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Scottish Medical Training

Scotland - the home of medical excellence

Speciality: Trauma and Orthopaedic Surgery

Programme Description
GMC Reference: WOS/509

1 a. It offers opportunities to gain experience in all subspecialties and in particular the West of Scotland hosts the National spinal injuries service, the National brachial plexus injury service and more recently, the Queen Elizabeth University Hospital (QEUH) has opened as a Major Trauma Centre and the regional hospitals are now organised into Trauma Units. The Royal Hospital for Children has the largest single group of paediatric Orthopaedic surgeons in Scotland offering trainees an excellent experience in this subspecialty. In addition the Golden Jubilee National Hospital (GJNH) is situated within the region. This unit carries out somewhere in the region of 4000 joint arthroplasties per year and can therefore offer trainees a unique level of exposure to this type of surgery though currently, the availability of postings there are limited and reserved for more senior trainees.  In addition, a number of hospitals within the region offer experience in such procedures as hip arthroscopy, and computer navigated surgery and there are also tertiary referral centres for complex elbow trauma, pelvic and acetabular trauma and circular frame surgery. Hospitals within the region also contribute to the Scottish sarcoma managed clinical network.

 

b. How do trainees access these opportunities?


All rotations are individually planned, but everyone will get exposure to all the major sub-specialty requirements as per curricular requirements. All trainees will rotate through the Royal Hospital for Children at some stage during their training. In general this is done close to their specialty examination in order that this important subspecialty is still fresh in a trainee's memory prior to the exam. Not every trainee will have the opportunity to be exposed to all of the above opportunities, however the training programme director does his best to accommodate specific requests, within the context of the needs of other trainees and the rotation as a whole

2 a. What opportunities are there for research, audit and teaching?


Audit and research is actively encouraged throughout the programme. The training programme has forged close links with a number of academic departments throughout the city, including the bioengineering unit of Strathclyde University, the anatomy Dept. of Glasgow University, the tissue engineering section of the Dept. of engineering at Glasgow University and the Dept. of experimental medicine within Glasgow University. These links have greatly strengthened research activity by West of Scotland Orthopaedic trainees over the last few years and have significantly increased the number of presentations from local trainees at Scottish and UK national meetings. In particular at ST3 & ST4 level, trainees are encouraged as a specific objective, as part of their educational goals, of undertaking a research project during that year. These collaborations offer opportunities for an MPhil with the option of an MD or Ph.D. thereafter. Recently, Professor Neal Millar was appointed to the Chair of Orthopaedic Surgery at the University of Glasgow. Mr. Jon Clarke, Consultant Orthopaedic Surgeon at the GJNH has close research links with Strathclyde University. These are both excellent contacts for those of you who may have a burgeoning Orthopaedic academic interest. 

There are close links with the medical school at the University of Glasgow and Honorary Clinical Lecturer status is available for those with a teaching interest. There is regular medical student small group teaching for both clinical examination and tutorials, both within the hospitals and at the medical school. The senior STs are heavily involved teaching the more junior STs on our programme e.g. exam coaching, surgical procedures and we have a mentoring system for newly appointed trainee.

We have a regional research group (West of Scotland Orthopaedic Research Society) that has an annual scientific meeting and financial support is available by the award of grants to help with research or fellowship plans. We also run a yearly meeting known as GlaMOR (Glasgow Meeting of Orthopaedic Research) which is a well-attended, industry supported educational day, with approximately half devoted to registrar research presentations and half for invited speakers.

In the wider Scotland Deanery context, we have a national yearly specific registrars training day (STOTS) each year, held in Central Scotland for all 4 Scottish regions to access. We also have twice yearly Scottish National meetings (SCOT) which again, is a mixture of research presentations, invited talks and business meeting for various sub-groups.

All trainees are encouraged to go on a clinical / educational supervisors course towards the end of their training to prepare them for a consultant post. There are Chief Residents posts in most hospitals now which allow managerial experience and we have had several orthopaedic registrars being awarded these posts through competitive interviews. Trainees are also encouraged to undertake leadership and management training prior to CCT, the Scotland Deanery runs a specific Leadership and Management course (LaMP).

b. How do trainees access these opportunities?

In addition to the above information, at ST3 & ST4 level, trainees are encouraged as a specific objective, as part of their educational goals, of undertaking a research project during that year, being facilitated by the information provided above. Those on run-through training may also be in a position to start earlier.

3 a. How are rotations are hospital sites organised?

In order to meet the specific educational needs of individual trainees all the rotations are individually planned and there isn’t a set pattern we follow, partly as we have fluctuating numbers of appointments each year, drawing from both ST1 run-through and ST3 national recruitment. As this is the West of Scotland rotation, trainees can expect to rotate to most if not all of the hospitals in our region during their time on the rotation. ST1 appointments may spend a 6 month rotation in Plastic or General Surgery during their first year. During ST3 to ST6, time is spent with postings covering the breadth of orthopaedic surgery. There is an attachment in paediatric orthopaedic surgery around the time of the specialty examination, and in the last 18 months, the rotation is generally planned individually to meet the educational requirements primarily, and where possible the interests of each trainee. Fellowship training after CCT allows some further specialisation prior to individual consultant practice.

 


b. Which hospitals are involved?

University Hospital Ayr, Ayr

University Hospital Crosshouse, Kilmarnock

Dumfries & Galloway Royal Infirmary, Dumfries

Glasgow Royal Infirmary, Glasgow

Golden Jubilee National Hospital, Clydebank

University Hospital Wishaw, Wishaw

University Hospital Hairmyres, East Kilbride

University Hospital Monklands, Airdrie

Forth Valley Royal Hospital, Larbert

Queen Elizabeth University Hospital, Glasgow

Royal Hospital for Children, Glasgow

Royal Alexandra Hospital, Paisley

Inverclyde Royal Hospital, Greenock

 

c. What degree of choice is there for trainees?

Given the individual nature of each rotation, the training programme director does his best to accommodate all reasonable requests so long as they do not disadvantage others whilst ensuring educational requirements are treated as the first priority.

4. What teaching (e.g. day-release or exam preparation) or learning opportunities (e.g. e-learning, OOPE), are unique to this post or a key feature in the West?

There is a core curriculum teaching programme is aimed at ST3+ that runs on a rolling full day basis on around 10 months of the year with the exception of peak holiday periods. There is a 3 year rolling programme. This programme is highly rated by the trainees. In addition, to help trainees prepare for the specialty examination instructional sessions in viva examination technique are also run. Currently, due to COVID pandemic, the teaching programme continues to be delivered via an online format. The core curriculum teaching sessions are recorded and stored on our regional training rotation website for future reference and to help trainees catch up on these session if on annual leave etc. There is also a separate teaching programme aimed at the ST1 & ST2 level doctors to focus more on their educational needs. We also run a mock FRCS exam every year, to help senior trainees prepare for the real thing and there are many trainers in the region who regularly provide FRCS viva sessions to help with exam preparation

 

5. What can trainees expect of their trainers in this post?

There has been significant consultant expansion in the West of Scotland over the last few years with the result that many of the trainers in the region are young, energetic, and enthusiastic. There is a close community within orthopaedics in the West of Scotland which leads to excellent communication and support the trainees.

6. What are key markers of success? (e.g. exam pass rates. MD, PhD, papers)

Trainees within the West of Scotland have an above average pass rate in the intercollegiate specialty examination. The level of operative experience of trainees in the West of Scotland, as recorded in the electronic logbook, is generally above the national average. In recent years, we have had a steady stream of trainees completing higher research degrees, including Ph.D.'s and a number of others are working on M.D.'s and M.Phil.'s.

7. What additional information would you like to include that may encourage trainees to apply for specialty training in this programme in preference to similar programmes in other parts of the UK?


Aside from the fact that the West of Scotland is a wonderful place to live and offers the widest possible range of recreational opportunities, the trainees on the West of Scotland programme share a very positive experience of their training. This results in a great team spirit amongst the trainees who share a good social life in Glasgow, with the highlight of the year being the annual trainee's dinner. The fact that many trainees who graduate from the region wish to stay on as Consultants and give back to the region as trainers is testament investment we all have in the region and the training programme

 
Programme Descriptor submitted in 2009-2010

The West of Scotland Orthopaedic training programme provides training across the region and serves half the Scottish population. A consequence of this is that trainees in the West of Scotland programme generally have surgical experience above the national average. As well as providing a volume and breadth of experience the training programme covers all major Orthopaedic subspecialties with the exception of spinal deformity. The region contains the Scottish National brachial plexus injury treatment service, the Scottish National spinal injuries unit and also contributes to the orthopaedic oncology managed clinical network. The Scottish National waiting times centre at the Golden Jubilee hospital is also within the area giving trainees an excellent exposure to arthroplasty surgery. The programme has forged strong links with the bioengineering department of Strathclyde University, and with the division of immunology, infection and inflammation in the University of Glasgow. This means that the programme is able to provide ample opportunities for research, and this is actively encouraged as part of training.

Glasgow is simply the best place to live in Scotland. It has been European city of culture, and the SECC is a regular venue on the international tours of a wide variety of live acts. The surrounding countryside provides excellent recreational opportunities including world-famous golf courses, world-class sailing, and top quality hillwalking. The international airport is a major hub providing ready access to many destinations.

Research, audit, teaching and management opportunities

The West of Scotland offers opportunities to gain experience in all subspecialties and in particular the West of Scotland hosts the National spinal injuries service, the National brachial plexus injury service and more recently, the Queen Elizabeth University Hospital (QEUH) has opened as a Major Trauma Centre and the regional hospitals are now organised into Trauma Units. The Royal Hospital for Children has the largest single group of paediatric Orthopaedic surgeons in Scotland offering trainees an excellent experience in this subspecialty. In addition the Golden Jubilee National Hospital (GJNH) is situated within the region. This unit carries out somewhere in the region of 4000 joint arthroplasties per year and can therefore offer trainees a unique level of exposure to this type of surgery though currently, the availability of postings there are limited and reserved for more senior trainees.  In addition, a number of hospitals within the region offer experience in such procedures as hip arthroscopy, and computer navigated surgery and there are also tertiary referral centres for complex elbow trauma, pelvic and acetabular trauma and circular frame surgery. Hospitals within the region also contribute to the Scottish sarcoma managed clinical network.

Audit and research is actively encouraged throughout the programme. The training programme has forged close links with a number of academic departments throughout the city, including the bioengineering unit of Strathclyde University, the anatomy Dept. of Glasgow University, the tissue engineering section of the Dept. of engineering at Glasgow University and the Dept. of experimental medicine within Glasgow University. These links have greatly strengthened research activity by West of Scotland Orthopaedic trainees over the last few years and have significantly increased the number of presentations from local trainees at Scottish and UK national meetings. In particular at ST3 & ST4 level, trainees are encouraged as a specific objective, as part of their educational goals, of undertaking a research project during that year. These collaborations offer opportunities for an MPhil with the option of an MD or Ph.D. thereafter. Recently, Professor Neal Millar was appointed to the Chair of Orthopaedic Surgery at the University of Glasgow. Mr. Jon Clarke, Consultant Orthopaedic Surgeon at the GJNH has close research links with Strathclyde University. These are both excellent contacts for those of you who may have a burgeoning Orthopaedic academic interest. 

In order to meet the specific educational needs of individual trainees all the rotations are individually planned and there isn’t a set pattern we follow, partly as we have fluctuating numbers of appointments each year, drawing from both ST1 run-through and ST3 national recruitment. As this is the West of Scotland rotation, trainees can expect to rotate to most if not all of the hospitals in our region during their time on the rotation. ST1 appointments may spend a 6 month rotation in Plastic or General Surgery during their first year. During ST3 to ST6, time is spent with postings covering the breadth of orthopaedic surgery. There is an attachment in paediatric orthopaedic surgery around the time of the specialty examination, and in the last 18 months, the rotation is generally planned individually to meet the educational requirements primarily, and where possible the interests of each trainee. Fellowship training after CCT allows some further specialisation prior to individual consultant practice.

There is a core curriculum teaching programme is aimed at ST3+ that runs on a rolling full day basis on around 10 months of the year with the exception of peak holiday periods. There is a 3 year rolling programme. This programme is highly rated by the trainees. In addition, to help trainees prepare for the specialty examination instructional sessions in viva examination technique are also run. Currently, due to COVID pandemic, the teaching programme continues to be delivered via an online format. The core curriculum teaching sessions are recorded and stored on our regional training rotation website for future reference and to help trainees catch up on these session if on annual leave etc. There is also a separate teaching programme aimed at the ST1 & ST2 level doctors to focus more on their educational needs. We also run a mock FRCS exam every year, to help senior trainees prepare for the real thing and there are many trainers in the region who regularly provide FRCS viva sessions to help with exam preparation

There has been significant consultant expansion in the West of Scotland over the last few years with the result that many of the trainers in the region are young, energetic, and enthusiastic. There is a close community within orthopaedics in the West of Scotland, which leads to excellent communication and support for the trainees.

GATE aims to foster academic development & training beyond academic FY, through Core Training / ST1 & 2 and across a broad range of specialties, to prepare trainees for subsequent application to competitive local and national research training programmes (eg MRC, Wellcome Trust, BHF etc). GATE provides academic mentorship to facilitate attainment of academic objectives that are additional to the requisite competencies required of Trainees.

Appointment to GATE is in open competition, through interview, that takes place shortly after appointment to the programme. Further details are available from the Training Programme Director.

Where is the training delivered?
Training is delivered across:

University Hospital Ayr, University Hospital Crosshouse, Kilmarnock, Ayrshire, Dumfries and Galloway Royal Infirmary, Forth Valley Royal Hospital - FVRH, Glasgow Royal Infirmary, Golden Jubilee National Hospital, Clydebank, University Hospital Hairmyres, East Kilbride, South Lanarkshire, Inverclyde Royal Hospital, Greenock, University Hospital Monklands, Airdrie, Royal Alexandra Hospital, Paisley , The Royal Hospital for Children Glasgow, The Queen Elizabeth University Hospital Glasgow , University Hospital Wishaw

University Hospital Ayr, Ayr

University Hospital Crosshouse, Kilmarnock

Dumfries & Galloway Royal Infirmary, Dumfries

Glasgow Royal Infirmary, Glasgow

Golden Jubilee National Hospital, Clydebank

University Hospital Wishaw, Wishaw

University Hospital Hairmyres, East Kilbride

University Hospital Monklands, Airdrie

Forth Valley Royal Hospital, Larbert

Queen Elizabeth University Hospital, Glasgow

Royal Hospital for Children, Glasgow

Royal Alexandra Hospital, Paisley

Inverclyde Royal Hospital, Greenock



 

Contacts and Useful Links
Programme Type Deanery based or National: Deanery
Administration office West of Scotland
Lead Dean / Director Professor Alastair McLellan
Responsible Associate Postgraduate Dean or Assistant Director (GP) Mr Dominique Byrne
Specialty or Sub-specialty Specialty or Sub-specialty: Specialty
Date of GMC recent approval August 2010
Associated Royal College - Faculty
Joint Committee on Surgical Training (web site)
Curriculum and Associated Assessment System http://www.gmc-uk.org/education/postgraduate/trauma_and_orthopaedic_surgery.asp
Programme Administrator: Named Programme Administrator: Fiona Fourie
Address: NHS Education for Scotland, 102 West Port, Edinburgh, EH3 9DN
Tel: 0131 656 3470
Email: fiona.fourie@nes.scot.nhs.uk
Programme Director Programme Director Name: Mr Evan Crane
Address: Glasgow Royal Infirmary
Tel:
Email: evan.crane2@ggc.scot.nhs.uk
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