Forum młodych chirurgów
Cardiac surgery training in the United Kingdom. Visiting Wales for training

British surgical training system is based on traditional consultant ‘surgical firm’ structure. Consultant, Specialist Registrar (SpR), Senior House Officer (SHO) and House Officer are on call together and on regular weekdays. This impacts on service delivery and training. There is continuity of care and spread of knowledge from master to his apprentice. The system is unique in Europe and each consultant creates his own practice choosing cases he operates depending on his interest. It is the hospital’s responsibility to select a team of specialists necessary to provide a sufficient cardio-thoracic surgical care in any given area. The majority of departments are staffed with a variety of different specialists in cardiac and thoracic surgery. Each SpR works with a consultant for 6 months and then moves to another consultant thus gaining gradually more experience. Cardio-thoracic surgical training lasts 6 years, of which part is devoted to thoracic surgery. Depending on his preferences a trainee may decide to concentrate on either branch. However, the final exam and title involves in full both cardiac and thoracic surgery. Since 2004 I have been working as Specialist Registrar in University Hospital of Wales. Thanks to professor Stanisław Woś cooperation with various centres in the United Kingdom young Polish cardiac surgeons are recognised as valuable trainees and successfully compete with others for training positions in the UK. However, competition for high training posts is fierce (applicant to post ratio averages 20:1). To be successful one must be equipped with determination, perseverance, technical skills, sound clinical judgment, and the ability to communicate and work effectively in a team.
Advantages of the British training system
First of all, working with one surgeon in his practice allows familiarising thoroughly with the healthcare process since the patient is qualified for operation to the patient’s assessment in the follow-up clinic. Binding patients with surgeons also makes it necessary to treat all possible complications and to perform reoperations. The cardio-surgical case always remains a consultant’s patient and any problems whether or not due to the operation must be resolved. Depending on his training a registrar is exposed to different parts of this process both clinical and surgical. In the beginning of the training it may be required to look after and assess postoperative patients...


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