Scottish Medical Training

Trauma and Orthopaedic training in the East of Scotland Deanery is led by Programme Director Mr Simon Johnson, who is an examiner for the JCIE FRCS T&O exam. The East of Scotland Deanery is based at Ninewells Hospital and Medical School, a level 2 trauma centre in Dundee. We have further attachments within NHS Tayside in Perth Royal Infirmary and Stracathro Hospital in Brechin. Two trainees are allocated every year to the excellent rotation in NHS Highland based in Raigmore Hospital Inverness with outreach clinics in Fort William and Sutherland.

The Tayside Region has a complement of 18 consultants, all with sub specialist interests. These include lower limb arthroplasty and revision arthroplasty, knee soft tissue reconstruction, foot and ankle, limb deformity/reconstruction, spine, paediatric orthopaedics, and upper limb and hand surgery. We have 15 national training number posts, which allow signifcant personal and informal support for the trainees and excellent logbook numbers of operative cases. NHS Highland has 11 consultants covering the majority of subspecialty interests.

The Scottish Orthopaedic Training programme commences at ST1 level and is an 8-year run-through programme. There are four geographical rotations – East, North, South-East and West. Trainees must pass the inter-collegiate MRCS exam to allow them to enter ST3 and commence Higher Surgical training with CCT normally awarded at the end of the ST8 year. Assessment is via the annual ARCP process and is supplemented by an educational review 6-months into the training year. A satisfactory yearly ARCP outcome is required to progress through to the next year of training. The JCIE exam is normally sat in the ST7 year of the Training Programme (once a satisfactory ARCP at ST6 is achieved).

Clinical components of the programme include daily trauma meetings, where the trainees present the previous 24-hour trauma ‘take’ and are actively encouraged to participate in planning patient management and operative decision making. There are elective and fracture clinics, trauma and elective theatres, ward rounds and review of in-patients and attendance at several weekly MDTs. Ninewells is a L2 MTC and trainees will be involved in all aspects of the management of major trauma patients from initial assessment as part of the trauma team, through operative management to the recovery in the major trauma unit.

The postgraduate teaching programme includes formal teaching days once per month (on a rotating speciality topic), Journal Clubs and MDT Radiology meetings run by Consultant Radiologists with an MSK interest. Trainees also are welcome to attend the lecture programme for the University MCHOrth programme. Trainees will be offered Honorary Clinical Teacher recognition with the University of Dundee and will be encouraged to teach medical students in both clinical environments and tutorials and formal lectures.

Each trainee will have on average half a day in their weekly programme dedicated to research and audit. They will be expected to submit a unique piece of research or audit annually to the TORC (Tayside Orthopaedic Research Club) meeting. To support this research activity, there is an outstanding University department on site in Ninewells Hospital which includes the IMAR (Institute for Motion and Research Analysis). Mr Jariwala is the head of the University department and encourages trainees to consider further degrees such as M.D. or Ph.D.

Ninewells Hospital, Dundee
Perth Royal Infirmary, Perth
Raigmore Hospital, Inverness
Stracathro Hospital, Brechin