DOI: 10.1093/bjs/znad258.596 ISSN:

701 Designing a Transition Programme: From Higher Surgical Training to Consultant Practice

Z Kamran Siddiqui, R Jayasuriya, C Lewis, J Tomlinson
  • Surgery



Higher surgical training (HST) in the UK focuses on delivery of clinical knowledge to pass FRCS exams, technical skills to fulfil CCT requirements, and clinical preparedness for a day-one consultants.


To identify specific professional capabilities deficient in HST which may inform new training objectives to aid transition between HST and T&O consultant practice.

Study Design

PRISMA Scoping Review. Review of existing courses and interviews with course directors. Semi-structured interviews with newly appointed consultants (< 5 years) exploring non-clinical attributes necessary for new consultants. Interactive questionnaire with senior trainers and with post-FRCS trainees exploring timeframe for current trainees to gain non-clinical experience compared to the ideal timing of developing these skills.


PRISMA-ScR papers identified n = 434, screened n = 276, eligible n = 105, included n = 50, of which surgical = 7, T&O = 0; demonstrating limited literature characterising the gap in preparedness during this specific surgical transition-point.

Specialities with dedicated courses include paediatrics and ophthalmology; programmes reviewed demonstrated a wide array of topics.

Interviews identified strong themes of lack of understanding of NHS structure, job planning, procuring specialist equipment, handling complaints and human factors.

The interactive survey undertaken by both senior trainers and post-FRCS trainees demonstrated a similar trend with a clear shift towards pre-FRCS delivery of skills.


Differences in trainees’ perceived needs and those identified by consultants pose a potential challenge in HST. Across all groups involved, deficiencies were identified in acquiring non-clinical skills and knowledge. This mixed methods approach identified key topics to cover in transition to consultant course to improve challenges during transition.

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