Looking back - my first year as JCST Chair

created 01 December 2016

2015 began with chairing my first JCST meeting. I knew what to expect, having been a member of the committee for 5 years. Chairing a 30 strong committee for over 5 hours was an interesting experience, however. Fortunately I kept to time and I was reassured to receive supportive comments from colleagues, some of whom had been on JCST for a lot longer than I had.

The keynote presentation at the meeting was by Professor Ian Finlay, chair of the UK Implementation Group for the Shape of Training review, the document that seems likely to define my term of office. Indeed, it has already been the focus of two large projects in which I have been closely involved – the Academy of Medical Royal Colleges’ specialty curricula mapping exercise and the RCS England project commissioned by Health Education England (HEE) and entitled Improving Surgical Training. I believe there are real opportunities to improve the experience of surgical trainees, particularly within Core Surgical Training.

So what was the first year like?

In practical terms, I have attended approximately one day of meetings per week, spent half a day per week working with the JCST secretariat on a whole variety of issues and approximately another half day in more informal reading, correspondence and problem solving. I am very conscious of the relationships with our key stakeholders, with trainees and their representatives at the top of the list. I spent a couple of days as a guest at the ASiT annual meeting and the BOTA annual training weekend. The highlights were very enlightening presentations in the Women in Surgery meeting at ASiT, and a highly effective interactive session on major trauma at the BOTA gathering.

I represented surgery at a variety of meetings and workshops under the auspices of the GMC, the Academy of Medical Royal Colleges and HEE amongst others. I have a responsibility to ensure that our aims are consistent across all specialties and training programmes throughout the UK and Ireland. I am accountable to the four Royal Colleges, reflected in my quarterly report presented to the Joint Surgical Colleges Meeting. As Chair, I have a particularly close relationship with the Confederation of Postgraduate Schools of Surgery (CoPSS), and the combination of JCST and COPSS has proven very effective in managing the quality of training. A clear example of our collaborative activity has been the joint approach to the development of simulation in surgical training.

The meetings have not all been committee-based. I spent a fascinating day at ENT-UK, including visiting a large area in the exhibition hall dedicated to low and high fidelity simulation training ranging from a child manikin with a post tonsillectomy bleed to temporal bone microsurgery. A major benefit from attending all these events has been the opportunity to talk informally with colleagues from senior consultants to early years trainees. Such conversations have not always been easy, although they have certainly drawn my attention to issues which need exploring and resolving.

What is different now from this time last year?

As regards JCST core business there has been a major focus on the quality assurance of national selection, ensuring consistency in recruitment across all specialties. There has been a change in the externality role of SAC Liaison Members in the ARCP process, which will be implemented this summer.

As JCST moves to paperless records, there will be significant changes to the ways of working in the office. We have had a helpful review of different ways of working with the staff teams, focusing on trainees as our prime customers and culminating in an invaluable meeting between the JCST staff and senior representatives of ASiT and BOTA. This also provides me with an opportunity to acknowledge the high quality support and work of all the JCST team, which often goes unrecognised.

One area of our core work remains to be implemented - the launch of the revision of the ISCP web platform. Like all major IT projects this has proven more complicated than anticipated; we are confident, however, that when released later this year it will be a significant improvement on the previous version.

So where are we now?

It would be remiss of me not to mention the subject I am asked about the most – the trainee fee. In August 2015 the fee increased to £255 - the third of the incremental increases agreed by the Surgical Colleges in 2012. This coincided with 2 publications reporting the cost of surgical training and the contract dispute in England.

I am very conscious that the JCST should provide value in all that we do to improve the experience of surgical training. We must nurture our future senior colleagues and support and encourage them to achieve their potential as highly competent clinicians and innovators. Unfortunately such support is not resource neutral. Current evidence clearly shows a lack of satisfaction and this represents a huge challenge, which cannot wait. I hope that over the coming months the JCST, in collaboration with its stakeholders, will promote different ways of training, particularly for Core Trainees, to reverse many of these negative trends – although we know that these are difficult times.

So, an interesting and extremely busy first year and 2016 promises to be just as challenging. I have a very clear vision of what I believe I should be doing as the chair of JCST. I will always welcome any comments and suggestions so please do not hesitate to contact me, to enable me to ensure that I fulfil my role for the maximum benefit of surgical training.

Mr Bill Allum, JCST Chair

Lewis Ashman

Tags: Blog,