Training and development (trauma and orthopaedic surgery)

This page provides useful information on the training and development for this specialty and also has tips for people at all stages of their career including medical school.

After completing foundation training there are two routes into T&O surgery training:

  • core surgical (CT1-2) and specialty training (ST3-8)
  • run-through training (ST1-8) that incorporates core surgical training  (CT1-2) and specialty training (ST3-8)

Core surgical training

Core surgical training lasts two years or more and provides training in a hospital in a range of surgical specialties. During the first two years of your training you must take the examination to achieve membership of a Royal College of Surgeons (MRCS) or equivalent.

Following successful completion of your core surgical training it is necessary to apply competitively for the next phase of your training (ST3).

You will need at least ten-twelve months’ experience in T&O surgery during your core surgical training if you wish to progress to specialist T&O surgery training. Some core surgery programmes may be themed towards T&O surgery.

The NHS Person Specification (2015) states that desirable criteria for ST3 T&O training include at least 8 months experience comprising two related specialties eg acute general surgery, vascular surgery, plastic surgery, neurosurgery, intensive care medicine or emergency medicine. At least 12 months experience in trauma based T&O posts with a major commitment to T&O surgery is also desirable. This experience might be gained during core surgery, although many applicants obtain a LAT (Locum Appointed for Training) or LAS (Locum Appointed for Service) post after core training and before applying for ST3 to provide the necessary experience.

Completion of an elective in this specialty is an advantage as is other related experience. Participation in national and international meetings relevant to T&O will also enhance your application.

ST3 specialty T&O Surgery Training

Specialty T&O surgery training (ST3-7) takes six years, although this can vary according to individual circumstances. During this time you will be employed as a specialist trainee. Upon successful completion of this training you can then apply for consultant posts. However, before you can do this you must pass the Intercollegiate Specialty Examination (FRCS). Once you have passed this you will receive a Certificate of Completion of Training (CCT) and you will be eligible to be on the GMC Specialist Register.

Completion of other training courses such as Advanced Trauma Life Support (ATLS), Basic Surgical Skills and Care of the Critically Ill Surgical Patient (CCrISP) will also greatly enhance your application for ST3 training. You will also need an excellent working knowledge of anatomy and pathology relevant to T&O surgery.

Selection panels also look for evidence of academic and research achievements, such as degrees, prizes, awards, distinctions, publications and presentations. An understanding of research, audit and teaching is also important as is evidence of the ability to work in a team and manage situations.  Entry is highly competitive so you will need achievements that are relevant to T&O. Completion of an elective in T&O surgery will demonstrate your commitment to the selection panel. Your portfolio should have evidence of your commitment to this specialty.

Anyone applying for a role providing NHS healthcare, is likely to be asked to show how they think the NHS values would apply in their everyday work. Find out more about NHS values.

The GMC provides information on the curriculum for T&O surgery training.

Getting in tips

It is important to develop your practical skills and interest in surgery as early as you can. This will also give you valuable experience to add to your CV.

At all stages of your career (including medical school) it is recommended that you appoint a mentor who will enable you to maximise your opportunities. Future Orthopaedic Surgeons FOS) recommend having multiple mentors at various stages of your training. Whilst at medical school contact the professor or lecturer responsible for T&O who will put you in touch with suitable people. Also keep up to date with surgical events and enter competitions run by professional T&O organisations and The Royal College of Surgeons of England/Royal Society of Medicine.

The BMJ Careers website has a useful article ‘How to succeed in ST3 general surgery recruitment’ which although aimed at general surgery has lots of tips and advice for all ST3 surgery applicants.

If you're applying for a role either directly in the NHS or in an organisation that provides NHS services you'll be asked to show how you think the NHS values apply to your everyday work. The same will be true if you're applying for a university course funded by the NHS.

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