Official Partner The Royal Society of Medicine


Improving Surgical Training

This week, the first of a new generation of surgical trainees have begun their posts in the IST, or Improving Surgical Training, scheme. They are the first cohort, and we are looking ahead to see if the scheme does indeed do what it says on the tin.

The pilot training programme which began this week has been developed by Health Education England and the Royal College of Surgeons, and is intended to improve the quality of training for junior surgeons. The first group of trainees will be trialling new innovations to the system – designed to better balance the provision of healthcare with the quality of learning for trainees. It is also expected that the role of surgical supervisors will be treated more as a professional pursuit in of itself.

The programme was greenlit following a review of surgical training that revealed how many surgical trainees felt dissatisfied with their careers – and, more specifically, their training provision. Too much time was being spent on providing care, and not enough on fostering the talents of the surgical workforce in training. This viewpoint has been supported by General Medical Council research that suggests that surgeons are amongst the least satisfied speciality trainees.

The IST will provide its trainees with 60% ‘elective daytime training activity’, with at least one hour per week with their trainer. These weekly sessions allow trainees to receive feedback much more quickly than under the current structure. The Royal College of Surgeons has also provided IST trainers with a two-day course to help bring them up to a standard appropriate to the new level of contact.

The scheme is currently running in over 30 hospital trusts across the UK, with the exception of Northern Ireland. It is currently being undertaken by 80 General Surgery trainees, but there are plans to introduce Urological and Vascular trainees next year, with applications for 2019 starting this November.

If you are intending on applying to the IST this year, or are one of the cohort, we would love to hear from you! Feel free to email our editorial team on


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