ࡱ> %` Lbjbjٕ 7$>>>>>>>R***8++R5v,v,v,v,v,Q-Q-Q-g4i4i4i4i4i4i4$6hF94>Q-Q-Q-Q-Q-4>>v,v,5222Q->v,>v,g42Q-g422>>2v,j, b_rP* .233450529/929>2Q-Q-2Q-Q-Q-Q-Q-441vQ-Q-Q-5Q-Q-Q-Q-RRRDD RRRRRR>>>>>> This form is intended to help identify whether you have met the 2013 Curriculum requirements for CCT. It is mapped to the 2013 Curriculum in General Surgery and will assist your ARCP panel in making this determination. A similar form will be used by your TPD and/or Liaison Member at the ARCP. Please complete this form and take it along to your ST8 ARCP. Trainee Name ......................................................................................................................................... Deanery / Programme .......................................................................................................................................... National Training Number ......................................................................................................................................... Date of ARCP ............................................................................................................................................ GuidelinesClinical experience sufficient clinical experience in the different components of general surgery as defined by the posts required in the curriculumThe panel will examine your training posts looking for experience in the different components of general surgery and in emergency general surgery Number of CBDs (satisfactory to CCT level) presented in: emergency general surgery ..(10 by CCT) special interest ..(10 by CCT) other areas of general surgery ..(10 by CCT)Operative experience consolidated logbook evidence of the breadth of operative experience as defined in the curriculumTotal number of cases so far in operative logbook (excluding endoscopy), indicative number of 1600 ............ by CCT Please complete Appendix 1 giving the total number of procedures for the cases listed Operative competence evidence of competence in indicative operative procedures Please complete Appendix 2 indicating the PBAs presented for the procedures listed Research evidence of an understanding of, and participation in, research as defined in the curriculum Number of peer reviewed papers (not case reports), to which you have made a significant contribution, ............ published in an indexed journal Number of first author presentations, to which you have made a significant contribution, at a regional, ............ national or international meeting, Quality Improvement evidence of an understanding of, and participation in, audit or service improvement as defined in the curriculumNumber of audit or service improvement projects to which you have made a significant contribution ............ Has the audit cycle been completed in one? Yes % No %Medical Education and Training evidence of an understanding of, and participation in, medical education and training as defined in the curriculumHave you attended a  Training the Trainers Yes % No % course (or equivalent)? Have you collected feedback on your teaching? Yes % No % Management and leadership evidence of an understanding of management structures and challenges of the NHS in the training jurisdictionHave you attended a management course? Yes % No % Have you been involved in a management role? Yes % No % Additional courses / qualifications evidence of having attended specific courses as defined in the curriculum Is your ATLS certificate valid? Yes % No % Have you attended a course relevant to your Yes % No % special interest?Educational conferences evidence of having attended appropriate educational conferences and meetings as defined in the curriculum How many national or international meetings have you attended? ............  Appendix 1 Summarise the number of cases (P+ S-TS + S-TU + T) you have performed for each component of General Surgery (the indicative numbers for CCT are shown), indicating which is your special interest General Number inguinal hernia 60 ... cholecystectomy 50 ... emergency laparotomy 100 ... (peritonitis, obstruction, to include: trauma) Hartmann s 5 & & ... Segmental colectomy 20 & ...... appendicectomy 80 & & ... Breast Special Interest % breast lump excision 40 & & ... mastectomy 50 & & ... sentinel node biopsy 70 & & ... axillary clearance 45 & & ... Colorectal Special Interest % anterior resection 30 & & ... fistula surgery 20 & & ... segmental colectomy 50 & & ... haemorrhoidectomy 15 & & ... prolapse surgery 4 & & ... (some colonic resections should be laparoscopic) UGI Special Interest % Major UGI procedures 35 & & ... (includes anti-reflux, obesity and upper GI/HPB resection) (some trainees will choose to focus primarily on benign and others on resectional) cholecystectomy 110 & & ... Vascular Special Interest % AAA repair 15 & & ... (including 10 open - elective or emergency) carotid endarterectomy 30 & & ... infrainguinal bypass 60 & & ... varicose vein surgery 60 & & ... Appendix 1 continued There is, at present (May 2013), insufficient data to give indicative numbers for the special interests listed on this page. Future versions of this form will include this. Transplant Special Interest % Number Cadaveric multi-organ retrieval & & ... Kidney transplant & & ... Insertion of PD catheter & & ... Creation of AV fistula & & ... Endocrine Special Interest % Thyroidectomy & & ... Re-operative thyroid surgery & & ... Parathyroidectomy & & ... Adrenalectomy & & ... General Surgery of Childhood Special Interest % Paediatric hernia repair / hydrocoele & & ... Paediatric circumcision & & ... Orchidopexy & & ... Advanced Trauma Special Interest % Trauma laparotomy & & ... Paediatric trauma laparotomy ... Trauma thoracotomy ... Severe peripheral trauma ... Surgical airway management ... Stabilisation of jaw ... Remote and Rural Surgery is not included as there are no specific index procedures listed in the curriculum and it is not expected that trainees would have the specific skills required by the end of ST6. The skills required need to be determined according to the particular consultant post under consideration. Appendix 2 - PBAs required for General Surgery Indicate the number of PBAs (to the level shown) you have for each of the procedures listed, indicating your special interest. At least 3 PBAs by different assessors for each of the procedures under General Surgery All Trainees and for each of the procedures under at least one Special Interest are required for CCT General All Trainees Number Hernia repair all types Level 4 ... Emergency laparotomy Level 4 ... 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Hartmann s procedure Level 4 & & ... Segmental colectomy Level 4 & & ... Appendicectomy Level 4 & & ... Breast Special Interest % Breast lump excision Level 4 & & ... Image guided breast excision Level 4 & & ... Mastectomy Level 4 & & ... Sentinel lymph node biopsy Level 4 ... Axillary clearance Level 4 ... Duct and nipple surgery Level 4 ... Implant reconstruction Level 4 ... Pedicle flaps Level 2 ... Mammoplasty: augmentation and reduction Level 4 ... Colorectal Special Interest % Anterior resection (high) Level 4 & & ... Segmental colectomy Level 4 & & ... Fistula surgery Level 4 & & ... Surgical treatment of haemorrhoids Level 4 & & ... Colonoscopy - diagnostic Level 4 & & ... Prolapse surgery Level 4 & & ... Upper GI Special Interest % Liver resection Level 3 & & ... Pancreatic resection Level 3 & & ... Oesophago-gastro-duodenoscopy Level 4 & & ... Anti-reflux surgery (both laparoscopic and open) Level 4 & & ... Oesophagectomy Level 3 & & ... Gastrectomy Level 3 & & ... Cholecystectomy Level 4 & & ... Vascular Special Interest % Number Open aortic aneurysm repair Level 4 & & ... Carotid endarterectomy Level 4 & & ... Infra-inguinal bypass Level 4 & & ... Varicose vein surgery Level 4 & & ... Creation of AV fistulappqdqqq%rHrprrrrrtXtttFuuuuv byd7$8$H$gdc  byd&d7$8$H$Pgd} byd7$8$H$gd}rr$r%r8r?r@rArBrGrHr_rhrirjrorrrrrrrrrrrrrrrrrrrr sttt(t8tFtHtJtVtXt~ttttttttttt4u6u8u:uDuFuݿݝٝٝhsX h9hsXCJ OJQJ^JaJ hsX5hfhZ5 hU5 hvhZhZCJ OJQJ^JaJ hZ hfhZhe CJ OJQJ^JaJ hsXCJ OJQJ^JaJ >FuxuuuuuuuuuuuuuuvvvvHvJvLvNvXvvvvvvvvwrwtwvwxwwwwwwwwwwwwwwx.x0x2xxBxTxVxvx|x~xĿĿɦhsXCJ OJQJ^JaJ hfhZ5 h9hsXCJ OJQJ^JaJ hsX5 hZ5 hU5 hvhZhZCJ OJQJ^JaJ he CJ OJQJ^JaJ hsX hfhZhZ<vZvvwwww>xBxxx@BLN48:<FHJϾﲫﲫﲫﲫﲫﲠjhoUhfh$u5 h$u5 hZ5UhsX hUh$u hUhC hC5 h9h}CJ OJQJ^JaJ h}5hEhC5 hU5hsXCJ OJQJ^JaJ hUhCCJ OJQJ^JaJ 5dNHJ  byd$d7$8$H$Ngdr bdgdcld#  bd&dPgd}ldabilisation of jaw Level 4 & & ... 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