Paediatric Surgery

Requirements for the Fellowship in Paediatric Surgery

The Fellowship Examination presently consists of three major components:

• The anatomy examination, which may be undertaken from the end of the second year of specialist training (during the adult general surgical component).
• The paediatric surgical pathology examination, which may be undertaken from the first half of the fourth year of specialist training (minimum of 12 months into the paediatric specialist paediatric surgical component of advanced training.
• The Fellowship Examination, which may be undertaken in the final (sixth year) of advanced training and incorporates written papers, operative surgery and clinicals. The exceptional candidate, prospectively arranged, and at the discretion of the Board, may be entitled to spend the final training year overseas, and take the Fellowship Examination at the end of the penultimate year. Candidates must have satisfactorily completed the EMST and APLS courses and satisfied the College research requirements in order to be eligible to present for the Fellowship Examination. Trainees must also have submitted log book summaries, in a standardised form, and in-training assessments by the Supervisor of Surgical Training indicating satisfactory performance and completion for each period of training.

Specialist Trainees in Paediatric are also required to satisfactorily complete the Paediatric Surgical Modules during the Paediatric Surgery component of the training programme. It is the Board's intention to incorporate these modules into the Fellowship Examination assessment package in the future. The Fellowship will not be granted until all training requirements have been completed and the Board of Paediatric Surgery has indicated to the Censor-in-Chief its approval of the duration and quality of the training. 

Paediatric Surgery as Practised in Posts Approved for Specialist Surgical Training

• A detailed knowledge of the surgery of those conditions recognised as belonging to general paediatric surgery.
• Less detailed knowledge of the surgery of those conditions recognised as belonging to specialist areas within paediatric surgery.
• General knowledge.
• Principles of surgical practice such as infection control, electrical and radiation safety, safety in the operating theatre, communication with families.

Paediatric surgery as practised in posts approved for Specialist Surgical Training incorporates the following:

General overview

• A detailed knowledge of the surgery of those conditions recognised as belonging to paediatric surgery.
• Less detailed knowledge of the surgery of those conditions recognised as belonging to specialist areas within paediatric surgery.
• General knowledge in both paediatrics and surgery.
• Principles of surgical practice such as infection control, electrical and radiation safety, safety in the operating theatre, communication with families.

Embryology, anatomy, physiology and pathology

• Knowledge of the structure, function and development of the organs of the fetus, infant and child.

Embryology

• General development of the embryo
• Aetiology of developmental anomalies including genetic aspects and embryogenesis
• Natural history of abnormalities diagnosed before birth

Anatomy

• A thorough knowledge of the regional and surgical anatomy
• A practical knowledge of the regional and surgical anatomy

Physiology and Pathology

• Fetal physiology and pathology
• Neonatal physiology, metabolism and pathology
• Physiological disturbances and pathology of the surgical conditions of childhood
• Principles of the physiology and pathology

Surgery in detail of the following:

• Neonatal surgical conditions
• Trauma and burns, including prevention and management
• The abdomen (eg: intussusception, acute appendicitis)
• Abdominal wall, hernia and undescended testes
• Genito-urinary tract (eg: posterior urethral valves) and external genitalia
• Head and neck (eg: thyroglossal cyst)
• Skin and subcutaneous tissues
• Tumours occurring in childhood, including genetic aspects of tumour aetiology (eg: neuroblastoma)
• Congenital malformations
• Non-cardiothoracic (eg: oesophageal atresia)

Surgery in less detail of areas covered by other specialties, except as specified above:

• Surgical principles
• The management of emergencies, both traumatic and non-traumatic
• The management of more common conditions
• Ability to recognise the less common conditions, to know their treatment options and likely rognosis/outcomes.

Rehabilitation and ethics

• The trainee should be familiar with the indications, needs and limitations of rehabilitation and the facilities available
• Trainees should have a knowledge of the ethical implications of paediatric surgical practice, including abnormalities diagnosed antenatally.

A detailed syllabus is available in all recognised posts.