Clinical Role, Department of Colorectal Surgery
St Peter's Hospital

Job Plan

I have been a consultant surgeon at St Peter's for 20 years. My current position is as a consultant in general surgery and coloproctology at Ashford and St Peter's NHS Trust which serves a population of 500,000 who live around North Surrey.

I have a 10 PA job plan. This involves 2 outpatient clinics, where I personally see around 20 patients. One clinic is on the St Peter's site and the other at a peripheral clinic in Woking. I have an all day operating session which regularly runs through the lunch break and consists of a mixture of large colorectal cases for cancer and colitis as well as intermediate cases requiring inpatient stay.

I attend a weekly benign Gastrointestinal MDT Meeting, a weekly MDT for cancer patients and I am on Emergency General Surgery on call 1:7 & Emergency GI haemorrhage on call 1:6. I organise the departmental monthly educational half day & collaborate with other departments for presentations.

My SpA work includes supervising Foundation, Core & Higher trainees. I have been the Lead surgeon on North West Surrey Cancer Network for Anal Cancer Surgery since 2005.

Operative Surgery

I have a low complication leak rate for my bowel anastomoses (<5%). I am the Nominated Theatre Champion for WHO checklist. I introduced laparoscopic colorectal surgery & now (approx 50%) benign + malignant conditions are treated this way. I was a participant in the Classic Trial which showed no outcome difference between open & laparoscopic surgery. I have led a Health Protection Agency Colorectal Surgical Site Infection Audit [rate down 24%] (2008-now).

I am the Trust designated surgeon for malignant skin conditions & soft tissue sarcomas (since 2000) and liaise with the Royal Marsden Sarcoma MDT and the Trust's malignant skin MDT.

We have implemented an Enhanced Recovery Programme which has reduced our hospital stay by 38%, from 13 to 8 days.

I have developed a Vertical Rectus Abdominus Muscle (VRAM) flap for abdomino perineal resections and have had a paper & international presentations on this procedure with its excellent outcomes.

I also work with a gynaecologist on complicated endometriosis cases. Laparoscopically we jointly operate on these complex cases; this has been presented at national & regional meetings (2009).

Leadership & Management

I share leadership of the colorectal firm with my three colleagues. We operate on 180-200 colorectal cancers per year. We have a weekly joint teaching ward round which enhances patient safety, where all cases are reviewed and difficult diagnostic problems are discussed in detail (1996-current). We have good trainee feedback and I have personally had excellent feedback using the 360 degree NHS multisource tool (2008).

I have led a local annual Basic Surgical Skills Course for six years and continue to teach on local surgery training programmes.

  • Chair of the Medical Staff Committee between 2001-2006. I had changed the format of the meetings to a more topic based interactive style.
  • As MSC Chairman I sat on the Trust Board and Management Board Committees.
  • Sit on local clinical excellence award panels and have been involved in giving feedback.
  • Liaised with and sat on the Local Negotiating Committee. I have been involved in consultant disciplinary issues.
  • Deputy clinical director (1999-2002) and carried out annual appraisals on colleagues.
  • King's Fund "Management for Clinical Director's Course" Modules 1-3 in 2002.

Education & Honorary Roles

I have been Surgical Tutor 2003-2008 and I managed the rotation for 12 SHO's. I have organised an annual Basic Surgical Skills Course for 5 years and an MRCS course for 2 years. In this role I was involved in the development and instigation of Modernising Medical Careers. This facilitated my position on the Hospital at Night Committee.

I am President of the Ileostomy Association, Surrey Branch and Chair local meetings (2004-present). I am on the Advisory Board for the National Association of Crohn's and Colitis and have produced a patient booklet on Surgery for Colitis.

Kent, Surrey and Sussex Deanery, School of Surgery

Role of Head of School

I have been Head of School and Associate Dean since 2006 and have developed the Kent, Surrey & Sussex (KSS) School of Surgery (SoS). I take part in Deanery, College, National and International meetings and committees related to postgraduate surgical education. The SoS has been recognised by the College of Surgeons and GMC as having many areas of best practice;- for curriculum implementation at CSTC Forum (RCS 08,09) by Head of JCST and at Regional Representative Meeting (RCS Nov 09).

I sit on many College and Deanery committees. I represent the Schools of Surgery in several areas and sit on JCST.

I spend my time at the Deanery seeing trainees, trainers, attending meetings and interacting with Deanery staff. I have completed the KSS teaching course parts 1 & 2 QESP (2010), and had excellent written feedback.

I chair the Core Surgical Training Cttee (CSTC) which sits 5 x/year (2006-now). All Surgical Tutors are asked to attend. The CSTC is key to the success of the KSS School of Surgery.

I also chair the executive surgical strategy group which plans educational strategy for the School. Membership includes the Dean, RCS Council Member and Regional Co-Ordinator and Training Programme Directors (TPD's) (06-now).

Trainees

I manage the Training Programmes for 112 Core Trainees (06-now) and am developing the Training Programmes for 197 higher surgical trainees (T&O, general.surgery, OMFS, ENT, urology).

I manage and appraise all Training Programme Directors annually (since 08).

I am responsible for educational environment of 309 surgical trainees (of which I manage 112 core trainees) (since 2006). I am developing Higher Surgical Trainee (HST) Programmes (2010), and have appointed Interim Higher Specialty and Training Directors. This has involved exhaustive negotiations with London Deanery for KSS HST places and posts.

Quality Management

I am responsible for the quality of teaching in Surgery throughout the Deanery and the quality management is monitored through me by College & Deanery processes (06-current). I lead 4 formal Trust Quality visits per year and lead other structured visits at a Higher Surgical Training (HST) level. I sit on the Quality Management Steering Committee. We have developed a structured KSS regional training programme which maps the Curriculum for trainees. Due to the geographical size of KSS the identical programme is given in the 3 KSS regions each year.

I sit on Education Subcommittee at the University of Surrey Post Grad Med School Advisory Board (2008-now) and sit on the Association of Coloproctology of Great Britain and Ireland Education and Training Committee (July 2010-now).

I chair and am responsible for trainees' Annual Review of Competence Progression (ARCP) in KSS. I am Lead Author on ARCP Summary Report. I partake in the Trainees in Difficulty meetings (06-now). KSS's good practice has been noted by Royal College Surgeons England.

I sit on the College's Professional Affairs Panel for KSS. I write the Annual School Review which is passed to the intercollegiate Joint Committee of Surgical Training (07-now).

Innovative Training Days & Finance

As Head of School of SoS I have developed a Prize Presentation Day which is held annually for KSS trainees. The President of the Royal College of Surgeons of England has attended. (2007-now). We have an annual Induction Day at the Royal College of Surgeons of England, which has been held for the last 3 years. I developed this with Exec St Group. All KSS trainees attend. We also have an annual Awayday which takes place for trainers and those involved with trainees; we encourage active interaction and less didactic teaching.

I control the School's budget (circa 40K) with an annual business plan (08-now). I liaise with medical workforce officer's regarding the recruitment and selection of Surgical Tutors. I am a College External Assessor, and sit at Consultant Colorectal Appointment Committees (Equal Opportunities Recruitment 05). I present annually at the BMJ Careers Fair ( 08 - now)

I represent the Schools of Surgery at Joint Committee on Surgical Training (JCST).(06-now).

With the education department we are carrying out a curriculum mapping project to identify areas of good curriculum delivery within the Deanery.

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Local and National Recruitment

Local

Recruitment involves me interviewing for trainees for the Trust, the Deanery and I have interviewed for workforce officers, MWO's, consultant tpd's and programme chairs. In the past I have managed the recruitment process and selection process for applicants to CT1 & 2 in KSS. The interview has used 3 themed panels and I have had to organise and arrange the panels.

National

In 2010 I led on the National Recruitment Pilot Project for national selection for Core Surgery and I chaired the Steering Group and have talked at various communications meetings at the College, Department of Health and Deanery meetings. In our first year we have achieved a 100% fill rate. This has dramatically reduced consultant time at interview panels, has improved the candidates experience of the selection process and has negated the requirement for a round 2 selection process.

I also sit on the Selection Board for ST3 in general surgery.

I have presented at international education meetings AMEE, 2009, 2010, 2011, 2013, 2014, Assn Coloproctology 2011, 2013, 2014, ASGBI 2014.

Academia

Research and Publications

I was awarded an MA in Clinical Education. This three year project produced a dissertation (distinction) in which I studied the reason why consultant surgeons became interested in postgraduate surgical education. Papers and presentations have resulted from this work. I was elected to Fellow to Academy of Medical Educators in 2010.

I have continued to publish and carry out clinical research as a consultant and to date 19 papers/presentations have been published since my appointment and more than twelve presentations at regional, national and international meetings have taken place. Major review articles have looked at Vaginal Melanoma, Inflammatory Bowel Disease in pregnancy and Myocutaneous flap reconstruction of the pelvis after abdomino perineal excision.

I have presented at international education meetings (AMEE) in Malaga (2009) and Ottawa, Miami (2010).

Examiner & Reviewer Duties

I have passed the "Inter Collegiate Board of Surgical Examiners" Examiner Trainer Course. I have subsequently examined on applied surgical anatomy, the principles of surgery, and clinical examinations for the Membership of Royal College of Surgeons (03-08). I am now an Examiner for the Intercollegiate Exit FRCS (General Surgery) exam.

I am a regular reviewer of submitted papers to the British Journal of Surgery and Colorectal Disease and I review abstracts for the Association of Coloproctology and the Royal Society of Medicine

Societies

Royal Society of Medicine

I have been President (2003) and sat on the Council for the Clinical Section of the Royal Society of Medicine (RSM) (1999-2004), and now sit on Council for the Section of Coloproctology. I attend the meetings and mark submitted abstracts and mark the presentation hosted RSM meetings locally.

I was elected as Secretary to the Section of Coloproctology at the Royal Society of Medicine (RSM) 2008-2009. I have been a council member for 5 years. In my secretarial year I have helped organise the teaching days, presentation days and the 2 day overseas meeting with German colleagues in Berlin which included an educational symposium.

President Elect for 2018.

Association of Coloproctology of Great Britain & Ireland

I sat on the council of the Association of Coloproctology (1999-2003), and have organised and chaired regional meetings. I sat on the PR & Ethics committee for the Association.

I sat on the Council of the Association of Coloproctology when I was regional Chapter representative for South Thames between 2001-2004. I have been elected onto the education committee (2010) and am currently looking at Chapter and Deanery boundaries and am looking at colorectal curriculum delivery across the country.

Visiting Professor Surgery

Canterbury Christ Church University

Developing a multi professional workforce in Surgery. I am supporting the Physician Associate programme and am ararnging a surgical MSc/diploma. I am promoting postgraduate medical education and supporting the university in its endeavours.

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