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Uh Right, good morning, everybody. Um I hope you can all hear me. Uh Welcome to everyone, ladies and gentlemen and everybody in between those here in person and those who are online before we start. There's just a few housekeeping things that we need to be talking about. There's no planned firearm testing today. So if there's a fire alarm, it may be real and please head to the green fire alarm exit, do not use the central stay away and the staff will direct you to the nearest emergency exit if you're not able to use the stairs, just please tell a member of staff and they will make arrangements to take you safely out of the building. There's toilets on this floor and there's signposted you can go through and um to the toilet. There's no access restrictions to there. There is wifi freely available uh as the R CS public Network and there's no password required. Um If you would like to post any of your comments on our social media channels, it is at R CS News and uh please feel free to do that. You can put photographs and everything. Of course, only appropriate stuff uh to be put on there. Um When the broadcasting starts, everyone can access the online platform, the sessions are recorded and will be available after the event via the online platform, certificates and feedback forms will be shared via the online platform as well. So you can get your certificate of attendance and so on through that platform just as an introduction to what's gonna happen today. The first part of the conference is the court annual business meeting. Following the meeting, we'll break for lunch at 1230 then return to our afternoon session at two pm. And the afternoon session is titled as the surgical team of the future. I've deliberately chosen a controversial topic which is very topical now in the news and obviously it's an interactive session. So feel free to make your opinion and views and ideas known to all. Uh Once the final remarks and panel discussion will finish at 430 in the afternoon. For those of you who are staying for dinner, a drinks reception will start at 6 p.m. at the ground floor lobby near the John Hunter statue with dinner promptly at 630 in the Lumley library, changing facilities are available if you require them, just ask a member of staff and they'll tell you where you can change into your black tie outfit for the dinner, right? So, um we can get started on the first topic of the day, which is the chair's report and matters arising from the court executive. And um I feel free to interrupt or ask questions after or during. Um, and um I will just basically give an overview of all the business that the court has been involved in over the last year and the planned, just touch on the plans for next year. And then there will be a presentation from Clare who's head of exams and she will add on a bit more detail on the businesses that we've been um involved in. Now, they're currently about 350 court members, about 100 and 24 are overseas members. And this does not include the recently approved examiners or the examiners that are going through the training to become er MRC S examiners for the Part B. We currently hold an exam for MRC S part B every month of the year except April and December. Three exam dates mainly in the UK, February May and October and they're usually about 14 days or 12 days. Um And there's a week in Sheffield as well in May and that just gives a bit of an overview of what we're involved in. There's about 6 to 7 overseas diets. There's three in Cairo, Egypt every year and this year we're going in June and November and next year will be March, June, July and November as well. There was an exam in Delhi in July this year. It will be in Mumbai, Hyderabad is always in January, Kuala Lumpur, Malaysia is in September, Abu Dhabi, which was a new edition last year is in August. The exams usually run for 5 to 6 days except in Cairo. The November 1 usually runs about 1012 days sometimes. So you can see the numbers of candidates going through are quite sorry, quite significant. And so it is important that we have sufficient numbers of examiners. Um and we have now in collaboration with IC BSE GMC, all the Royal Colleges of Surgeons in the UK changed the eligibility criteria to be an MRC S examiner. Uh It will now invite non consultant grades or SAS grade surgeons to examine the uh requirement is that they be eight years post clinical um or clinical experience after MRC S. Of course, that's quite variable internationally. Uh You could be eight years post MRC S but not actually in clinical practice. And so we still have to have some um oversight of all these applications and scrutiny. The 10 year for the court of examiners has been agreed to be 16 years in total six years initially and two further extensions of 55 years each of course, if the examiners want to. Um there is also a requirement now that we have increasing diversity of the court and particularly with female examiners, uh both lay and clinical and basic sciences examiners. Um the application uh are through the website. And so if you know any colleagues who want to apply. Um There is a link on the website and it's got all the four Royal college of the Surgeons of the UK and every one of them has got a separate link, obviously just encourage them to use our link. Yeah, again, I don't need to repeat this. Why do you need or why should you be an examiner? But this is just a jogging memory. So when you talk to colleagues, you can actually highlight the usefulness both to the examiner, to the college and to the profession in general of being an examiner. It does challenge you even as you grow as a surgeon, there's always something that will surprise you in the exams where it's a question that you never thought of or a question that you thought of or an answer that you um you know, agree or disagree with. You also gain a new perspective of all the new trainees going in. You don't lose in touch with your profession as you get older and more experienced. You also interact with many surgeons across the world and that is quite an eye opener to see all the different practices around the world and how they cope. And you also make a lasting contribution that is non erasable to your profession. And hopefully you have your name on a plaque somewhere in the college eventually, if not in oil painting. So um because of this issue of needing the number of examiners uh when we looked at the numbers on our court, uh when we look at a 16 year, 10 year that results in a fair number of the court having to be dimit and you, there would be a lot of expertise and experience and commitment, which is nonreplaceable easily. Um And so we have made a decision to offer the examiners who are due to demit uh M MRI Sis role and that makes you still active on the court. You can examine, you can attend all the social events and you can continue being an examiner if you so wish. Um And um the last cohort to dimit should have had letters inviting them to remain as right um examiners. And so hopefully that will allow stability as we go forward. Um And this is also especially relevant to the numbers of supervising examiners or convenor examiners. If we follow the 16 year rule, you will lose almost 80% of those two cohorts. So that is at the, at this time, the most important thing is sustainability and stability of the court and the examinations as we go forward. Of course, we aim to recruit more and more examiners and hopefully we will then look again at the numbers and the number of candidates and see how far do we need to carry on the ait roles and for how many years and basically the second limb of um a business that we've been um looking at in the court is to have a more effective court of examiners executive com committee. And this is to oversee all the arrangements between the Intercollegiate MRC S on behalf of the R CS England to oversee the affairs of the court insurers views and policies are represented to council and all other communities in the UK and also to provide clinical leadership advice and support to the R CS examination staff where required, there are many roles and requirements that they may be approaching different examiners throughout the year to be involved in such as webinars, training, examiner, training, lay examiner, training and so on. And um we envisage that there will be three meetings a year of this uh executive committee. The composition is there for those of you who want to have a look at it. This is a proposal, it is still working its way to become a reality and you can see that other than the usual sort of head of exams, director of exams, Chair of Court, there is a representative for Basic Sciences, a representative for Ent which may not be required as we go forward. There is also a council um representative, an I QA representative representative of conveners and supervisors examiner, representative lay examiner, representative equality, diversity representative. And um obviously the O and M CQ subcommittee representatives and that will allow us to really join up everything so that we don't have ideas that are not being implemented that will be helpful to our court. The recruitment process is still being worked out and we will identify these roles, advertise them to all eligible members of the court and there will be a clear application process, timeline, interviews and so on. And really, ideally, if you feel one of your colleagues is very suitable for the role, you can nominate them and if they are willing, we can put them through the process. Now, uh going back to the MRC S exam activity in 2023 um the UK exams have been pretty stable. Part A and part ba slight increase in part B numbers that uh go through our college here internationally. There has been an potential growth in the part A candidate numbers and there has been a steady growth of the part B numbers. It probably is mainly led by the MRC S exam being um eligible to um the candidates to register with the GMC to practice or train in the UK. So there's now currently about 8000 people in the whole uh internationally sitting this exam of which about 2, 2.5 1000 are in the UK. So um that means we have to look at what is the share of our college of these numbers and these are very rough. Um figures that we have a strong position in the UK. So almost 70% of part A candidates sit the exam with R CS England and overseas. About 60 62%. But we have a decreasing share of the international market in part B which is 28%. And so what it means is candidates sit the part A through the R CS England internationally and a lot of them sit the part B with other colleges. And that really is something that we're trying to have a clear strategy for going forward. And we cater very well for the two countries with the largest numbers of part A candidates which is Egypt and India. But we need to focus on where the other part, a candidates are. Um Because even though Egypt and India are very accessible internationally for people to visit and sit the part B, it doesn't seem to be capturing enough of that percentage who passed the party there. And um on that note, I don't want to um carry on and take more and more time. But um we are working through all of this and if you look at the numbers, the exam days are about 42 exam days in the UK and 42 internationally. So almost 80 days of examining a year and every day you need 24 examiners. So you're looking at 2000 a year. And if you look at a quarter of 350 examiners, that means each examiner minimum should be available for five days a year. Of course, it doesn't work that way. Some people do 20 days and some people do one or two days. And so it becomes imperative that we look at recruitment and the younger colleagues have so many commitments that are very strict and structured within the UK. And so the availability is difficult and that's one of the impetuses for making sure that dimit examiners is looked in, in a sensible um structured way. And thank you. Yeah. What, why are different? Where are these part B candidates? Is it, is it the far East? They are um surprisingly in the largest centers of part A candidates which is Egypt and India. So the other colleges hold exams in India in various centers over the year and they have now started holding exams in Cairo as well. The other colleges also have other centers that we don't go to. Um Singapore Hong Kong, two centers in Malaysia and so on. And so we probably hitting the maximum in Cairo. We're not hitting the maximum in India by any means and that needs to be looked at and there's a cohort in Pakistan who can't access India. And we've done Sri Lanka as one of the centers now, but it's still a way to go from Pakistan to Sri Lanka. So, I mean, tomorrow we have a conveners and supervisors meeting and with head of exams and all the staff and we need to be looking forwards at, you know, how do we structure more international centers? Yeah. Good job. Thanks. Yes, sir. Just a quick question, why do you think they're going to the other colleges if they're sitting majority with us as part a as some of the issues are relating to um temporary issues, we're going through such as, you know, website revamping and accessibility of bookings and so on. A lot of it relates to the dates of exams. So if you come once a year to an area and the other colleges go there, you know, twice a year. Um people abroad want to pass the exam as soon as possible to carry on with their training. And so they do book multiple sort of, you know, in case they fail one, they go and book the other one straight away. And the dates obviously that are available is the first thing they do. Plus there is a historic um idea abroad that, you know, the other colleges may be more kinder and easier to pass their exams. It's not true according to the data and John will tell us. But so um but that's the idea abroad and I feel the two are really the, the issues that we need to, the issues we can tackle are availability, frequency of examinations and centers. Yes, I'm in a privileged position of not working for the NHS anymore. But when I speak to my friends and colleagues who are still working, it's very clear that the hospital will not let them off if they want to examine. If you don't do something you have to take it as annual leave. And of course, that's not acceptable. And for us to expand in other places, we need more examiners rather than less examiners. So we can, as you quite rightly say, we need more dates. So I think we need to solve that problem somehow and I don't know how through the powers that be if you like. Yeah, I mean, there, there's been letters gone out from all the colleges, the chief executive of the NHS and so on to all the trusts. But uh I think every year it has to go out again to the chief executives in every trust to say that this college, the college work and the other extra trust work that um you know, consultants can be involved in has to be respected and the issue of professional leave and study leave uh is a bit of a fudge in the NHS and it really depends on your trust. Um I can say with my trust, um I probably have sort of limitless professional leave but in return, I do extra, you know, lists and extra clinics at my own time. So if I do need to come, for example, to annual court day, sometimes I do annual leave, sometimes it's professional leave and beyond the 10 days of professional leave are allowed. And if I take 15 days I pay back five days eventually, somehow during the year, young Children, etcetera, etcetera, it is true. I mean, everybody's different and that's why we're not holding all the examiners to the criteria of saying you must examine for five days a year. But when we look at it, if your maximum that you can take is five days. Well, that's absolutely brilliant. If every examiner did that, then we will, we will not have a problem. Yeah, because there's again, examiners like you who can do more than five days. Yeah. So, yes, Dean. Who's that? Yeah, I think, uh, I think the concern about the drop in the number of international exams has been a concern for a while. I think your answer was diplomatic. But the elephant in the room is that there was always a sort of a gentleman's agreement between the variety of colleges about where they would examine. But some of the other colleges are much more predatory than perhaps we are. And this is perhaps a question really for the college about how they're willing to engage because if we're not going to engage, we're going to continue to lose international market share as it were. So, I don't think it's a lack of enthusiasm from the court, but it is a real need to engage at perhaps a council level about how far they're willing to push the exams. Yeah. II think there is some truth in that Tim, we're quite lucky. Our current president is, well, he's still an examiner of the court. There are many members in council who are examiners, there has been a now sort of agreement that resources for staff and so on will be put in. There has been agreement that we will not um be as diplomatic as we were before with international centers because there are other issues that the other colleges are doing that probably not in liberty to say within a public forum, but they're a bit unsavory. And so we really need to grasp and um we have to have a business mentality uh with this, not because of the money, you know, the money is neither here nor there, but it is actually being um looking at what happens to the college in the future, the membership, the number of fellows, the subscriptions, the international engagement as well. And if you start losing that, it's a downward spiral. Um and exams are the most important probably uh sector which uh people internationally would identify with the college. Um And so we have to be looking at that and we are looking at that and uh we are, you know, looking at the modus operand of other colleges and how they, you know, duck and dive internationally. So yes, perhaps I ask a question about mrcs courses. We are all keen to encourage candidates to prepare properly for the examination. So various colleges do courses for the mrcs. Do you have any information as regards timing of these courses in relation to the examinations, especially abroad? They II think, you know what I'm realizing very quickly in this job is that there's a lot of stuff that is we think should all is agreed, which is not agreed and, you know, it falls on IC BSE to be the regulator of this exam, um, to decide the rules about it. And for example, we have other colleges like Edinburgh doing a course at the same, you know, a week before the English College does an exam in Cairo and so on. And we thought the agreement was, there must be a gap of six weeks between the two. Apparently there's no agreement, there's been other sort of issues where examiners abroad are being paid and there's no agreement about that as well. And we all thought it was voluntary and that was strictly what should happen. So you can see why the other colleges may be doing things like that abroad. There are exams being held abroad by other colleges which are not approved by the GMC. There is a, a college that goes to Sri Lanka that issues an mcs that's only recognized by that college in Sri Lanka. And this is an issue I CVS E um should be dealing with so that the other are doing a course an examination and especially if they're going out more than once a year, we would encourage them to go for that. It's true, we've taken that on board and I think unfortunately here there has to be a bit more liaison between the educational side of the college and the exam side of the college, which is now beginning to happen. And uh we are gonna be holding, holding, holding courses abroad uh for the MRC S exam and we have an incentive for the candidate who attends the course to be booking the exam through us. So, I it is gonna happen and there are plans for it to happen. But again, it does take time organization and of course willing volunteers. So it all rolls back to the number of examiners available that we have, who can go out and do these things. Yeah, I am your report. Do you think part of the problem is also the way the exams are advertised, particularly part B for example, the English College gives a range of dates when the exam is held. Whereas other colleges give you exact specific date of one or two days in which it's held to. Do you think maybe candidates are opting for that because they have more certainty around when they would sit the exam. Do you think that could be? We're certainly now scrutinizing our online presence and I think the college is now going through with it here to revamp all the online sort of information because that is now the only access point really for everywhere in the world to the college. And so we're looking at that the set dates, the set times, you know, the flexibility, the closing dates and so on. And unfortunately, there's not a mechanism where the other colleges tell us when and where they will be. That is actually unchangeable. So we can't really time the exams to fit in with others or you have a sensible timetable for candidates, which is my main concern. Candidates should have a sensible timetable in all centers internationally. Um And there shouldn't be this business about two colleges being holding an exam at the same time in the same city. Um It affects both sides. Yeah, I think, I think difference, I was in NHS for 18 years now. I'm in Delhi for the last 10 years. I think the difference in the college, other colleges, they are socially, very active. So they will have a social meeting. Also say once or I think once every three months they have a great alumni network as well. This is what we need to enhance. Also the president of other colleges, they are traveling more often. So they are conducting uh they are getting involved in the annual conference of the country, having a network and they are most and when you are having those social gathering and professional gathering and our name is there, obviously, it will enhance our image and it will get us more students coming for the exam. It's quite true what you say and that's been taken on board. And I think Tim is quite willing to travel abroad and have social events. We're also looking to roll out fellows and membership events internationally in the centers where we are involved so that we can invite the local Alumin to come and attend and so on. So it is being looked at because um you know, over the last year there has been so much um activity from the executives and the, you know, president and so on of other colleges abroad, uh agreements being signed and so on and so forth. So I think we need to move with the times. Yeah, we got a question from the online audience. Um I'm gonna read it out. Uh Can you make it compulsory to see part A and B with the same college? Um Presumably it's the same price except for the location would cost effective locations be part uh pertinent example, Kolkata. Yeah, I, we can't sort of say if you've passed because it's an intercollegiate sort of agreement. So you can pass the party a with any uh college and sit the part B with any college. But yes, we've taken on board the costs involved. OK. So um they are, we're looking at all the international centers and uh the accessible centers always have ca candidates coming from neighboring countries. So in Cairo, you get people from Nigeria, Sudan, you know, everywhere, Libya, everywhere in the Middle East, they can access it. It's cheap. Cost of living is cheap and so you can do it. But when you hold the exam, for example, in Abu Dhabi, you sort of get confined to the numbers that are locally living there or, you know, training there or something like that. We're looking at Saudi Arabia as well because Saudi Arabia, um they want us to be going there and that is also another accessible position. Now with the change in their visa requirements, the Emirates and so on their visa requirements have become a lot less stricter and so on. So we are looking at the costs as well. So yes, that is a fair point as well makes sense. We in a country say, for example, India, there are so many big cities. What is the basis of choosing a particular center apart from numbers? There's certain criteria Clare could expand on that, you know, where we have criteria about what a center should look like and what should be available and the support locally and so on. And we're going to trash that out into a formal sort of thing. There is a link on the website where any person who would want the exam to come to their center abroad can actually apply and say, well, look, I can accommodate an MRC S exam in my city wherever it is. Um and they fill in the all the application and we get back to them and so on. Um There's also uh personal links. Uh We've got surgeons from everywhere in the world working in the UK and they have links abroad and they can facilitate that. Um And that's really a, a big role for the conveners. So we tend to try and look at the convener appointments as people who are relevant locally. Uh They may be based in the UK, but they are relevant locally and then they're able to afford the agenda of social interaction, you know, uh language barriers, all that sort of thing. Yeah. Yes, that's different. Uh Yes, sir. Sorry. Just to say we've got, I think we've got time for just one more question. OK, perfect. Um Thank you for your report. I'm uh there's three points. One is um I think my colleague from Delhi who mentioned how uh approachable and potentially friendly our different college might be when it comes to social occasions. I'm glad you've taken it on board and see what we can do from England College. The English College. The second bit is about the, I know a particular number of colleagues who have applied to be examiners and for what they know their process has been has gone through, but they haven't heard and it's been about a year and a half and there's a backlog, especially when we want more examiners and I think we can probably try and streamline this. And the third thing is as you mentioned and Tim at our table mention about the predatory nature of some other colleges, it's an intercollegiate exam. And I think the difficult part is, of course, having a very honest conversation with our other colleges and I'm glad you've got that also on board. Thank you. Yeah, thank you for your comments. I mean, I, II hope me and Tim are very sociable. So, and, uh, we are quite willing to travel and, you know, um, you know, forward that agenda. Uh, the intercollegiate thing really is, it's, uh, it's difficult and, um, to get colleges to agree, there's two levels of it. One level is us, the examiners and the other level is the presidents and so on. Uh, but I think we should be looking out, um, well, personally, the interest of our college and move forward with that. I don't want to take everybody else this time. Is there a, a question um Esteban or should we just one, just one really quick? It's just listening to these comments. The college have now taken some of this on board and have advised a new role which is clinical lead for mrcs learning to take, to try and develop courses for candidates and to take on timing and work between education and exams. I'm delighted to be doing that role for the first year. So if anyone online or in the room has particular issues, they want to put forward or participate and offer their help to develop these courses. I'll be delighted to hear from them. Excellent to hear that Sean and we are going to move forward with that agenda very, very quickly. Ok, so I envisage that within the next few months, we'll be starting one of the very first courses abroad. So great to hear that you're now in post, right? Thank you everybody. Uh sorry. And at the end of the day, you could we could ask more questions or anything you think of, I think um Clare you're on next uh I think it's, it's John, sorry. Yeah, that's the thanks. No. OK. So uh thank you very much indeed. Um We've heard IC BSE mentioned a couple of times uh and y and I didn't chat before today and I'm going to cover some of the things he covered and I have some very secret data here on my ipad mentioning other colleges uh which, which I can tell you some but, but uh possibly not everything. Um So um I have some disclosures, I suppose. I don't think I have any serious conflict of interest, but I am truly intercollegiate in this role. The uh there were three national Intercollegiate chairs, one doing IC BSE, one who chairs J CST and one who runs JCI E the Fr CS. And we are appointed by um by the four presidents uh interview. So each of the colleges has an equal say about who's appointed. Um I'm not the only person in the room who has done this job and the last three chairs have been from this college. So I think we've been influential. Um, I am a fellow here. I am a fellow in Edinburgh, uh, but both for the last 34 years, but I am only an examiner here. I've been a supervisor and examiner since 2010 and outside here I am the vice chair of the Assessment Committee at the Academy of Colleges. And, um, and I have a role with the GMC in assessment as well, but none of that really interferes with this role. I don't think. Um, and my daily job is I'm a urologist at UC H. Ok. So this is my report. So I wasn't told how long I'd got. So I planned for an hour and I have a few slides, but actually, you need everything. I'm gonna say I've just written on my hand in having, having her jass discussion. So, so we need to be a bit more sociable. I agree. So, where's the drinks trolley? We need the drinks trolley back, don't we? And who's been down to the fellows room on the ground floor? Did you notice the bar? I'm just saying this, this has nothing to do with exams, but we need a bit more of this, don't we? As I think we do need to be a bit more sociable. And you hear, I hear from Edinburgh examiners how they travel everywhere, business class at least. Ok. And we're allowed to go on the airplane if we take a big suitcase with us to help the team as an, you know, I'm not talking to you as an England examiner but, but that's how it feels. So, um, I'm just gonna cross these things off as I cover them. But I II do think that a drinks trolley would be really helpful because when you, when, as a supervisor and examiner, when I run the exam, all the questions are about, where's the drinks trolley? Not, you know, not, no. What's, what's the real answer to? Question seven? Ok. Um, I'll cover other things on my hand as we get there. So we were talking about the ability of us to examine and three times now, IC BSE has run this survey. The latest one was a bit different. It was run by the new head of IC BSE. Um, and I was saying in a minute, sh she unfortunately has been off sick for the last six weeks and I didn't quite get all the data. But, but there are some interesting data here. So for a start, there's over 1000 examiners. Now, we have 300 something I think you said, but there's over 1000 examiners and, you know, the response rate to this survey wasn't, wasn't fantastic, but it still was 247 examiners. And this tells you, uh, where we all work as far as we know. And most of us, although it's not quite half are, you know, bog standard NHS employees who go to work every day, work far more house than we paid for. And then when you want to take a day off to examine, you get told to shove off. Um, but that's, that's the breakdown of our jobs and that clearly has uh an impact on, on how we can arrange to be at an exam. So this is data for the last three years. But the number of days relevant to what you were just saying, the examiners were able to examine and there's a couple of people who, who turn up all the time they've examined for more than 50 days in the last three years. And I suspect they're probably basic scientists, but I don't know, like I said, I don't have all of the information here. Um But the most common category, 89 examiners examined for not even five days and the job advert says we're meant to do five days a year. This I report back to the president and, and I report it to the GMC via the academy. Um And every college has the same problem. Every, everyone has the same problem. And um it's very difficult. The chief executives do get letters from the government and from NHS officials, including the medical director. But my problem personally and I've been stopped examining once when I wasn't quite given enough notice is that I've been a consultant for 26 years and my general manager happens to be 26 years old and she hasn't got a clue and there's no connection. So when I became an examiner, I had to get a, a letter of agreement from the chief executive who I think is now dead. And that, that information doesn't get passed on. And this has an impact not only on individual colleges but on IC BSE because we have to hold the exam. And as you spotted quite rightly, uh when it was determined that quite a few of these slightly, those of us approaching early middle age examiners would have to stop examining cos we'd done our term. Um The, the slightly older ones amongst us and I'm 63. Um but I still work full time, but you can, if you're retired, you can just turn up and younger examiners clearly find it very difficult. And that is something that needs to be tackled, I think. And this is where the, the data are not complete. The last time we did this survey, 48% of leave to attend the MRC S was professional, which means that less, you know, less than half the leave is other. And I'm still waiting to find out the definition of personal leave, casual leave or leave or duties and events. I don't think they exist within the NHS, but this is what we find. So there is a lot of annual leave and it's clearly a difficulty and the presidents need to take this forward. Um Myself and the two other national cl chairs spend two days every three months with the presidents. And, uh, the next time is next week and I'll be telling them this but they know this. So, um, we, we have to, uh, fight our corner a bit here but we need the presidents to do it for us. Ok. So we were talking about candidate numbers. So part A is run now by Pearson View wherever you are in the world. And it's, and it's, it's exactly the same exam it's done at the same time. Um And lots and lots of candidates do it. As you can see 11,000 internationally, about 7000 are now taking part B. Um And as for this MRC S exam that's awarded by one college for doing something somewhere. IC BSE knows nothing about that. It's not an IC BSE exam. So this tells you what is going on with part internationally. Many of us don't have too much to do with part A but we want everyone to write questions, please because we always need more questions. Um And as you can see, the pass rate is about 50%. Um They're done in Pearson view census. We are now examining on the mainland in North America, in Canada, not the States, but in Canada. Um And we are also now examining in Australia and traditionally Americans. And slightly more recently, Australians don't take the Fr CS anymore. Um But we, we have made these small inroads. So this is what's going on with part A and we do want more question, the, the, the four colleges are now holding question writing, um, days or more than days. And we do want more questions, please if you can take part. Um, and this examination is done at the same time, we make minor differences if you're a long way east or a long way west, but they're done at the same time. Um Pearson View, I think are running it very well. We've had some incidents. We had one incident where unfortunately a uh a, a sole female candidate wasn't allowed in because everyone else was male and he wasn't allowed in. That was clearly not in the UK and Ireland. And we also had an incident where there were some unhappy candidates and they took the Pearson View representative hostage for two hours while, while that was sorted out. But apart from that, it's running increasingly well with fewer and fewer problems. Um And then we were talking about dates, the dates are advertised and you, you have one chance every three months, you can't maneuver on the dates. Um So that's, that's for part A now, part B is slightly different because part B is run by the colleges in the UK and Ireland and overseas. So this is the UK and Ireland uh joint activity. Um And the pass rate is about 60% because of changes made with applications for ST three exams. The last time someone in core year two can take the MRC S. And if they pass a apply for an ST three job is, is February. If you take it in May, now you're too late. The human resources system doesn't work and you can't move on if you're appointed. Um And that's been so for a couple of years, uh and this has, this has been stable. So the candidates know which month the exams are in and the way it runs is the four colleges together, say which one or two weeks in May will be the exam weeks. And then it depends how many candidates apply to that college. So we traditionally know and I do, I always get permission from the presidents when I start using these data, but they won't mind me telling you this. I don't think if I can turn the ipad on. Um So in May 2023 UK and Ireland 414 candidates took the MRC S part B and at one of the other colleges, only 54 did. So whether or so they, they would probably only examine for two days. For example, um the, the pass, the pass rates were more or less identical, which is good. But it does mean we're talking about uh how we can attract candidates to a particular college. I don't know if there's any much flexibility with the dates, but I do know there was one diet of the MRC SA couple of years ago where this college had to ask another college to help because so many people applied here. So I think data availability. Ya might be a, a fact. Um This is nothing to do with IC BSE. We oversee the exam run by the, the colleges and we're responsible for um outcomes. Um ok. That's dates and diets. Ok. Um Right. So there are some things changing. Um Twice in the past, there have been challenges from what we used to call SAS doctors about being examiners and twice in the past both time, both times that was considered by IC BSE. It was turned down early in the process. There's been, there was another challenge and um and now because of some work done by a committee that reports to the I QA committee, uh we decided the best way to approach this was to rewrite the application criteria starting from what someone who's been a consultant for two years looks like. So if you've been a consultant for two years, you've probably had the MRC S for eight years or more. So that's that, that covers that. And then to be an examiner, you still have to go to work every day. You still have to do operations, you still have to do ward rounds, you still have to be on call, you still have to be a trainer. So in other words, we've encapsulated what being a consultant for two years means but in a series of, of different categories in the application form. So I have to approve every examiner in every college but the colleges send them to me. I very rarely turn anyone down because the college is are the filter. And so far this college hasn't sent me any um applications from candidates who are not consultants, but I know they're in the system and I also see the dates that the applications are written. Um And the IC BSE promise is is to process them within a month and there is still clearly a log, a lag, a log a lag in different colleges. So if you do know someone who thinks I applied more than a year ago, that is possible. Um And um the applicants we've had who are not consultants have all been actually very high quality and they will go through the standard and usual process of assessment by our assessors. Um So I think, I think that's been successful and everything that IC BSE does has to be approved by the four presidents. Um And the four presidents were, were very happy with that process and it has to go to the GMC. Um Now we're going to ask everyone to do the E and D training every three years rather than when you're reappointed and that should be happening quite soon. I don't know whether that's been said back to you. Uh the E and D training is actually run by the college in Dublin. It's their training, but that, that's gonna come along very soon. Um Something else we're working on is the M, the M CQ questions. Three, the MRC S part, a 300 questions. It's probably going to become best out of three, not best out of five. And that's simply because the analysis shows that most candidates don't choose oxygen as four and 5 to 2%. So that makes the questions harder to write. It makes the question is easier to do if you've only got to choose three options. And the GMC are very much in favor of this because of uh diversity. So we're just, we're just looking at this now. But if you look retrospectively out of the thousands and thousands of candidates who take part a the same ones would have passed had it been best out of three, not best out of five. And this is something the Academy is interested in for all of the um other, they at the academy, they oversee 294 post graduate exams um of, of which we are one. Um So, so that may happen. Um And we're hoping that will make it much easier for those of you who, who write questions to write questions, cos if you have to try and think of four wrong answers, they start to become more ludicrous the further you get down. So, but having two wrong answers which are credible is, is probably possible. So that's why we're doing that. And then, uh many people have now heard that the MRC S Ent is almost certainly going to disappear. This is because the GMC don't like the MRC S ENT. Every other candidate has to take the MRC S as the er, exit exam for core surgical training if they're doing core. But the MRC S Ent counts for that. Usually about 300 candidates a year take the MRC S Ent and most of those are from overseas as opposed to the many thousands who take the MRC S and in a uh um a conversation with the GMC about how we can improve the MRC S ENT, which has very few questions and uh and the pass mark, by the way, the pass rate is well over 80%. So far more chance of passing the GMC said we're not gonna let you change it. It's a, it's, we don't want the exam, so that's what's happened. This has been discussed at the President's level for the past four years now. I told them four years ago and we've now got to the point where the er, the, the Delivery and Development Committee which reports to I QA, which reports to the main IC BSE has spent a la lot of time communicating to the A NT community and the proposal will go to the President's networks next week and the GMC. But I can't see it not happening. So it's not official, but lots and lots of people know about it. And MRC S ent examiners will become MRC S examiners. They can be more better trained if they wish to do other training. And when we looked at the MRC S bearing in mind, there are sort of 10 surgical specialties, 9% of the questions in the MRC S at the moment are ent so already without an adjustment, the ent community, if you take the MRC S, um you're, you're b you're, you're taking an exam that represents your chosen specialty fairly. So I think that will happen, the colleges are keen to lose the MRC S ENT because they're very expensive exams to run for not very many candidates. Um And, and, and it will probably be end of next year or, or after. So it won't, it won't be straight away. Um But the Ent sac have said that from now they will consider applicants for higher surgical training with the MRC S. They don't need the MRC S ent if any, if any of you are training anyone in that position. Um OK. Now the slide stop moving on slides have stopped moving. The, the next slide a me says the other thing that's changing is that I'm very near the end of my four years. Um And, and my, I come to the end of my term of office at the end of August, the job has been advertised. I don't know if it's been, um, appointed yet. I simply don't know. I haven't heard that it has, has, um, and that's it. And then so that's it. And so, uh, as ever when I speak here every year I've got lots of people to thank the presidents are helpful and they often work together as a team from what I can see. Um, the, the two other intercollegiate chairs, John Lund and Mike Lewis, er, the three of us meet all the time to talk about everything. Uh Mike Mike has fairly recently, er, replaced John mcgregor. So everyone used to be called John to be an interleg chair. Uh The I CBSC team are fantastic. So thank you to them. Uh and, and Bronwyn in particular who's uh taken over Pauline's job while she's been off sick, I've had lots and lots of help. Um and the heads are exams from the colleges. Uh They, they've always been very helpful and um very useful for their knowledge. Part A and part B leads uh are crucial to me and also also the psychometrician, John folks and Richard Arnett. So for example, Richard Arnett's got this thing in the MRC S part A where he analyzes everyone's right and wrong answers and then he analyzes which sense they took it in and then he analyzes which seat they sat in and you get this big graph with about 16 million data points and A couple of diets ago, we had this big graph with 16 million data points on it in two little dots. And these two little dots have given the same right and wrong answers to every question and they have sat next to each other in the same center. Some are overseas. So we do have a handle on this. So they didn't get their results because it was felt their results might not be reliable. So the psychometrics are, are fantastic and the amount of data is is is amazing. But all that, all that we use to protect uh the MRC S er examination. Um Right. So that's what I wanted to say. The other thing about courses is IC BSE main committee is going to talk about courses again and examiners pa participation in courses because clearly courses are very important. We do want to help candidates pass but we don't help them pass just by telling them the questions, please. So, so some new rules and regulations about that, which I think will be very helpful. I think you can anticipate. Um And I think that's it. So thank you very much. There can't be any questions to remind you to just mention your name and status when you're asking a question so that the online audience can actually hear you and wait for the microphone, please. Uh We do Saint George's um when the exams were completely separate. So you had the the English part a and part B did we have much more of the candidates coming to the English exam. So, um, I've got no idea. That was a very long time ago. I've, I've never passed the MRC S, like many of you in the room. I'm, I'm an old Fr CS candidate. Uh, the old Fr CS exams before the specialty exams were separate. Um, and if you, um, a lot of us applied to do two Fr CSE s in case you failed one. Um That was why people took two. That's why I took two. Um, the current exam in its current format has been running now, I think, and someone in the room II don't know who might, who might know uh because it did used to be different. It's been running this format for more than 10 years now. Yes, it was. And the format then was different, wasn't it? Because there were three parts, not two parts, two parts made up the, the final exam and then the final exam, which was the OSK used to be VRS and then a clinical. Um That's what it was when I started. II, can't give you an accurate answer to that. I'm old enough to remember because it all happened around about the turn of the century when the old mrcs, the FRCS disappeared. And the old mrcs went into that role and the exam morphed fairly quickly and it had to because of the coming PTB, which is David set up a meeting at Heathrow between the presidents to set up what eventually became the ICB to set up a proper inter exam. It's gone through several iterations back in those days. And as you say that there were lots of different parts and I'm pleased to say that most of what eventually evolved into the inter exam was English College, MRCS Practice, which was good. But the other question was about numbers. It was always considered much easier to pass the exam in Scotland or Ireland than it was for the English one. Although as the exam developed, we did quite a lot of research looking at that and it wasn't actually a thing, but the perception was certainly that was the case. It was only when the bios came in that the true numbers came out. So we got a much better share. Thank you Ryan Asset training rep. Thank you very much for the report. I think the issue about the ability to take leave for examiners, I think is a very pertinent one. And I think it's a great idea raising with the president. Do you think there's scope to potentially raise it with the BMA consultants committee to come up with National Guidance on what and how you can take professional leave for, to help in local trusts with taking leave if I don't know how well the BMA represent user, but they know about it. Everyone knows about it. Everyone knows about it. Um It just seems that if we all had copies of the letters sent to chief executives and we could get them out all the time, we'd still have a fight on our hands, I think at work during the day. Um And all I can advise is when you become an examiner, you know, the most senior person in the trust should know and it needs to be reflected in your job plan. It has to be written down. Um And, and then, and I do what you do. I do extra clinics and uh extra operating lists. So I can say to someone by the way, you owe me several days now. But it's um and it isn't only examining, it's everything else, everything else, the numbers from part A is 11,000, half of them pass that let's say 5000, but only 2.5 1000 said part B doesn't make sense. No, it doesn't make sense, does it. And, and there are big gaps. So you have to take part B within seven years of passing part A and that's quite hard to take into account. And the other thing that's changed recently is that the um start of last year, a process called harmonization was agreed with the four colleges in the GMC harmonization being that um if you're going to work in the UK and progress through training as a surgeon, despite what you might have done beforehand, anywhere else in the world. You have to take the MRC S um take part in agreed training, which now of course might not be a training program and then take the Fr CS and move on. So that's linked everything together. There are many different factors but it sort of doesn't make sense. I agree. John David Ward, various roles in exams over the years. Has there been any discussion about backfilling for the colleges to pay trusts for their examiners time? I know it'll be controversial to colleges and councils and the trustees of the colleges, but it's an insoluble problem. You know, I've suffered from it in the past. Many other people have, you just can't get the time off and ultimately, it comes down to money as far as I know the answer to that is no, I'll bring it up next week. Paul Watkins. One thing you haven't mentioned in your talk on ICBC is the role of the assessors, which I have noticed that they are now becoming quite trying to get involved with our marking at the start of the day we're told to set our standard, which we do and then they start challenging us. This is what we should expect expect from the assessors. No, an assessor is not meant to challenge the marks that are given the assessor. Um might at the end of a question just make sure that you have filled in all the boxes. So it adds up to 20 um, they're not meant, they're not meant to mount a challenge at the time. They do make a note if they think you've been too harsh or too easy. But that, that's all they're there to do. And then they can look at subsequent marks for all other questions given by that examiner and other examiners in that question. And then they feed that back to the psychometrics. So there is a process if someone, if it's quite a complicated process and then if uh if an examiner stands out at either end of the range for three consecutive diets, then um the head of exams at that college is informed so they can have a discussion about it, but they're not meant to challenge an examiner during the exam while it's running about anything. Could that be relayed to them, please? Yes. Thank you. Mhm. Um Anybody else any questions online? No. Ok. Thanks very much, John. Ok. Thank you very much. Uh Yep. Um Next um I've been told off for not introducing our speakers. Well, the next speaker needs no introduction. Really, Fiona Mint is a consultant vascular surgeon at the Royal Free. She's rcs, England's most senior vice president and has for as long as I can remember been involved in undergraduate postgraduate curriculum development examiner for mbbs mcs for many years. She's also in the National Selection Board for Co Surgery and holds a master's in clinical education and she's going to talk to us about examiner recruiting interface with co between the court and council. Thank you. Thank you. Yes, interestingly, firstly, apologies that I can't be with you all day today. We're actually in the middle of a council meeting right now, but my affiliation has always been with the court. So I've stepped out of council to come and talk to you for five minutes. Now. Um initially, I was asked to talk about overseas examinations, international examinations, but I know that Clare is going to cover that quite comprehensively straight after me. But what I will say is that over the last few years, we are, we're back on track to increase our footprint across the world with international examinations. As we came out of COVID, we reopened in Cairo and KL. The following year 2023 we introduced New Delhi and Abu Dhabi as well. And this year we're expanding our wings further to Hyderabad and Mumbai as well. With Colombo coming on board in the future, the college wants to increase its footprint across the world. We want to improve our offer not only to our members and fellows in the UK, but also to our overseas members and fellows. In order to do that, we have to increase number of overseas members and fellows and that's part of the move going forwards. Um I would say that um part of our policies pose not in the right way, part of our plan over the next few years is to look very hard at the offer that we make to our members and fellows. Um So many times we get asked, what does the college do for us? I think actually the college does quite a lot, but we don't tell everybody that we do it and people aren't aware of what's available, but also we can improve what we do and going forwards. We'd be very grateful for any ideas, advice that any of you can give us also as to what you think we can be doing to help. Clearly, there's always a financial limit to what we can do. But there are a lot of things that we can do that don't necessarily require a lot of money. One thing that will improve things in the future is that our new CRM system that has as David will probably members, we've been trying to get up and running for many years. It is actually going to come into play probably realistically, not until the beginning of next year, but it's still within this college's financial year which starts in the summer and that will help us communicate with our members and fellows better, that will help us organize what we do and provide better because we have a better handle on how things sit if that makes sense. Also, the website, which is something that I've been banging on about for years is also going to be improved again, that has had several hiccups. Um But what I'd like to say here, sitting as says, as the current and actually outgoing senior Vice president following in David's footsteps here just to thank the Court. I know that of all the many people who volunteer for the college, you probably have the quietest voice and yet you do an awful lot of work. A lot of other college roles are much more high profile, much more publicly facing, but you're not. And I'm very aware being an examiner myself, that examiners work so hard for the college on behalf of the college don't necessarily get the recognition that you deserve. Even the candidates don't know who you are because you're an unnamed number just as they're an unnamed number. So I'd like to thank you on behalf of the college. I know that Frank Smith as the chair of the, we put this to the learning assessment committee that I chair that you will get at least some degree of thank you when you leave. And for many years, you haven't had much of a thank you other than bye. So that is in process. But I'd just like to thank you on behalf of the college for everything that you do for us. I think that bringing in the emeritus position is actually great. I know that we talked about that before, but giving the title is fantastic because actually there's so much skill in this room and it would be such a shame to lose it all. So those of you who are willing to carry on in some way or other, we're very grateful. That's really all I have to say. Thank you. Any questions, any pressing questions at all? For Fiona? Oh, David, thank you. It's not a question. It's just something I'd like you on behalf of the court to take back to counsel. It's something that's been going on for many, many years since I've been examined is a complete change of the mindset of council towards running overseas exams. And we heard about it, what's happening in the message from our colleague who now works in Delhi. It's not just a matter of taking the exams over there. We go over, we get off the plane, we run the exams and we come straight back. It's what else is on offer. And I can give examples of what one of our sister colleges has done. For example, in Sri Lanka. I'm very glad to hear that we're trying to go back to, but it is a matter of what else our college gives to their medicine, their society over there. It may be financial and that's something that college does need to think about. But it's also the social side. It's a big ask to ask our current president to go to every exam. So it's something that it's very important to surgeons locally for officers of the college to go. So it should be something for your successor. And the other vice presidents to actively participate in obviously Frank as well in his official role. So please take that message back to Council. It's not just the exams, it's everything else that goes with it. Thank you, David. And what I will say is that with our, we're developing packages to go out with our exams teams which involves, as you say, perhaps the social sore giving lectures, taking courses out and we're certainly going to try and do that on every center that we hold an examination. But you're quite right. Having a senior face also says something, doesn't it? If we can see it on social media afterwards? As one of our sister colleges regularly sends photographs out. Yes. Yes, we're not quite so good at that. Um, WW we, we've all I have to say in the English college, we've always been so gentlemanly. Um, and some of our sister colleges are somewhat less gentlemanly than us. Um, but, but taken on board. Thank you. Thank you so much. There's another question for those of us who did 16 years. It would be lovely to have a nice certificate, but remember to put our name on it because I got one from the National Health Service. Got 40 years of experience. Thank you very much, but they didn't put a name on it. We will absolutely make sure your names are on it. And I know that our social secretary has the last subscription dinner organized for the names of those leaving because it used to be called the leavers dinner, their names to be put on the menu. I wonder whether he might do that again for the next one. So recognition more than once just to Mark Chapman Surgeon in Birmingham. Just to echo what David Ward was saying. Anecdotally. I was at the Kenyan Surgical meeting and there were representatives there from the Edinburgh College, the Irish College, they had their bags, their pens and they were selling their courses to people to sign up to here. This happens in other parts of Saharan Africa, English College not particularly interested. So that's food for thought, I think, and I just wonder whether the Emiratus examiners might have a role to go out to these meetings. I think these people have shown huge commitment and they have a bit more time study leave is less or professionally, bit less of an issue there. So there may be something that you want to look for. The Emirate. Tourist examiners may wish to look at. In fact, thank you for that mark it. Part of we are doing a piece of work in learning and assessment at the moment about putting together a program of a program. If you like a shopping list of things that people who are leaving college roles could continue to do at the college, for instance, volunteering in the museum and maybe things like that we can add on to it because as I say, it's a shame to lose the expertise and the memory, the institutional memory that so many people have in so many of the volunteer roles in the college. Yeah. Any online questions at all? Ok. Thank you, Fiona. Thanks very much. Um ok. Um We move on, the next speaker is Claire and she's um R CS England, Head of exams, operations for both dental and surgical exams. She's been in post for six months. So be gentle and she will, she will expand on the topics that we've been talking about. Thank you. Ok. So I'm going to try to get through my slides quite quickly because I have a section that I'd like to get some feedback from everyone in the room and people online um to start with. Uh I think just a little bit of an overview of where we're currently at and the past five years, I'm sure that I don't really need to elaborate on 2020 as a little bit of a blip in the numbers, but you can see that things recovered very quickly in the UK, slightly less quickly overseas. Um But we are now looking pretty healthy and we're seeing a lot of growth, especially in international numbers. Um It's not clear whether or not the UK significant increase for last year will be reflected this year. Sure, many of you are probably involved in examining during the, the kind of bumper exam last October where we did 15 days straight, I think, um which obviously is quite difficult for staff and for examiners. But obviously, I think that's fairly clearly reflected in the candidate numbers. Um It's also part of the issue. We had a question earlier around uh allowing candidates to book on to specific sessions. Part of the issue is that we use the full amount of time that we have allotted for the exam if we need to. And so it would be really difficult for us to allow people to book on to um specific sessions or specific days because of that. And then as you can see 2024 so far is looking incredibly healthy in terms of candidate numbers, we still have lots more exams to come. We're only really through the first diet if we want to think about three diets in a year. Um So as you see, significant growth has, has already been mentioned, we hold the market share of 62% of international part A candidates, but only 28% of International Part B candidates. Um Because of this, we're obviously looking at how we can expand and what we can do to improve the amount of candidates that follow through and sit to part B with the R CS England. We looked at where the significant numbers of Part A candidates are sitting and it's obviously not going to possible for us to run a Part B Center in every country that has part candidates. But we're trying to think about locations that are useful for people to be able to travel to and which have immigration policies that lend themselves to that. Um The next slide is talking about 2025. Before I put it up, I want to say this is very much in draft. We can't confirm anything. Please don't make notes in your diaries or calendars for any of this stuff. But if we're able to do the expansion that we want to, we're looking at at least one exam every month for 2025. So yes, this is the very tentative plan. Um We're looking at a, we're currently in conversation with a number of potential new centers. Um And yeah, the there's a couple of things to point out with some of the number of exam days. They're obviously also very much in draft form. It depends on how many candidates sign up. Um in the UK, you'll see that there are two for each of the months that there are. So we currently in May Diet have Sheffield as well as London. We are also looking potentially to expand within England as well. So we're looking at the northwest and the northeast. Um If anybody does have any contacts locally in Liverpool, Manchester, Newcastle, similar areas either for hospitals or medical schools, we'd be very happy to hear from you in terms of where we can potentially run the exam. Um but yeah, that's basically an overview of what we want to see in 2025 in terms of our examining profile. Now, the really difficult question is how we achieve that currently, in terms of staffing resource, we're very much at the limits of what's possible. Um So before we can really consider actually following through and scheduling exams for 2025 we need to see the college support this program by providing extra staff who can be involved in running the exam. So we're in the process currently of recruiting to expand the candidate support team. So they're the team that is responsible for outward facing communications with candidates. And it's really important for us that we do this to improve customer service for our candidates so that they get timely responses to inquiries so that they get all the information that they need to succeed and to, to complete their exam. Um And we're in the process of writing a proposal for expanding the surgical operations team, many of whom are in the room um so that we can effectively have one exam on one exam off. So we're not asking any of the team to travel to all of the exams that I just showed on the last slide. Um In addition to this, we're also looking at development projects. There's been some mention of the website, possibly slightly boring for those in the room. But we're also currently starting a project to have a new um CRM, which is basically a management system for members and that includes candidates and examiners and that should hopefully be really helpful for us in terms of increasing our capacity and what we can do technologically speaking. Um We are also looking at new host venues, so we have a link on the website to information and a form to complete if anybody and those of anybody who would be interested in becoming a host venue for the MRC S part B, we have had a few applications that have come through that process already. One of them is Mumbai, which we are looking at for June this year, but we're also looking at some of that will be coming up for next year, potentially now into 2026 as well. This is very much a long term aim to expand. It's not something that's kind of we're just going to do 2025 and then we're going to sit on our, we're going to rest on our laurels with what's happened. We're looking to look at where we can change things up where we can have a broader international reach. Um I think the Emeritus Examiner program has been talked about quite a lot. So II won't spend a lot of time, but obviously, in order for us to be able to do this, we need more examiners and we need more active examiners. And so a big part of our plan over the next 6 to 12 months is examining recruitment and engagement. So as we've talked about previously, um early career consultants, staff grade surgeons, the expansion of the Court Executive Committee and also looking at increasing the number of supervising examiners and conveners that we have. Again, this is all in process. We're writing raw descriptions, we're writing recruitment processes. The aim is to be as transparent as possible and as open as possible to encourage as many people who are interested in taking on more leadership roles within the court to be able to do so. Um And sir, I've always do that as quickly as possible because what I want to do now is to open the floor to you. So what I'd like you to do is spend 10 minutes on your tables. You'll see that you have station numbers that you may be familiar with from the exams themselves. If you're on a table that says station one, I'd like you to start on question one. If you're on a table that says station two, please start with the second question. Station three, please start with the third question. You should try and cover them all, but it's just so that you're able to. So we don't get everyone just doing the first question and not talking about any of the other questions. I think there's a couple of people who are on this table here. Maybe if you want to move over to this table for the course of the discussion online. Please do feel free to submit your questions. I do want to give you all about 10 minutes to do this. If you can nominate a speaker from your table and then after the 10 minutes are up, we'll get that person to, to kind of stand up or maybe remain seated and introduce themselves and then just talk through a little bit about what discussions you've had and what thoughts you've had. So the first question is how can we support you to actively become recruiters? The reality is in volunteer management, the the best recruitment tool is happy existing volunteers who already know the the lay of the land as it were and who can effectively use word of mouth to help us recruit others. What resources can we as a college provide you to help you with recruiting from your colleagues friends. Um And how can we better engage with your employers to facilitate your examining? Um Obviously working wherever we can to avoid people having to take annual leave if possible. Um And also thinking about engaging with your colleagues to do the same. So one discussion that I had a recent exam was that there were two surgeons from the same trust and they effectively had kind of agreed to cover each other shifts to a certain extent and to be able to support each other. So one could go and examine whilst the other one didn't and could swap out and things. So really anything is on the table as far as potential ideas for things that either we can do or that we can encourage your employers to do so that people who are still very active in terms of clinical practice have the opportunity to do the exams as well if possible. So we're literally just before 12. So I will give you until 10 past and then if we can just feedback really quickly after that, I will leave you to it. Thank you. But hey, everyone, if we can come back, uh that would be really helpful. Um Is this table here? Ok to start? Have you got a nominated speaker? He II feel like it's probably unnecessary at this point. But if you can just introduce yourself really briefly see you, right? So uh I've been chosen. Uh so I'm, I'm John John Hines. Um So we we've had a quick chat about most of the points here. Um I used to be on the court executive some years ago and none of this is new. Um And we spent a long time talking about how we can help recruit consultant as it was then colleagues and was it fair and appropriate to try and approach all the lady consultants we knew because that doesn't seem appropriate in terms of, you know, training. And um so I don't, I don't know what you do about that, but we do think there should be better communications, um, about exams and other roles going out to absolutely everyone. And I think you could have actually the college who develop contacts in hospital management teams, someone that the college can go to, it doesn't matter what the other colleges do, but some that this college can go to and it does seem that every hospital, um, has a college tutor. Well, how we don't use them, do we? II don't, who's a college teacher where you work? Do you know? We, we do have still and they, they are in every hospital. Um, but their role with exams is not as clear cut unless they're an examiner themselves. Um, so yes, I worked together in deanery roles before and the college students used to turn up. They don't turn up anymore. So I think we need to revamp what the college tutors do because they're in the trust already. Yeah. Um, resources we didn't really talk about, you know, mummy, I, II don't know, but certainly covering expenses perhaps more easy. I don't know. Um, and, and more events together and then, uh, my advice about how can you go with employers? Well, I think, you know, all, all the, all the letters and, and all the communication so that should be sent to everyone and could be online. So the next time a letter comes out from, say, the medical director of the NHS goes to the chief executives. The college needs to know and all examiners need to know and it should go online. Um, and then as for us, I think everything needs to be in your job plan because if your job plans agreed it's in your job plan, it's much harder for someone to turn down. So your job plan might say that you operate on a Monday morning, you don't have to negotiate that every week, do you? So if, if examining is in your job plan, you shouldn't have to negotiate that every week either. Ok. Thank you very much. Uh the table behind. Ok. Now, working, right? Um 123 and 4561 is clear. The backlog of applications two is clear. The backlog of applications three is clear. The backlog of applications, right? I've got a colleague who's been waiting a year, 15 months. It's ridiculous. He's excellent. He's a professor. He's a professor who can operate, he knows what he's doing rather than just a professor who taught. But clear the backlog of applications. Number one, simple, simples, 45 and six money, money, money. Um the trust concentrate on undergraduate education. Why they get paid? They don't get paid anything for post graduate education. So you're going to have to pay them. Ok. Um, agree with John Annualized five days of examining in the job plan. OK. And then what does the examiner get out of it when I II say that when I was training, I was 80% work and 20% life. Uh, my wife debates that 20%. Now, if you ask the juniors what they want, they want 30% work and 70% life. Ok. So what are you going to give them to try and persuade them to become an examiner? So one is sell it as fun, which is going to be difficult with GMC and good news, knows who else, but sell it as therapeutic. Ok. Stress relieving. So you have your, your day to day grind in the NHS. Uh And I've got to write an article for Journal of trauma and orthopedics soon on. You know, what does the old fart do as he's coming into retirement? And afterwards, but I always say that you've got to have something out of the ordinary grind to keep you sane or else you go completely bonkers and examining is one of those things. It's the best continuing Medicare education of the year. You see all your colleagues from different specialties. I don't see boring orthopedic surgeons day after day after day. A few of those around. But no, um, and you hear about everybody else's problems and everybody else's problems are just as bad as yours. Sometimes they're even worse. So it's a therapeutic to get out of your, um, NHS day to day work, but still be involved with this lovely group of people, both examiners and also the staff. So number one clear, the backlog of applicants that should be your 100% priority. And two, you've got to talk money and money to the trusts in some form and they might start to listen and three, sell it to the examiners as a therapeutic. There's lots now about stress and goodness knows what, but sell it as, as, as a therapeutic, er, episode in their, in their work life balance. Ok. Thank you. Um, before we move on to the next one, if I can just remind everyone that lunch is supposed to be at 1230. So the quicker that we do get through this feedback, the quicker we get for lunch. Um So if you want to move to the table behind, for some reason, I've been given the microphone, I think some of what we've talked about has already been alluded to resources you can provide to help us and to get recruitment is to make it appear to be fun for the examiners. We're giving up a lot in terms of time. We do. Many of us do have to take annual leave to do it, whatever the rights and wrongs of that are and it needs to seem to be fun. Something that I was very unhappy about many, many years ago was when the long days were brought in. They are jolly hard work. You start at 730 in the morning, you don't finish until early evening and then you've got to wait for the results. Yes, a drinks trolley would be fun. But as was pointed out, quite a lot of examiners nowadays, don't drink alcohol, but that's just one of the things. But the long days are a particular problem. Not only for traveling. If you live near London, that's fine. You can get here for meeting at 730 in the morning. But if you live far away or even a medium distance away, it becomes an increasing problem as soon as we're allowed to leave. Once all the results are in, a lot of us are straight out of the door because we've got to get trains or other transport back. And this also applies to making the overseas trips fun. They are very long days and no doubt this will come up at the meetings tomorrow with the conveners and supervisors, the finances. I'm afraid we always come back to that. The expenses that I gather are offered to. Those of us who do examine overseas are limited. And it does mean that it may not be possible for people to travel even one class forward of economy, let alone business class and you need to have time to go to look at things when you do go overseas. One thing that struck me, it's not something we actually spoke about, but looking at your previous slide of all the possible venues overseas. Do you actually look at the weather when you think about some of those places I've been to Kuwait in August? It's a little bit farther north than Abu Dhabi. It wasn't to do with exams. It was an educational thing and it was jolly hot and you really, you would not choose to go to Abu Dhabi in August. Necessarily. Kolkata in July is not possibly the best time of year to go either. And that will limit the number of examiners who actually want to go there, particularly when they know they're going to get there one day, get straight off the plane at 730. The next morning, they're going to be starting to examine and then when they finish, they come straight back home and the next day they're in the clinic or the operating theater. Um, tho those are resources in an indirect way which will help you get examiners. Um And I know it's not necessarily, it's not part of the exams, department's problem, but it's the finance department. They're not very quick at paying our expenses and people are concerned about effectively being bankers for the college. So your department will process our expenses claims promptly, but then they get stuck in the big hole known as finances. So that needs to be taken back at executive director level. Thank you the next table back. I'm not sure what our table actually discussed. I went for a peek. So just come back, but I can give you my own personal view on these things. What's the first one? How can we support you to actively become recruited? Well, I've not done too badly. I had six people from my hospital, three of them were on the table who are now examiners. So, but that's only because I've been on the called EXEC for a number of years and when all these guys didn't hear anything, I had the year of Alex Landau and badge him to be in contact. But for most people, we put people's names forward and then they hear absolutely nothing. We should be biting their hands off. Ok. But at the moment we put people forward, they get all excited, they don't hear anything for two years and then guess what? They've moved on and done something else. So we need to be a little bit more responsive resources to help us. I don't know, perhaps just having an event where you can invite some of these people. I'm not talking about an event in uh recruitment in Malibu, but just uh an event at the college to say, look, come and find out about the exams, show people what the OSC involves, uh A and introduce them. Perhaps introduce them. They can come along for the annual Court day, something like that. So they can actually come along and see if they want to join. But there's nothing about that because there's not enough information out there. So if you want to engage them, you need to get them bums on seats in the college, uh a and get them that way. How do we engage with employers? Quite honestly? I think the college needs to grow a pair. Ok. We have surgical tutors in every single hospital. Ok. Most of us are trainers in our own trusts. Ok. The average registrar will make about 100 and 50,000 lbs profit for each trust. Ok. So getting trainees makes money for trusts. Ok. So if we're gonna train trainees and we're gonna have surgical tutors in hospitals, then I think there needs to be a little bit of a quid pro quo. And so if you want us to train it attracts in registrars, it makes hospitals money and then it can also give us some time off to come here. So I think the, the, the, the college as a corporate entity needs to be a little bit more aggressive with the hospital management. Say if you won't give our guys time off to come and examine, then perhaps we don't want to engage with training either, but that has to come from above. Yeah, thank you. Um If we can move on just thinking about the, the last three tables, if you have anything that's already been covered, can we skip that and just go on to anything new, please? Thank you very much. I agree with you and a lot of the points have been covered. One of the problems at the moment in the NHS is the enormous waiting lists and the fact is that we all get paid handsomely for those waiting lists. So if there is a choice between traveling standard class for 3.5 hours working and then hopping back on a train and going back versus being paid quite handsomely. That is a bit of a encouragement. Maybe that has to be considered. The other thing was clarity on the website. There is nothing specific to find where the application for an examiner is. My colleague said if there was a link to click on it, that would be very important, but it could make life easy and take you straight on. And certainly the duration that it takes to approve an application is important because people move on our job plans change. There are so many wider roles in the NHS now available that an examiner role is competing with those roles and those are closer to home now. So there has to be some brand management or advertisement or information around it to make this more attractive than a general role, which would always, which would also give a pa Thank you. Thank you. I II think most things have been said, but one point I would like to make is communicating to us about when exams, which exams we've been booked for. I don't think we need to reinvent the wheel. I used to do plan exams for the JMC and they've got an electronic system where you book online, you can see which exam you're doing. And if you can't do it, you take your name off it. I think we need to, we need to move with the times finding something more, more modern than just waiting for that email. Cos by the time we get the email more often than not, we've got something else lined up. Anything else guys that we've talked about? I was just gonna say it'd be nice that if an examiner did, I don't know, 30 days of examining that he got some recognition for that, you know, you've now hit 30 days almost like alcoholics anonymous. You get a pain when you've done this many days, but you just got something and it, it doesn't have to be much but something. Ok, thank you. Uh If you want to move on to the last table. Yeah. Um The most of the things uh we discussed here, do we agree with that? Especially the most. Uh The one thing I want to stress is, um the application because uh when I wanted to become an examiner, there was no information how to apply for the examiner. But finally, um an email came from the college uh after waiting so long. Um But many of my colleagues have got the same issue because now what I do is I send there is a link on the college website so I forward that link to them. Um But it is not easy to find out that. So because I know I can forward it to the other people. And the second most important thing is the sorting out the application takes because the Glasgow College is really proactive compared to English, English. Yeah. So that's also a criticism from many of my colleagues who have become an examiner. So they had to chase up a lot. Um Yeah, so that's something you have to address. Yeah. So if any other things like job plan, um incorporating job plan and you know, the same thing, we agree. Ok, thank you. Ok, thank you very much. Uh Is there anything I'm wanting? Yeah, very quickly from online. There is a comment about Mumbai in June and it being affected by heavy rain in the cans might not be able to for the and there is a question, please can examiners have at least one half day off for the overseas diet. That's ok. Um ok, so we we're kind of done with the section so I'll hand back over to y Yeah, I mean just a quick thank you very much for all your contributions. Brilliant. Um Claire. Um I think there's several points that we're all in agreement, unacceptable backlog of applications needs to be dealt with. We need to let our examiners know they should annually the examining days in the job plans. We need to bring up a bit of fun element back into examining expenses, points taken on board, college events to publicize our, you know, social events. Um We need to highlight to trust that they're being rewarded for undergraduate education delivered by examiners and other colleagues from the college. And they should really accept that that's enough recompense for the time off that the examiners may have to take and that needs to be a bit formalized IC BSE again. So um visibility of the application process and um arrangements about the exam and how you actually book yourself in to have or tell or inform everybody that you are available to examine during these days and so on and so forth. So, thank you very much for those suggestions and we will hopefully sort of work on that cla and um Alex when he's back uh is now the most important part of the whole um presentation, which is Tim Lane, our social secretary, very topical, all social events, increase of social events and so on and so forth. And uh Tim needs no introduction. He's the next chair of the court of examiners, been an examiner for a long time. He's a urology consultant as well. So II think I've got about three minutes. I think I can spin it out for that long if, if I go slowly I can spin it out. So it's interesting, isn't it? There's been a lot of talk about the social side of things about the need for the Roy Cold of surgeons of England to be much more sociable uh on a, on an international scale. And so I think I'd like to take this opportunity today to formally announce my candidature for the international planning role for the Royal College of Surgeons. Um I need nothing more than business class, travel, a portable drinks trolley and perhaps access to the presidential finch fund for the occasional incidental expense. But I think, uh I think I'd be good at the role anyway. I'm going to just tell you about the, uh, the um uh leaver's dinner from, uh, from last year. And the leaver's dinner historically was when people used to leave. And in fact, it was your great honor in those days to actually fund the dinner for your entire colleagues shows you how life has changed because that's not happening today, is it? Uh, but the, the Leavers dinner went into uh abeyance for many years simply because no one left and we sort of substituted it for the annual subscription dinner just to keep the event going. But it's only since the implication of the, uh, the, the I CBE rules about terms of tenure that we now actually have people leaving in, in, in the post COVID era. So this was last year Leavers dinner. This was held at the AM Club in, in Palm. And uh we're very grateful for, er, madam, senior vice president for uh giving us an introduction to the, er Ahan Club. But she was very pleased uh uh she was there because she's the member and they wasn't going to let us in otherwise. Um, so, uh she, uh, she allowed us to access to some of the areas of the Athan, which the general public aren't allowed. Er, and she gave us a little bit of a history on the, uh, uh, the, the club. Um, this is me doing my world famous impersonation of uh Robert Liston, er, who was uh formerly a member of the AE, he's my favorite surgeon because he would uh walk into theater as Vencat will tell you, I still do today saying time me, gentleman, time me and he would walk in, in his lime green jacket and Wellington boats and they would, and they would, everybody would time him. He's the only surgeon to have had uh a 300% mortality rate for a single operation. Patient died. His assistant whose finger he cut off died. And when he threw back his arms at the end of the operation, he skewered someone's testicle and they died from apoplexy 300. That's not bad going. Is it really? So, uh we had a little uh review of some of the uh uh the famous surgeons have been a member of the athenaeum, everybody from Robert Liston to uh uh Joseph Lister from uh Thomas Huxley through to uh Ashley Cooper. Er, and we were actually very honored that the archivist actually brought all this stuff out and they came and showed us and this stuff isn't available to the General public but we were able to see some of our forebears and what they were doing, drinks, reception. How many have you had, uh Esteban by this day? II mean, yeah, there were certainly a glass or two had gone down. Well, I say, but I, but I should say that actually, I'm very grateful for Alex Lander because uh, he, he uh facilitated that the exam staff could come to the leaves dinner and that was paid for. And I think hopefully that will be, uh, something we can, uh, carry on with. Uh, so that worked very well and it was nice when we all work so hard that we get the occasional opportunity to, uh, to meet up socially. Er, this is our dinner. So, so for the leavers, after 20 years of hard service, you've got your name on a menu. If that's not reward enough. I don't know what it is. Uh, but, yeah, so it's, uh, you can all take that home and frame it. Uh, but this is the, uh, the private member's, uh, smoking room, not allowed to smoke in it, but you can eat in it. Um, and, uh, uh, Yasser, er, gave us a nice talk and, uh, thanks for all the, the people who would, uh, put in so many years before they left only to be phoned the next day to say. Do you want to come back as Emeritus? Uh, I'm not sure there's gonna be an Emeritus Leaver's dinner, but we'll worry about that later. Um, so that, that was a leaver's dinner from last year. Really? Uh, in terms of the future, we sort of, er, said we would sort of balance London clubs and London restaurants, er, over the years. And I think that seems to be the most, uh, popular option also talking about putting in a summer event. Uh, David Parry suggested having sort of a clay pigeon shooter some time. And uh it means we can meet up not only for the leavers dinner, not only for today, which is the annual court and council dinner, but perhaps an event in the summer. You don't have to be good at clay pigeon shooting. I did it once I shot a pigeon wasn't a clay one, but it still counted. Uh And uh so uh we'll be sort of just garnering anybody, uh some support for that, but hopefully, we might plan that sometime in September. Uh And uh there's still an issue with people having uh knowing about these events. So there will be an opt in for some sort of social media, close groups. So the college will put out a message to you guys and if you want to join you can, but it means that we can share some of this stuff on, on social media. Any questions or any requests for future leavers dinners or any summer events, you can talk to me over lunch, which is now overrun by two minutes. Oh, thank you then eight. Yeah, thanks very much, Tim. Um, definitely, um the international remit for the social sector is uh on the cards to do social events abroad. Now we come to towards the end of the first half of today. And is there any other business that anybody needs to be discussing or wants to raise at all? Ok. Right. So we come to the sad part of the morning and we gather today with heavy hearts to honor two of our esteemed colleagues, Professor Bob Woodward and Professor Kim Servana, who for many years, we've had the privilege of working alongside them through though their personalities varied greatly, they both had an unwavering commitment to excellence in their respective fields and served it as an inspiration to all of us. Their work ethic and skills were true. Testament to their passion with his ever present smile and remarkable ability to bring positive energy to any event. And he had a unique talent for which he would be valued and appreciated. He was a highly respected examiner with an illustrious career. He played a pivotal role in establishing a crucial surgical oncology service in North Manchester and his passions did extend beyond the walls of the hospital or the college. And uh he was a keen um vintage car racer and a flyer and aviator and it was a qualified pilot. We especially remember him for those of us who had been in Cairo. A few weeks ago, we remember his presence and um his testament to the adventurous skills do. Professor Kim S was also a pillar pillar of knowledge and experience and a dedicated educator who tirelessly mentored his students and trainees. His passion for cardiothoracic pathology autopsies was infectious. And his unwavering commitment to thorough investigation of complex industrial disease cases made him an invaluable asset to the pathology profession in the UK. He was a dedicated educator and served as both educational supervisor, program director, head of School for pathology trainees and his extensive knowledge and insights reached countless individuals through his publications and textbooks. Bob and Kim live behind a remarkable legacy, Bob for his unwavering optimism and dedication to patient care and Kim with his vast knowledge and unwavering commitment to education, they truly embodied the very essence of our profession. And as we move forward, let's remember both of them, Bob for his unwavering commitment and positivity and came for his dedication to excellence. May their memory be a source of inspiration to us? Thank you. May they both rest in peace right now. It's lunch time. We can make our way to um the view um where lunch will be served. We reconvene here at two o'clock for the second half of the proceedings. Thank you in climbing trees. I've skinned my knees, my hands have so scrubs kitchen. She's losing some trees cross you pass. I want to thank you through a few I.