Specialty specific guidance for CESR in Cardiothoracic Surgery

The new surgical curricula were published on 17 November 2020. Due to the significant changes that are being made to the curriculum we will be offering applicants the opportunity to make your CESR application in either the new curriculum or the previous version of the curriculum. This option of dual running of curricula for this specialty will be available until 31 July 2023. See the position statement on transition of curricula for further information.

Specialty Specific Guidance

The Joint Committee on Surgical Training and GMC have produced guidance documents for each version of the curriculum.

How to apply

You can apply through your GMC online account. There is one application form which includes sections for both versions of the curricula. You should declare which curriculum version you wish to be assessed against in sequence one and only provide evidence in the sections of the application relevant to your curriculum.

2021 Curriculum

The GMC designed its new standards for postgraduate medical curricula Excellence by Design and its framework for Generic Professional Capabilities, published in May 2017, to help postgraduate medical training programmes re-focus trainee assessment away from an exhaustive list of individual competencies, towards fewer broad capabilities required to practice safely as a day-one consultant.

As a result, the 2021 surgical curricula are outcomes-based, meaning that trainees will be assessed against the fundamental capabilities required of consultants in the working week. These include the general skills which all doctors need to have (the GMC’s Generic Professional Capabilities) as well as those needed to carry out all the specific day to day tasks undertaken by a consultant surgeon (Capabilities in Practice – CiPs).

Content shared between all surgical specialties

There are now generic requirements shared between surgical specialties in the following areas. 

  • Research
  • Quality Improvements
  • Medical Education and training
  • Management and leadership

You can find out more in section 5.4 Completion of training in your specialty

There are five CiPs which are shared between all surgical specialties:

  • CiP 1. Manages an out-patient clinic
  • CiP 2. Manages the unselected emergency take
  • CiP 3. Manages ward rounds and the on-going care of in-patients
  • CiP 4. Manages an operating list
  • CiP 5 Manages multi-disciplinary working 

In addition, Cardiothoracic surgery has two specialty specific CiPs:

  • CiP 6 Manages patients within the Critical Care Area
  • CiP 7 Assesses surgical outcomes both at a personal and unit level

Assessment tools

A new assessment tool has been developed for outcomes based assessments. The Multiple Consultant Report (MCR) allows assessment of performance relative to the level required of a Day 1 consultant in each CiP and the GPCs. The MCR is an assessment based in the workplace using observations gathered over an extended period of time. For trainees, this is the entire duration of a placement. For CESR applicants we would expect observations to be over a similar time frame. The MCR for CESR should reflect the final MCR for a trainee and should be a summative assessment. The MCR should cover a period of at least 6 months prior to making the CESR application. Applicants should bear this in mind when they first begin to gather their evidence for CESR.

The MCR and guidance for applicants and their supervisors can be found on the JCST website.

Changes in knowledge and skills

The majority of service needs relate to providing cardiac or thoracic surgeons, rather than Cardiothoracic Surgeons. The 2021 curriculum reflects this. For trainees this means an initial period of training across Cardiothoracic Surgery, moving on to continuing to 

  • attain knowledge and clinical skills in the generality of Cardiothoracic Surgery
  • be involved in care of both cardiac and thoracic patients, and 
  • increase focus on either cardiac or thoracic surgery. 

This is described in more detail at 2.3 -The training pathway and duration of training on pages 5-7 of the 2021 Cardiothoracic Curriculum.