Core Surgical Training
The Core Surgical Training (CST) programme lasts for two years (CT1-2), during which time, trainees work in several surgical specialties, such as
Although CST generally lasts for 24 months, trainees in Oral and Maxillofacial Surgery can apply for higher specialist training after 12 months of core training. Trainees must use the Intercollegiate Surgical Curriculum Programme (ISCP) website to follow the curriculum of, and document their progression through, the CST programme. It is essential that they keep their information updated on the website, otherwise it may not be considered in their Annual Review of Competence Progression (ARCP).
To meet the requirements of the CST programme, most trainees go through the national CST system. However, for those using a different pathway, it is paramount to check that their courses are approved. Once the trainee begins a National Training Number (NTN) programme, they not be eligible to train for a particular certificate – be it the CCT, the Certificate of Eligibility for Specialist Registration via the Combined Programme, or CESR (CP), or a Certificate of Eligibility for Specialist Registration (CESR).
There are 10 modules in the CST curriculum.
Trainees are expected to show that they have gained knowledge of the basic sciences relevant for surgical practice, such as
- anatomy, physiology, and embryology;
- microbiology, sources of infection, and hospital-acquired infection;
- the safe prescribing of drugs; and
- diagnostic and interventional imaging.
Trainees are expected to show that they understand the basic science underlying common surgical conditions, and that they can assess and manage patients with
- gastrointestinal problems, such as
- inflammatory bowel disease,
- gastrointestinal cancer,
- intestinal obstruction,
- peritonitis, and
- trauma and orthopaedic problems such as
- peripheral neuropathies,
- spinal cord compression inflammatory joint disease,
- compartment syndrome, and
- degenerative joint disease;
- breast diseases, such as breast lumps, and abscesses;
- vascular diseases, such as peripheral arterial disease and deep venous thrombosis;
- cardiovascular disease, or coronary heart disease;
- pulmonary diseases, such as lung cancer and obstructive airways disease;
- genitourinary diseases, such as urinary tract infections, benign prostatic hyperplasia, and cancer;
- dermatological problems, such as benign and malignant lesions of the skin; and
- head and neck diseases, such as benign and malignant lesions of the mouth and tongue.
Trainees are expected to acquire basic surgical skills such as
- hand-washing, scrubbing, and gowning in preparation for surgery;
- handling of instruments and tissues,
- administration of local anaesthetic,
- accurate incision of superficial tissues, and accurate closure of superficial wounds;
- the secure tying of knots,
- using diathermy in a safe manner,
- understanding when to use drains, and which type of drain to use.
Trainees should show that they can assess and mange patients, and formulate a management plan including both surgical and non-surgical treatment.
Trainees must be able to assess and manage patients in the pre-, peri-, and post-operative period.
Trainees are expected to be able to assess and manage trauma-suffering patients, including those with multiple injuries, in the initial stages. As evidence that they are competent to manage such patients, trainees should have a certificate in Advanced Trauma Life Support (ATLS), Advanced Paediatric Life Support (APLS), or an equivalent.
Trainees are expected to assess and manage children with problems requiring surgery. They also need to be aware of any issues regarding child protection, and should be able to take appropriate action.
Trainees should be able to manage patients who are at the end of life, and understand the ethical issues that arise in patients who have been certified as DNAR.
Trainees should understand the principles of transplantation, such as the indications for an organ transplant, and the procurement and donation of organs and tissues.
Trainees should be able to support patients to improve and maintain their own health.