Expertise in general, abdominal, laparoscopic and colorectal surgery

Training

I was fortunate enough to have over 13 years of high quality postgraduate medical training before taking my first consultant position in 2009. Looking back at this period, it is clear to me that the attitude of the trainee is of primary importance in good quality training but this is not the only factor. The trainer needs to know how to deliver training effectively and efficiently, the opportunities must be created and regular clear objectives must be set so that progress can be monitored. Unfortunately, luck still plays a part but this can be minimised.

Since 2009 as a result of European legislation, junior doctors have been limited to an average of 48 hours of work per week. Although in theory this keeps doctors alert and safe, in practice it has a number of effects that do just the opposite because of the introduction of shift rotas that separate the junior from their consultant. This not only results in reduced quantity of work-based experience but also the quality of experience is diluted.

Training the doctors of the future has now become a real challenge and developing new ways to teach and train has become essential. I have developed a curriculum for junior surgeons to practice their operative skills in virtual reality prior to entering the operating theatre. This involves developing their technical skills in a virtual reality environment on a computer simulator. These machines are now very sophisticated and can measure safety and efficiency parameters so that progress can be monitored. Another key feature is the physical or “haptic” feedback that the instruments give the user depending on which tissues they are handling. This, along with the accurate depiction of anatomy means that the experience is as realistic as possible. You can watch me perform a virtual reality sigmoid colectomy. It is my vision that all surgeons of the future will have to be certificated to an agreed standard of objective measures before being allowed to operate on a patient, thus greatly increasing both patient safety and ultimately efficiency in theatre. You can read more about virtual reality laparoscopic surgery via the following links:

Virtual Reality Technology To Be Used To Train Surgeons

Virtual Reality Training Funding

In order to create a useful training experience for my junior surgeons, I use a standardised methodology for a training episode which ensures we can get the most from a short period of time. This is based on thorough preparation and assessment, aligning agendas, setting clear and achievable objectives, ensuring performance enhancing instruction, effective debriefing and a take home message.

I have been a national trainer for the Department of Health, training other consultants in laparoscopic surgery (pictured above with James Pitt, consultant surgeon at Ipswich) and in addition to this I am faculty on the LAPCO Train the Trainers course that helps develop skills for consultant surgeons that are involved in training in the NHS. Over the last two years, I have developed a successful new training course for trans-anal rectal cancer excision using the latest techniques in laboratory simulation. We have now trained over 60 senior colorectal surgeons in this technique - probably more than anyone else worldwide.

Since the new ICENI Centre was opened in 2011 by the Secretary of State for Health, we have expanded the range of training opportunities we offer. Our centre is an internationally renowned unit for research and development into minimal access surgery and it is here that I teach postgraduates during their MSc degrees and run numerous surgical courses.


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