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Good afternoon, everyone. Welcome to plenary five national training updates. My name is Ryan Lalu and I'm Director of Education for Asset, as well as the vascular registrar in Yorkshire. And my name is Laura Manley. I'm a CT to in east of England and I'm one of the incoming Asset vice president's. So today, it's my pleasure to introduce our first speaker, Mr Keith Jones, a consultant vascular surgeon with an interest in lower limb arterial disease and diabetic foot management. Mr Jones is also London's vascular training program director and a member of the National Vascular Specialty Advisory Committee. He's here today to provide us with an update from the J C S T. Okay. Um So not to be there in person. Thank you very much for the invitation from Martin. Uh Thank you very much for the introduction, Lara, just a slight correction. Um I'm no longer London training program director, not on the SEC, but I am the ICP surgical director, so I'm happy to come and give the J C C updates today slightly in all of the previous speakers. Very enjoyable session. Um I'm not so keen on the mood music. I've just been listening to in the break. Um Fine. Oh, to take you through, uh we've obviously lived through the process of COVID and effects that it's had on the route to CCT. Uh We in the agency recognized that you really need good trainers like never before and we're not so sure we're back to normal at the present moment in time. Uh We uh been lobbying that support for the last two years with that no train today, know surgeons tomorrow. Uh I'm still not convinced that everyone is fully on board with this. A lot of that is just because the pressures of the service, uh the new curriculum had come along and hopefully that has helped, but that in itself is in a degree of a journey and I'll allude to some of that uh in the following few minutes. The thing about the new curriculum is that there are obviously certain subtle changes, the large change in the M C R and Multi consult report. I would really suggest that all trainees do. Uh look at the syllabus component, the things that you're supposed to cover and ensure that your trainers are aware of that as well because I'm not sure by when I now look at the M C R is that people are coming through uh with all aspects are being covered both in the self assessment and in the M C R, we adjacency continue to look at the ERCP updates. Uh We were concerned that there may be an increase in outcome threes as the outcome tends dissipated away. You know, the outcome 10 delegation remains until the end of this year. Uh And there, there has been a small but subtle uh increase in the outcome threes. Um And we'll continue to monitor that uh the question. And we're also looking to monitor whether or not there's any changes in differential attainment. That is the focus of a lot of our research activity. Uh His teammates presentations to the uh presence of all four colleges. And we're looking for uh further uh planned uh support to assess differential attainment to ensure there's a quality through surgical training in relation to the RDP updates. The, this chart shows the updates um up until the end of December of last year, uh you'll see in some specialties, uh those uh dark blue lines on the right side, you look at it uh remain uh a higher proportion that that would be expected. Outcome 10.2, it has been variably delivered. And this, we feel that they're probably should have been more and more sometime extensions available. Some of those have morphed into the outcome threes. The uh this shows in relation where the updates are by region uh for uh A RCPs, there is some degree of variation uh but a lot of it uh is affected by the outcomes or outcome sixes and those that appear to be constant throughout the variable regions. So people are finishing training, we hope to see that improve as new curriculum comes online because certainly the uh uh requirements for C C T R it's clearer in a new curriculum. So moving to the curriculum, where do we stand? The assessment of it remains ongoing, the G M C feedback at one year was very positive. They did want us to look at more things in particular. Uh They'd like us to look at the impact of the curriculum on trainees with protected characteristics. So we are working on ways to do that. There's very few protected characteristics are listed on the I C P. So uh do some work with the examples to be able to further assess that. How does the specialty specific CRPS compared to shared sips? So that relates to pediatric characteristic and plastic surgery. Uh some to do the frequency of assessment as well. They did pick up on the impact of the new general surgery gi and surgery in childhood modules and working ways to assess that. And there's the ongoing assessment related to the delivery of uh and accessibility, story of endovascular training, the vascular trainees working with an in collaboration with interventional radiology uh in relation to transition, the vast majority of people have transitions now to to the new curriculum. Uh There are small numbers that have not opted out yet. There were three specialties where the opt out levels were still just into double figures and we've worked with those individually. Uh, we've now said complete much improved, um, to date. One needs to remember is the first of August this year. Because after that, if you stop, when starting a placement, you would have to do that on the 2021 curriculum. There could be no legacy old curriculum holdovers at that time if you are starting a new placement at that time. So if you remain on one, did finish, just extend the one that you're on. I put up again at the benefits in relation to, to the curriculum. Uh as we'd like to continue to, to focus on those relating to the high level outcomes uh to reflect the job of the day one consultant, uh the G P C providing the professional skills generate all medical disciplines. Now, I'm aware that many of you feel with the specialties that not all of that uh is uh appropriate and assessable within some of the surgical aspects. But these are assessments have come from, uh the G M C. Uh they were came to bear from uh fitness to practice cases and they were professional skills that the G M C and Acadian Medical Colleges want to be present in all practicing doctors. Um What is important for us now is that professional judgment is re established uh of the surgical trainers. It's what the trainers wanted. We understand what the trainees wanted as well as that change. That only works However, if you, as training is getting really meaningful feedback uh in readiness to practice on, uh we feel at least two occasions in each placement. And the wh usually have been tailored to individual trainee, focus on the index procedure and critical conditions. Uh I'm not sure that's translating as well as we expect it might do at this stage. And I said it will be doing a pre record webinar uh two from the I C P to show how this may be done better for both trainers and trainees. Uh Curriculum allows you as your trainees to demonstrate excellence. As just mentioned earlier, people coming to the end certification requirements within the curriculum, uh make sure the ambiguity has been removed, continue and uh to offer the curriculum support. There's been champions training all these accessible on the youtube channel skill still, especially in regional webinars and the pop up videos and these asquith sessions which I've done live helped us still very active less so with problems about the M C R sign off since we moved it down to 48 hours. We're listening to the feedback we're getting on that. Uh And uh the debate is on, it's likely, I think that we're going to move it slightly longer again uh than 40 hours, certainly not going back to the two weeks, but to allow to compensate for bank holidays at the weekends and people being on leave around the short time after the M C R. Well, I delivered a pre a ercp advice webinar and were, let's say, pre recording a optimizing WB outcomes webinars to support for everyone all specialties. And there have been hopeful input from yourselves, a specialty organization, training organizations. It's really important that uh everyone is aware of the critical progression points, the supervision levels for the end of phase two. Uh what we're seeing can be through is we're assessing the M C R s is that uh many of the supervision assessments uh in phase two are already uh marked at the level appropriate for a finish. Uh And that leaves a little room for development. Uh Certainly we have some work to do to uh correct that. Uh we're looking to show the developmental aspects of the Embassy are still further. What other JCs T activity is ongoing? Uh We are present piloting new processes come from the GM see about uh curriculum updates. Uh We're ensuring that the all the PBA S are updated to match each of the curriculum and that process is nearly finished. There's an ongoing rewrite uh for the court surgery curriculum. Uh and that's out to stakeholder views shortly. Uh We continue as a state ID to give feedback to the 2020 our curriculum for all uh specialties and given the G M C feedback and looking to their specific requirements. The GMCR challenge, changing the quality assurance aspect of the curriculum. So, uh the changing of the curriculum has gone through a different, was going to go through a different process. It's more like a revalidation type process that we'll submit a form with suggested changes. Uh and that will be informed, what do we have supporting evidence we need to give. We don't think it gives a great deal of difference to that that we have done in previous curriculum. Uh iterations, it may in fact to make it easier for us, but that process is ongoing. We do a lot of work with sec inductions. We saw that you have the appropriate trained, supporting liaison members. Uh There is uh we have been coordinating a application for breast surgery to be a soldier specialty at present that's gone to consultation uh with the UK Education Reference group. We've got no standing upon that question. We just provided all the documentation and the stakeholder feedback and we await a response on that. Uh There's uh a work reviewing all especially association guidance doctors and the I C P as well. Support other groups being social care practitioners. Uh The Iceland uh surgical trainees and dental surgery. We continue to do a lot of work in relation to flexibility of training. Uh I went to shortly the changes that come in about the seizure and the roots of the registry which the law changes in November of this year is work ongoing in relation to mentorship. Um uh We'll continue hopefully to manage the effect last year's examples, payment's but for which JCC was not responsible. Uh Hopefully, that has been mitigated throughout the log book is for those that know just about to go through a just change um in its app. And uh that many of you may have been involved in some of the testing of that. Uh There's certainly increased linkage with the I C P as well to make it easier to access information for A rcps. Uh We continue to be active with research activity. We're looking at differential attainment, our research group uh by David Hume's is working with several of the S A C S looking at assessment information, progressing through the curriculum. Uh And the data audit research group is open to take requests for people that want to utilize. I I see pay data of research purposes. Uh as we're looking for curriculum change is also looking to increase the component of genomics understanding. Um uh And we also continue to look to see how we can represent case makes change on the I C P over time, the one thing I just wanted to finally mention is that many may have heard about the changes to the root to the registry which become law beginning November of this year. So uh works to do a lot of seizure assessment. And so the standard of Caesar to demonstrate used to be equivalent is now moving to knowledge, skills and experience. Uh And there's a large process work on going through the J city to show how that would uh be for surgery and we're using the shared capabilities in practice to reflect the high level learning outcomes. Um And hopefully that will all be ready for the process of assessment when it starts in November of this year. Uh Thank you very much for listening. Uh What other big some questions at the end? Uh ensure your formula pool.