General Surgery

General Surgery has undergone a major reconfiguration over the past two years with acute and high risk surgery being relocated to the Conquest site together with emergency admissions. Low risk and most day case general surgery remains at the Eastbourne DGH

The creation of a new Surgical Admissions Unit at the Conquest has streamlined this process and together has created a fantastic environment for learning and surgical progression within the Trust of which we are very proud

I would like to welcome you to the directorate of Surgery here at East Sussex Healthcare NHS Trust. We are a large progressive Trust which has undergone significant change over the past 2-3 years, but throughout this we have attempted to put patient care and safeguarding of training foremost in what we do

Here at ESHT we have training programmes for General Surgery, Orthopaedics, Urology, ENT and Maxillofacial Surgery which are all supported by committed trainers and a fantastic Education Centre on both sites

I sincerely hope you thoroughly enjoy your time here with us and get fully involved with everything the Trust has to offer

Ash Subramanian – Clinical Tutor and Consultant Oncoplastic Breast Surgeon

Clinical Work and Support

You will be supported during your rotation in General Surgery by two dedicated consultant surgeons, one as Educational and one as Clinical Supervisor. In addition, the College Tutor for surgery has an overarching responsibility for trainees within the Trust. All of your trainers will give you regular constructive feedback on your progress and what you can do to improve both formally in the form of work based assessments (WBA’s) and informally via the job feedback. This will better enable you to deliver core competencies from the general surgical curriculum and ensure your eportfolio/ISCP logbook in competitive for career progression in your chosen paths

Trainee progress is reviewed via eportfolio/ISCP logbook, requiring the trainee to complete by way of:

    • Observation
    • Direct supervision
    • Independent practice
    • Attendance at relevant training courses and events

The individual trainee completes their individual eportfolio / ISCP which is monitored by the department in collaboration with our medical education team, to ensure you continue to meet your training objectives and achieve the best outcome. It should be remembered that engagement with the electronic logbook system and gaining evidence of competencies remains your responsibility

‘As my first Foundation Year rotation, I could not have asked for more from my General Surgery job at the Conquest Hospital. The team was friendly and engaging, with excellent educational support. As a junior I was encouraged to assist in theatre, always with active participation, and we were given a healthy amount of responsibility, working night shifts and clerking all new patients being admitted

We had 24hr, onsite registrar supervision and the teaching I received on the job was excellent throughout

Having compared experiences with friends who have worked at other hospitals, the opportunities we were given throughout the year at the Conquest Hospital were invaluable to our self development. Including teaching medical students, learning procedures, oncall responsibilitie and supportive access to taster weeks. I thoroughly enjoyed the transition from Medical Student to Doctor at the Conquest Hospital and strongly encourage you to consider it for your Foundation Doctor training’

Edward Monk – FY1 Surgery Trainee

Surgical Research Opportunities / Publications

There are ongoing research opportunities within the department of General Surgery and ongoing trainee involvement with these, together with the development of new projects.

Involvement in regular audit is both encouraged and expected during your placement. You should discuss this with your educational supervisors early in the rotation, to facilitate identification of opportunities and projects

Shift Practice and Rota

The General Surgery department at ESHT is made up of 10 consultant general surgeons (with a variety of sub-specialist interests), 3 consultant breast surgeons, associate specialists and staff grade doctors, up to 9 SpRs (dependant on deanery fill), 4 CT doctors and up to 13 FY1 doctors.

The number of junior and middle grade doctors may vary.

There are 3 ‘mega firms’, 2 general/colorectal, 1 breast/vascular, which makes cross cover at every level more effective

Rotas

FY1 Doctors – Duties include normal shifts covering the day to day care of your patients, long days during the week, night shifts and weekend work (both daytime and night shifts). All of these shifts have a degree of service commitment, but also should be utilised as educational opportunities wherever possible. There are clear paths of advice open to you and the support available is excellent

A sample FY1 surgical rota

ST Doctors – Duties include ward rounds and day to day care of patients on the ward offering support to the FY doctors where needed, cover of the SAU during the day, attendance at elective clinics and operating lists on both sites, where educational opportunities exist and attending emergency operating lists. The rota is essentially designed around a 4 week rolling rotation and had sufficient flexibility to ensure that trainees get maximum exposure to learning opportunities available. Trainees have the opportunity to work for all, and therefore are exposed to a wide range of teaching styles and clinical scenarios

CT Doctors – Duties include ward rounds and day to day care of patients on the ward, offering support to the junior doctors where required, cover on the SAU during the day and night, attendance at elective clinics and operating lists on both sites, where educational opportunities exist and attending emergency operating lists. You will be nominally attached to either one or a team of consultants, but will be required to work with the whole departments whilst on call. The clinical supervision is excellent and you will not be asked to run clinics or operating lists on your own. We will however wherever possible and appropriate, endeavour to help you progress towards independent practice, both in the clinic and in operative settings

‘I worked in the general surgical department as a CT1. I can honestly say I loved it! It’s quite a small department but it means you get to know everyone more importantly they get to know you. The consultants get to see what you are capable of and if you show an interest you can progress quite quickly. You become part of the team and there is plenty of operating and clinic experience to go around. As a DGH I would particularly recommend it for CT1, you can get all your basic surgical skills and become confident in them before moving on in CT2. The surgical assessment unit is run by an incredible group of people who are one of the best teams I have ever had the pleasure of working with and I loved being on call there as it meant surgery, experience and endless coffee and chocolate! On a personal note, the seniors are extremely supportive and will help with any issues or concerns raised. All in all I definitely would recommend this for surgical training.’

Anne McCormack – CT1 Trainee General Surgery

Educational Opportunities

Some of the teaching opportunities our trainees can benefit from include:

      • Weekly department organised teaching sessions aimed at FY doctors covering a range of surgically relevant topics largely based around the management of ward based and emergency patients
      • Weekly hospital wide teaching organised by the medical education centres aimed to cover generic topics for FY doctors
      • Weekly journal club meetings aimed at all junior doctors but predominantly CT and ST doctors
      • Weekly surgical x-ray meetings
      • Weekly MDT meetings
      • Excellent simulation facilities with plans to increase involvement in a dedicated simulation programme
      • Weekly Grand Rounds

Leadership Opportunities

The General Surgery Department continues to invest time in our trainers, to ensure that trainees have continued exposure to leadership opportunities

These include:

Type Descriptive Detail
Trainee representative The Surgical Local Faculty Group requires representation from the CT and ST levels. This is a fantastic opportunity to represent your peers 3 times a year and gain a better understanding of how formal education is organised within your trust
Journal Club Running weekly departmental Journal Clubs, to include:

  • Organisation of a rota to cover wide range of geriatric topics
  • Co-ordinating guest participation
Leadership Education Programme (LEAP) LEAP is run over 1/2 a day with 4-5 courses scheduled in any 12 month period, with the objective of:

  • Developing skills in teaching leadership and as an aid to completing your leadership appraisal
Teaching opportunities We have a regular presence from medical students from BSMS and Kings. All trainees are actively encouraged to take part in this scheme and are provided with appropriate evidence for their portfolios

On the Job Training, What to Expect?

Trainees should expect an extremely well supported environment for training and learning, within our department where the emphasis is on patient safety, skill progression and team working

Opportunities will be made available on the wards, in clinics and in theatre and aim to give the junior doctors a balanced exposure to the speciality whilst providing the more senior trainees with the requisite tools to progress in their choosen career paths

It is a very busy department and serves a broad and diverse patient group with a high percentage of elderly patients and a relatively transient population especially in the summer months

We hope that your time with us will be enjoyable and if you have any problems or concerns – please ask

Conquest Surgical Placement Video