Training Interface Posts in Hand Surgery
Hand Surgery is an “Interface Specialty” in that training can be provided by either or both of two parent specialties; Plastic Surgery and Trauma & Orthopaedic Surgery. Each discipline will provide its own perspective on the treatment of various conditions in hand surgery and its own balance of skills training.
Advanced trainees will have made a career decision that as a specialist they will wish to take a major interest in Hand Surgery or work purely as a hand surgeon. The inception of these posts was in 1992 and those trained in both specialties should be able to bring the best of both to the management of hand pathology. These prestigious posts represent the pinnacle of training in Hand Surgery in the U.K and should produce the leaders in Hand Surgery for the future.
Those undertaking an “Interface” Advanced Training Post would receive training in both parent specialties, typically in 4 monthly placements, broadening their exposure to all aspects of Hand Surgery, but also allowing focus on a particular area of interest. This would, in theory, produce a specialist who could work as a hand surgeon in the department of either parent specialty with better knowledge & experience, albeit with a different surgical skill set than determined by their parent speciality. Those in these posts should be encouraged to spend the majority of their time in their non parent specialty. The posts should provide a balance between training in both specialites and are expected to cover the whole syllabus theoretically and to be able to provide both bony and soft tissue hand training extensively in four of the six modules required for the Diploma. Those units where all areas are not covered practically are expected to assist their trainee in obtaining specialist knowledge outside of the unit but within the time of their training post appointment. The trainee will be encouraged to participate in hand meetings in UK and abroad and to work towards the Hand Diploma, although not to the detriment of acquiring practical skills in hand surgery.
The Advanced Training Posts in Hand Surgery are open to both T&O Surgery and Plastic Surgery in ST7-ST8. Candidates must hold a National Training Number in either Trauma & Orthopaedic Surgery or Plastic Surgery, and must have passed the full Intercollegiate Specialty Board Examination, FRCS(T&O) or FRCS(Plast), prior to taking up the post and have reached an adequate standard in their parent specialty. Trainees who are successful in obtaining one of these posts will carry their National Training Number with them. These posts count as “Out of Programme Training” (OOPT). One of the referees for these appointments must be the trainee’s current Training Programme Director (TPD). The OOPT form can be downloaded from the Deanery website and must be filled in by the trainee and the TPD.
From August 2022, these posts are expected to change to become JCST approved post CCT fellowships. The details of the specifications for the posts, funding and governance have not yet been settled. In the 2021/22 year, some candidates may be accepted to posts who are immediately post CCT as this is a transitional year – there are arrangements so they can continue to use ISCP.
There is currently funding for 10 appointments in England, one in Wales and one in Scotland, each of which will be for 12 months full time or pro-rota for part-time (minimum 60% FTE), although during the coronavirus pandemic, this has been extended when needed to achieve operative competencies. The successful candidates, who will be centrally appointed, will be asked to rank from the currently approved posts, with those ranked highest at interview being offered their highest choice unit available. Other units will be considered for approval in the future by the Hand TIG committee if they apply through the HAF process obtainable on the JCHST website, with the next deadline for applications being 31st August 2021.
There is a study leave allowance of £1000 for the year funded nationally until these fellowships become post CCT but, additionally, BSSH will provide up to £1000 in addition for attendance at BSSH-organised courses and certain meetings (BSSH, ASSH, FESSH and IFSSH). These monies cannot be used to fund the Hand Diploma per se. All will be expected to attend the annual residential event for all TIG trainees which deals with subjects more generic in training. Fellows will have access to the Hand-e educational resource of ASSH and the El-pras UK learning tools. The highest scoring candidate at the interview will also be awarded an ASSH travelling fellowship which includes attendance at ASSH meeting in the year of their fellowship.
At the end of the post, the candidate will receive a certificate of satisfactory completion of the TIG post if they satisfy the requirements. If there are concerns re their performance during the post, there will be a letter of completion of term,. Any concerns will be relayed to the local Training Programme Director but the award of CCT in the primary specialty will be their responsibility.
Advanced Training Posts
- Birmingham (2 posts)
- Derby (2 posts)
- Manchester - Wythenshawe Hospital (2 posts)
- Norwich - Norfolk & Norwich Hospitals
- Oxford - Nuffield Orthopaedic Centre (2 posts)
- Sheffield - Sheffield Teaching Hospitals
For further details of these posts, please contact the individual units. Details may also be available from the JCST
Applications for 2022 through Health Education South West will be published when available and all units hoping to host ATPs are expected to prove interviewers.