EBSQ

Jim Hill, EBSQ

Powerpoint File

It is accepted by the Intercollegiate Examination Board in General Surgery (UK) that the specialist component of the Intercollegiate Examination is unsatisfactory. In recognition of this, the Intercollegiate Examination Board has requested greater input into the examination from the Specialist Associations. The ACPGBI has welcomed this invitation, but the process has been hampered by uncertainty surrounding; restructuring of general surgical training in the UK, the role of the Post Graduate Medical Examination Board (PMETB) and the future of specialist training.

In order to progress specialist assessment in coloproctology the ACPGBI has written to the Chairmen of the Intercollegiate Examination Board and the Joint Committee for Intercollegiate Examinations to request approval for the ACPGBI to establish its own examination. Replies have been received from these bodies indicating that they do not have the authority to approve this request.

The ACPGBI has therefore two options. The first is to wait for the uncertainties listed above to be resolved or secondly to or to try to progress specialist assessment itself.

The Association of Coloproctology of Great Britain and Ireland wishes to establish a specialist examination in Coloproctology which satisfies the requirements of the European Board Surgical Qualification in Coloproctology and the United Kingdom examination regulatory authorities.

It was noted that in Europe, there is no process of certification and accreditation in coloproctology that is officially recognised by member countries medical regulatory authorities. The EBSQ in coloproctology is however recognised by the European Union.

At present in the UK there is no clear process of accreditation and certification that correctly identifies a trained colon and rectal surgeon.

EBSQ Comparison with UK

Eligibility

Elegibility

Detailed and robust ‘in house assessment’ by local subspeciality trainers

- a super-RITA’ (includes portfolio)

Operative experience

-see table below Portfolio of subspeciality work

Operative experience

-see table

Length training

-7 years – minimum 2 in coloproctology

Expected will be 6 years to CCST in general surgery then 1-2 in coloproctology
Quality of training

Speciality Boards advise Could be done via ACPGBI approved units

Emergency training

-required Will be done by all trainees in UK

Proof of diagnostic skills
-endoscopy, ARPS, ultrasound Could be done via portfolio
Could be done on JAG recommendations
Research
-optional Could be optional also
Relationship with National Certification Body – in all UEMS countries there is a CCST Could be same as for current Intercollegiate Examination
Part 2 EXAMINATION Part 3 FINAL ASSESSMENT
Written exam testing clinical knowledge Scientific knowledge
Viva voce 30 mins to discuss written paper Candidates own publications and relevant subject literature
Academic viva 30 mins selected paper form literature
Viva 30 mins general topics in coloproctology General topic clinical viva
2 representatives from each member state 4 or 6 examiners
half from ICB half from speciality association
EBSQ
Index procedure A (assisted) B
(performed assisted) C
(performed alone) Total
Anterior resection 20 10 10
Rectal prolapse/total colectomy 10 5 5
Haemorrhoidectomy 10 10 10
Fistula in ano 10 10 10
Points per category 1 4 3
Total per category 50 140 105

Max total points 295

ACPGBI
Median Range
Yrs since qualification 14 12-20
Yrs as HST/SPR 6 2-12
Anterior resection 40 11-79
Rectal prolapse 6 3-24
Fistula in ano 22 4-54
Therapeutic colonoscopy 101 20-380