The Part III FRCS(CTh)
Relating To The Specialty Examination In Cardiothoracic Surgery
Guide To Format And Scope Of The Examination
Books for the Exam
Candidates will be sent a schedule and covering letter outlining the arrangements, approximately 4 weeks prior to the examination. Where possible, the Intercollegiate Office will also provide a list of suggested accommodation or the telephone number of the local tourist information office. Candidates must make their own arrangements for travel and accommodation.
The names of the examiners will not be issued to candidates. No candidate should be examined by his/her current trainer. Wherever possible, no candidate will meet the same pair of examiners more than once. However, it is inevitable that on occasions a candidate may meet a particular examiner more than once where changes have had to be made within the schedule to prevent an examiner meeting his own trainee.
There may be a number of observers, normally new examiners in the specialty or visitors from other Boards, in attendance at the examination.
Examination Procedure - Orals
An outline of the sections or topics covered in the examination may be found in the Regulations. Each part of the examination will be conducted by two examiners both of whom will take part. Each oral will normally be split into two. A bell will be rung half way through to allow the examiners to change over and a longer bell will be rung at the end. During each half session, one examiner conducts the oral whilst the other records specific questions/areas covered and comments on the candidate's performance. Examiners may use x-rays, slides, photographs or specimens in this part of the examination. Candidates will not be permitted to take briefcases into the examination. Mobile telephones must be switched off during all examination sessions.
Examination Procedure - Clinicals
Candidates will be given time to examine the patient and take a brief history although examiners will be present during this part of the clinical. Candidates should bring with them stethoscopes or any other small instruments required for examining patients. However, candidates should ask medical staff on duty for any instruments they particularly require to carry out the clinical examination.
Log books will not be required at the examination.
Candidates must not bring into the examination any papers, bags, calculators, mobile phones, pagers, electronic audio, recording, communication device, textbooks, documents or items of any kind other than those specifically allowed for the examination. The use of any such items in the examination is strictly forbidden.
Where examination centres do not have secure areas to store personal items, these should be deposited as directed by the Secretariat.
Candidates who infringe the examination rules, or who are found to be in the possession of any unauthorised device, will be reported to the Head of Examinations. The candidate will automatically be deemed to have failed the examination.
Each pair of examiners is required to note down topics covered in the examination and record a joint mark at the end of each oral/clinical. These marks are not divulged to, or discussed with, any other examiner until the debriefing.
At the conclusion of the examination, a meeting of the Board of Examiners will be held to review the candidates' marks. The Chairman or Senior Examiner will preside. The decision of the Panel at the Debriefing is final.
After the conclusion of the Debriefing, all candidates will be handed an envelope containing their result. Those unable to remain for the announcement of results should inform the administrator present to make alternative arrangements for receiving his/her results. A letter confirming the results will be sent to all candidates from the Head of Examinations within a few days of the examination. Any discussion held during the debriefing is strictly confidential therefore Examiners are not permitted to discuss with any candidate his/her performance in the examination. It is also recommended by the JCIE that the Chairman of the Board will not normally discuss with any unsuccessful candidate his/her marks or examination performance immediately after the examination. These rules were drawn up to protect both the candidate and examiner from making hasty remarks.
Immediately following an Examination, the Head of the Intercollegiate Specialty Examinations will send a list of successful candidates (including details of their affiliated Colleges / designated College) to each of the four Surgical Royal Colleges.
Successful Candidates – who are already affiliated to one of the Colleges and hold either the FRCS, AFRCS or MRCS
A candidate who is successful in the Intercollegiate Specialty Examination and who holds a Fellowship in Surgery-in-General, Associate Fellowship or Membership will be advised by his/her affiliated College, in due course, of the process for applying for election to, or award of the Fellowship to which they may add the appropriate suffix indicating the Specialty in which they were examined e.g. (FRCS C-Th).
In the case of a candidate being a Fellow of more than one College, then he/she will be required at the time of applying for the examination to designate the College by which this award is to be made. Please note that this will also be the College through which your CCST will be recommended if applicable.
Successful Candidates – who are not affiliated to a College and who do not hold the FRCS/AFRCS or MRCS
Successful candidates who are not affiliated to one of the four Surgical Royal Colleges of Great Britain and Ireland (i.e. who do not hold the FRCS/AFRCS or MRCS) should notify the Intercollegiate Secretariat on application to sit the Examination, of the chosen Surgical Royal College from which they would wish to receive information on the process for applying for election to, or award of, the Fellowship.
Success in the Intercollegiate Specialty Examination does not automatically confer a Fellowship therefore, the designation FRCS (Suffix) must not be used until all formalities have been completed.
Please note that for Examinations from September 2002 the Intercollegiate Specialty Boards will cease to issue Certificates, these will be replaced by the Fellowship Diplomas of the Colleges.
The McCormack Medal may be awarded to a candidate who has been deemed, by
the Board of Examiners, to have shown an outstanding performance in the examination. Candidates from the two examinations each year are taken into consideration.
Performance Reports for Unsuccessful Candidates
i) Candidates in training:
Following the examination, the Chairman will write to the Programme Director of each unsuccessful candidate providing a summary of his/her performance highlighting areas of the examination under which he/she has failed. The candidate will receive a copy of this report.
ii) Candidates without supervision:
Following the examination, the Chairman will write to the unsuccessful candidate providing a summary of his/her performance highlighting areas of the examination under which he/she has failed.
The GMC has advised the Boards through the JCHST that in the event of an unsupervised candidate failing the Intercollegiate Specialty Examination who has demonstrated :
i) a lack of basic knowledge resulting in a poor performance across the entire spectrum of the examination such as would suggest the potential for adversely affecting the clinical care of patients and
ii) that the candidate’s ability to safely manage patients had caused grave concern to the Panel of Examiners.
then that candidate’s performance should be reported to his/her employing authority and, depending on the outcome, may be reported to the GMC.
Re-sitting the Examination
From 1st January 2003 candidates will be limited to three attempts at the examination after which they must seek specific counselling, re-training where necessary and the written support of the Postgraduate Dean and Programme Director in order to resit again. Attempts prior to January 2003 will not be counted.
There is no right of appeal against the results of an examination. However, there is an appeal mechanism for candidates who have a grievance with regard to the conduct of the examination where they consider there to have been a procedural irregularity. Should you require further information please contact the Head of Intercollegiate Specialty Examinations within one week of the examination concerned.
If you suffer from any medical condition which you feel we should be aware of then please notify the Head of Intercollegiate Specialty Examinations, in writing, at least one month prior to the examination.
Administration of Examination
A senior member of the Secretariat from the Intercollegiate Office will be present throughout the entire period of the examination. Candidates are strongly advised to contact either the Chairman or the Examination Secretariat present if they have any problems of any kind.
FOR CANDIDATES IN THE SPECIALIST REGISTRAR GRADE
The candidate must hold a medical qualification recognised for
registration by the General Medical Council or the Medical Council of
Ireland and must have been qualified for at least seven years.
2. The candidate must satisfy the current requirements for entry to an approved higher surgical training programme in Great Britain or Ireland.
3. The candidate must have completed satisfactorily four years of higher training in the specialty acceptable to the relevant Board.
a) A Type 1 trainee, who is training with a view to the award of the Certificate of Completion of Specialist Training (CCST) by the Specialist Training Authority of the United Kingdom, the Certificate of Specialist Doctor (CSD) or Specialist Registration with the Medical Council of Ireland, must have enrolled with the relevant Specialist Advisory Committee (SAC) and completed the above four years of training within a programme approved by the SAC. A satisfactory fourth-year clinical assessment form(s) covering this year of training and the appropriate declaration form signed by the Programme Director will be required.
b) A Type 2 trainee (i.e not eligible for CCST) must be registered with the relevant Specialist Advisory Committee (SAC) and must have spent at least one of the above four years in a training programme in Great Britain or Ireland approved by the relevant SAC. This mandatory clinical year must offer experience equating to fourth-year level within the specialist registrar grade. The trainee must obtain written confirmation from their trainer that the training will be at fourth-year specialist registrar level. A satisfactory fourth-year clinical assessment form(s) covering this year of training and the appropriate declaration form signed by the Programme Director will be required. Any other training completed in Great Britain and Ireland counting towards the examination must have been in posts approved by the relevant SAC. For consideration of training undertaken outwith Great Britain and Ireland the SAC will require supporting documentation at the time of registration.
Note: Type 2 trainees will not be eligible for the award of CCST and passing the examination, in itself, will not automatically entitle a trainee to enter a type 1 training programme.
4. From 1st January 2003 candidates will be limited to three attempts at the examination after which they must seek specific counselling, re-training where necessary and the written support of the Postgraduate Dean and Programme Director in order to resit again. Attempts prior to January 2003 will not be counted.
Please note that with effect from September 2002, candidates who are successful in the Intercollegiate Specialty Examination will be eligible for election to, or award of, the Fellowship of the College to which they are affiliated. Successful candidates who are not affiliated to one of the four Surgical Royal Colleges of Great Britain and Ireland (i.e. who do not hold the FRCS or MRCS/AFRCS) may apply to one of the four Surgical Royal Colleges for election to, or award of, the Fellowship.
TO FORMAT AND SCOPE OF THE EXAMINATION
format will consist of clinical and oral examinations in all aspects of
the specialty of Cardiothoracic Surgery.
pharmacology and their applications (30 minutes).
must be completed, in full, before being submitted to the
Intercollegiate Office. Incomplete applications will not be
considered by the Board.
Documentation Required for Submitting an Application
For those applying under criteria 3a and 3b of the Regulations, the following must be included with their application:
i) Curriculum Vitae
ii) 2/3 -page Summary of Operative experience of Higher Surgical Training
signed by Programme Director
iii) Passport size photograph
iv) Cheque for the Examination fee in full [£ Sterling / Euro]
v) Declaration form, 3a [green] or 3b [orange], signed by Programme Director
Application form must be completed in full and signed by applicant and his/her Programme Director
Closing dates will be strictly adhered to. It is the responsibility of the applicant to provide the required information and documentation, without it the application fails.
Early application is advised as candidate numbers may be restricted. Please note that there are two sittings of the examination each year. A list of dates are available from the Intercollegiate Office.
Please note that all resit candidates must complete the application form in full and forward it with the fee to the Intercollegiate Specialty Boards. The application form must be signed by the candidate and his/her Programme Director prior to submitting to the Intercollegiate Office. As we already hold a photograph, CV and operative summary on file you are not required to re-submit these unless specifically requested or have changed your training post.
4th Year Clinical Assessment[s] (Yellow JCHST Assessment Form) –
Applicants applying under 3a & 3b
All candidates are reminded that a satisfactory 4th year clinical assessment is required under criterion 3 of the 1996 Regulations. The Board will seek confirmation with the SAC that this has been complied with. Therefore candidates are advised to ensure that their Programme Directors have returned the yellow JCHST form[s] to the appropriate SAC office prior to submission of their application. This must be sent to the SAC at least 10 working days before the closing date for applications. All trainees must also be registered/enrolled with the SAC and those applying under 3a should have their CCST Date confirmed.
RITA A Form - Applicants applying under 3a & 3b
The Board will seek confirmation from the SAC that applicants are enrolled/registerd. For this to be confirmed a RITA A form must have been sent to the SAC Office from the Postgraduate Dean’s Office. This form confirms the trainees’ enrolment, date of appointment, training number (visiting or national) or LAT post and due date for CCST, if applicable. It is the responsibility of applicants to ensure that the above has been complied with at least 10 days prior to the closing date.
Operative Summary (All applicants)
A 2/3-page operative summary or consolidation sheets is required to be submitted with your application. This should be laid out in the format of the generic breakdown at the back of the log book. This should distinguish between emergency and elective procedures and categorise procedures performed as follows; performed without direct supervision; performed under direct supervision; assisting a more senior surgeon.
SAC Approved Training - Applicants applying under 3b
With regard to Condition 3b of the Regulations, applicants are advised that SAC approved training relates to a period spent in a recognised programme, inspected and approved by the appropriate SAC as fulfilling the requirements for higher training in the specialty. It is important that candidates register with the SAC and confirm that their training post[s] in the UK or Ireland has/have been approved. Applicants are strongly advised to seek this confirmation before commencing their training. Applicants are advised to send to the SAC the following documentation; i) curriculum vitae; ii) summary of operative experience; iii) confirmation of the periods of Higher Surgical training in Great Britain or Ireland for which eligibility to sit the examination is claimed, giving dates, grades and units in which you were employed (this information must be provided by Medical Staffing Departments). The contact details for the SAC office are as follows: Specialist Advisory Committee in Cardiothoracic Surgery, The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London, WC2A 3PN. Tel: 0207 869 6251.
Basic Surgical Training / Entry to Higher Surgical Training
With regards to Condition 2 of the Regulations, applicants must satisfy the current requirements for entry to an approved higher surgical training programme in Great Britain or Ireland having fulfilled the required Basic Surgical Training (contact SAC for further information). For those applying under Condition 3a of the Regulations candidates will require to have gained entry to a Type 1 post and hold a National Training Number (NTN) or Visiting Training Number (VTN). Applicants applying under Condition 3b will require to fulfil the entry requirements for a Type 2 post and hold a Fixed Term Training Appointment number (FTN/FTTA) or be in a Locum at Training post (LAT) approved by the SAC.
College Subscriptions [All Applicants]
It is a requirement of the four Royal Surgical Colleges of Great Britain and Ireland that Fellows/Associate Fellows and Members must be in good standing and have maintained payment of their subscriptions with their appropriate College prior to sitting the examination.
Withdrawing from the Examination
As a result of an increased number of Candidates withdrawing from the examination at a late stage it is necessary to draw your attention to the following section in the Guidance Notes for candidates:
i) Candidates withdrawing prior to the published closing date may have their full entrance fee returned or transferred to a future examination without penalty.
ii) Candidates withdrawing after the closing date, within 21 working days of the examination, may have 50% of their entrance fee returned or transferred to a future examination.
iii) Candidates withdrawing within 20 working days of the examination, or failing to attend the examination will not be entitled to a refund, except in the most exceptional circumstances, and at the discretion of the Board.
Written notice must be given by any candidate wishing to withdraw or transfer. These penaltiesn will apply to anyone withdrawing from an examination.