The South West regional training scheme in cardiothoracic surgery is based in 2 hospitals – Bristol Royal Infirmary (Severn) and Derriford Hospital – Plymouth (Peninsula). Overall supervision of the programme is led through the Severn Postgraduate Medical Education; however the TPD rotates between the two centres. The trainees rotate between the two training hospitals with approximately half their training at either centre.
Appointment to the Cardiothoracic Surgery Training Programme is undertaken by national recruitment and trainees can apply to enter at various levels:
- ST1: There are a limited number of posts nationally (usually 6-10 posts) where trainees can enter the programme from an early stage and receive Core Surgical themed training for two years followed by automatic entry to specialist registrar at ST3 level.
- ST3: There are approximately 15-20 trainee numbers available nationally annually and a degree of cardiothoracic experience is usually required.
- ACF: Academic Clinical Fellows posts are advertised through Bristol and appointed at national selection. These consist of 3 year academically themed years followed by 3 clinical years.
There has been a strong interest in separating the two disciplines in Cardiothoracic Surgery with the proposed eventual appointment of either only Thoracic or Cardiac Surgical Consultants. The training will still be combined to a degree Thoracic and Cardiac surgical themed training programmes are due to be developed in the near future and the South West will be able to offer these posts when available nationally.
All aspects of Cardiothoracic Surgery are undertaken in the South West with the exception of heart and lung transplantation. The following subspecialist areas are provided by the two centres:
- Bristol Royal Infirmary: Based in the new £62M Bristol Heart Institute the centre performs around 1400 adult cardiac operations each year as well as adult thoracic surgery. Particular areas of specialisation include off-pump CABG, minimal-access mitral and aortic valve surgery and clinical research. Paediatric cardiac surgery is performed at the adjacent Bristol Royal Hospital for Children. The department has strong links with Bristol Heart Institute research group led by Professor Angelini supported by a further professor, a reader and a senior lecturer in Cardiothoracic Surgery supervising of one to two ACF posts – (http://www.bristol.ac.uk/bhi/). The research group has over £50M worth of research grants and publishes nearly 100 papers annually in clinical and basic science. In the last 7 years 1 trainee won the Fontan Award, 3 the St Jude/SCTS Fellowship and all trainees have undertaken overseas fellowships in prestigious centres in Europe, Australia and America.
- Derriford Hospital Plymouth: Based in the new £30M Terence Lewis Building, the South West Cardiothoracic Centre performs 1300 adult cardiac operations each year with a specialist interest in minimally invasive surgery including minimally invasive aortic and mitral procedures, transcatheter aortic valve replacements (TAVI) and minimal extracorporeal circulation - (MECC). Major aortic surgery is performed including complex stenting of thoracic aortic pathologies. Adult thoracic surgery is performed with all the regional upper gastrointestinal surgery including minimally invasive oesphagectomies.
Trainees can expect a great deal of clinical exposure at the two centres with a reputation of extensive surgical experience with trainees performing a high percentage of cases. Regional training days are arranged biannually with additional wet lab days and mock exam sessions provided. We are proud to have a 100% first time pass rate for the part III exit exam for national trainees from the South West. Both centres offer access to locally arranged training days and simulation classes and there has been very positive feedback from the previous trainees in the region.
Annual Review Competence Progression's take place in July; further interim assessments take place as necessary. The panel includes the Training Programme Director and Deputy Director, Chair of the Specialty Training Committee, a Dean's representative, the SAC Liaison member for the region and a lay person.
The Cardiothoracic Syllabus is outlined in the ISCP website.
By agreement with the Training Programme Directors it may be possible and we would encourage trainees to spend a year out of programme at an overseas training unit (OOPT). Other opportunities exist within the academic departments of surgery for trainees to undertake a period out of programme (OOPR) to do formal research in order to complete a project that would lead to an MD, MS or PhD thesis.
Further details are available on the Severn and Peninsula Postgraduate Medical Education websites.
Please see the School Structure page for Head of School, Training Programme Director, College Tutor and School Management contact details.