Upon completing the Foundation Programme, trainees then have the option to complete two years of Core Surgical Training. The programme may be linked or themed to one speciality, or be structured as a general training programme. Once the core training is completed, the candidate can then progress to the six-year higher speciality training programme. All speciality training programmes are competence-based, and as such, candidates may take longer to complete programmes than the indicative timings in the syllabi suggest.
Division of Surgical Specialities
The surgical specialities are rewarding and varied, offering a balance between the physical interaction with patients, and the intellectual contribution to diagnosis. Surgeons can also see the results of their work in the shorter term, and much more frequently, but requires doctors to be extremely active in their approach to problem-solving.
There is also a wide range of different pathways through surgery, with nine different specialities from which to choose – all with a varying workload and on-call burden:
- Cardiothoracic Surgery, with a considerable amount of on-call and out-of-hours work;
- ENT Surgery, with little emergency work, but a chance of high-pressure airways management;
- General Surgery, with on-call work at weekends in particular;
- Neurosurgery, with demanding on-call work;
- Oral and Maxillofacial Surgery, with a low on-call requirement;
- Paediatric Surgery, with a flexible and low-emergency work requirement;
- Plastic Surgery, with regular on-call work;
- Trauma and Orthopaedic Surgery, with a relatively-high on-call requirement, often late into the night;
- Urology, with a low on-call commitment, and the option to work cross-cover with neighbouring hospitals; and
- Vascular Surgery, with demanding on-call work.
All surgical specialities allow some degree of sub-specialisation. Plastic Surgery, for example, allows subspecialisation in fields such as hand surgery, breast surgery, and paediatric plastic surgery.
There are also opportunities to go into management as a clinical lead, or to work in the education and training of junior doctors.