Shape of gastroenterology trainingFive year training program becomes fourChange in name of program to “Gastroenterology and Hepatology”All learn diagnostic (and therapeutic) gastroscopyAll learn core hepatology and nutrition skillsCritical progression point at end of ST5 year“Themed” training in ST6/7 years – hepatology vs luminal gastroenterologyALL OF YOU WILL NEED TO TRANSFER TO THIS NEW CURRICULUM
6. Endoscopy (the opportunity)All need to learn to scopeColonoscopy for those in the luminal streamStandards set by JAG with required numbers and quality metricsManagement of bleedingAdditional training in advanced polypectomy techniques, ERCP, EUS, etc
7. Endoscopy (the problem)The single largest problem facing gastronterology trainingCompeting pressures on endoscopy timeWe must change the modelTraining initiatives include SPRINT (Structured Program of INduction and Training), immersion training, ENTS (Endoscopic Non-Technical Skills)
8. Competences in Practice
9. ARCP and the Decision AidAnnual appraisal required for progressionRevalidation dependent upon ARCP documentsTriangulation of assessmentsCritical progression points ST5 and ST7.Interim review process
10. AssessmentsMajority unchanged from existing portfolioAnnual Educational Supervisor report mapped to CiPsMultiple consultant report completed by 4-6 consultantsAnnual multi-source feedbackSupervised learning events – ACAT, CbD, mini-CEX, DOPSTwo patient surveysAnnual involvement in audit/quality improvement projectAttendance at training days
11. European Specialty Examination in Gastroenterology and HepatologyAnnual sitting200 best of five MCQPlease attempt earlyMust be passed for CCT
12. Out of ProgramMedian time to CCT is 6.8 yearsOpportunity for time to:Participate in research (OOP-R)Gain additional clinical experience (OOP-E)Undertake in-program training not available locally (OOP-T)Career break (eg parenting, time in industry; OOP-C)Out of program pause (OOP-P)Fantastic opportunity to develop skills and broaden cv.Allow time to plan and involve TPD earlyWill normally only be permitted at rotation change over
13. Being flexible – dragging us into the 21st CenturyBSG Council members 1987BSG fully supports the rights of its members to work and train flexibly.
14. Training satisfaction79.7% feel positive about training76.1% would consider post CCT fellowships
15. Subspecialisation and the post-CCT worldThe CCT is just the beginning!Consultant careers are getting longer, and roles will continue to evolvePost-CCT credentialing…@BSGTraineesMedical schoolGraduationConsultantRetirement20212026 - 20272036 - 203720711823 - 246833 - 34