silver scalpel - awarding outstanding teaching and training

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230 Ramez Kirollos, a consultant neurosurgeon from Cambridge, has taken the title of surgical trainer of the year as he picks up the Silver Scalpel award for 2010. Now in its tenth year, the Silver Scalpel is organised, funded and awarded by the Association of Surgeons in Training (ASiT) to recognise excellence in surgical training. It is awarded annually to inspirational trainers who have scored highly across five categories: leadership, resourcefulness, training and development, professionalism, and communication. In March this year, Mr Kirollos was presented with the award. Ann R Coll Surg Engl (Suppl) 2010; 92:230–231 Fantastic,’ replies Mr Kirollos, when asked how he feels about being presented with the title. The consultant at Addenbrooke’s Hospital, Cambridge, adds quickly that the award came as a complete surprise and that he feels he has not done anything more than his trainers did for him. This modest reaction reflects Mr Kirollos’s general philosophy on a successful trainer–trainee relationship. According to the consultant, successful surgical training is based on treating your trainees as your friends and future colleagues and ultimately on recognising that trainees are the future of surgery. He explains: ‘It was the standard set when I was training and it works. I have a few trainees who have been appointed consultants who are better than me and it’s something I’m proud of. As long as one of your aims as a trainer is making the new generation better than you are then a successful relationship is easy.’ Mr Kirollos is responsible for approximately 13 trainees within the neurosurgery department at Addenbrooke’s, looking after a mix of registrars and clinical researchers. One of these trainees, Adel Helmy, currently a College/Medical Research Council clinical research training fellow within the department, nominated Mr Kirollos for the Silver Scalpel in November 2009. Mr Helmy explains that part of his motivation to nominate Mr Kirollos was his gratitude for the consultant’s willingness to go ‘above and beyond’ what a trainer is required to do. Mr Kirollos explains that taking time to build a good, trusting relationship with each individual benefits both trainer and trainee. ‘You learn how your trainee learns and knowing them also helps to predict where a problem may arise,’ he says. Time With the introduction of the European Time Working Regulations (EWTR) and other service demands, the squeeze on training time has prompted some surgeons to call for protected training time to be added into trainees’ contracts. However, when asked about protecting training time, Mr Kirollos is not drawn into the discussion. He says:‘Time is not a problem when you like something; you always find time for it.’ According to the consultant, the introduction of the EWTR is not the major challenge for a trainee; he feels instead that the pressure of the tick-box culture’ within the training structure often causes more problems. In my opinion EWTR is not the biggest obstacle,’ he says. ‘It is the paperwork the trainees have to complete alongside their operative training. When I was a trainee we were trusted to get on with things but these SILVER SCALPEL: AWARDING OUTSTANDING TEACHING AND TRAINING Heather Casey Media Relations Officer SURGICAL TRAINERS DOI: 10.1308/147363510X514073 Mr Kirollos receiving his award from David O’Regan CHASING THE PAPERWORK TO PROVE THEY HAVE DONE SOMETHING MAKES TRAINEES FEEL LESS PROFESSIONAL.

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Now in its tenth year, the Silver Scalpel is organised, funded and awarded by the Association of Surgeons in Training (ASiT) to recognise excellence in surgical training. It is awarded annually to inspirational trainers who have scored highly across five categories: leadership, resourcefulness, training and development, professionalism, and communication.

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Page 1: Silver Scalpel - Awarding Outstanding Teaching and Training

230

Ramez Kirollos, a consultantneurosurgeon from Cambridge, hastaken the title of surgical trainer ofthe year as he picks up the SilverScalpel award for 2010. Now in itstenth year, the Silver Scalpel isorganised, funded and awarded bythe Association of Surgeons inTraining (ASiT) to recogniseexcellence in surgical training. It isawarded annually to inspirationaltrainers who have scored highlyacross five categories: leadership,resourcefulness, training anddevelopment, professionalism, andcommunication. In March this year,Mr Kirollos was presented with theaward.

Ann R Coll Surg Engl

(Suppl) 2010; 92:230–231

‘Fantastic,’ replies Mr Kirollos, when askedhow he feels about being presented withthe title. The consultant at Addenbrooke’sHospital, Cambridge, adds quickly that theaward came as a complete surprise andthat he feels he has not done anythingmore than his trainers did for him.

This modest reaction reflects MrKirollos’s general philosophy on asuccessful trainer–trainee relationship.According to the consultant, successfulsurgical training is based on treating yourtrainees as your friends and futurecolleagues and ultimately on recognising

that trainees are the future of surgery. Heexplains: ‘It was the standard set when I wastraining and it works. I have a few traineeswho have been appointed consultants whoare better than me and it’s something I’mproud of. As long as one of your aims as atrainer is making the new generation betterthan you are then a successful relationship iseasy.’

Mr Kirollos is responsible forapproximately 13 trainees within theneurosurgery department atAddenbrooke’s, looking after a mix ofregistrars and clinical researchers. One ofthese trainees, Adel Helmy, currently aCollege/Medical Research Council clinicalresearch training fellow within thedepartment, nominated Mr Kirollos forthe Silver Scalpel in November 2009.

Mr Helmy explains that part of hismotivation to nominate Mr Kirollos washis gratitude for the consultant’swillingness to go ‘above and beyond’ whata trainer is required to do. Mr Kirollosexplains that taking time to build a good,trusting relationship with each individualbenefits both trainer and trainee. ‘Youlearn how your trainee learns and knowingthem also helps to predict where a problemmay arise,’ he says.

TimeWith the introduction of the EuropeanTime Working Regulations (EWTR) and

other service demands, the squeeze ontraining time has prompted somesurgeons to call for protected trainingtime to be added into trainees’ contracts.However, when asked about protectingtraining time, Mr Kirollos is not drawninto the discussion. He says: ‘Time is not aproblem when you like something; you alwaysfind time for it.’ According to theconsultant, the introduction of the EWTRis not the major challenge for a trainee;he feels instead that the pressure of the‘tick-box culture’ within the trainingstructure often causes more problems.

‘In my opinion EWTR is not the biggestobstacle,’ he says. ‘It is the paperwork thetrainees have to complete alongside theiroperative training. When I was a trainee wewere trusted to get on with things but these

S I L V E R S C A L P E L : A W A R D I N G

O U T S T A N D I N G T E A C H I N G A N D

T R A I N I N G

Heather Casey Media Relations Officer

SURGICAL TRAINERSDOI: 10.1308/147363510X514073

Mr Kirollos receiving his award from David O’Regan

CHASING THE PAPERWORK TO PROVETHEY HAVE DONE SOMETHING MAKESTRAINEES FEEL LESS PROFESSIONAL.

bulletin july 2010.qxp 11/06/2010 09:02 Page 230

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THE ROYAL COLLEGE OF SURGEONS OF ENGLAND BULLETIN

days they are being given paper to counttheir hours on or they are being asked forevidence of training. Chasing the paperwork

to prove they have done something makesthem feel less professional.’

ValuesMr Helmy says that Mr Kirollos stood outfor nomination because of the emphasishe puts on the basic science and anatomybehind neurosurgery. ‘It’s refreshing that thewhole department at Addenbrooke’s valuesanatomy so highly; sometimes within trainingit is neglected in favour of other morefashionable elements such ascommunications skills. Mr Kirollos inparticular gives up a lot of his own time toteach us the anatomy behind the surgicalapproaches,’ he says. ‘In addition to weeklyteaching we benefit from his professionalinterest in developments in neurosurgicalanatomy; for example, Mr Kirollos hascreated a successful international coursecalled Cambridge Lectures inNeurosurgical Anatomy, which has brought3D technology into our department – aunique and valuable resource.’

He also cites Mr Kirollos’s values andapproach to professional conduct asanother reason: ‘Mr Kirollos’s ownprofessional practice encompasses properfollow-up of his patients, includingunderstanding how complications have

affected patients not only post-operatively butsix months or two years down the line. As atrainee, learning this approach gives you a

more rounded view of how a patient hasdone,’ he says. ‘This is important withinneurosurgery as what you feel is a successfuloperation can often give you a skewed ideaof what is a good clinical outcome. Withoutappropriate follow-up you don’t see theimpact that an operation has on a patientover time.’

CareThe Silver Scalpel award also recognisesthat good trainers provide an element ofpastoral care alongside operative training.Mr Kirollos explains that this is where agood trainer–trainee relationship isessential. ‘A trainee being stressed orovertired doesn’t come as a surprise whenyou know your trainees well. You can predictit,’ he says. However, he adds that thehardest part of caring about your traineeis when something goes wrong and apatient is involved. ‘This is a very difficultsituation because patient safety is paramountin all training; however, if a trainee is facingdifficulties it is vital that trainers intervene ina way that does not destroy his or herconfidence forever.’

Mr Helmy concludes that all good surgicaltrainers, including Mr Kirollos, leave alasting impression. ‘All trainees are a

product of their trainers, that’s the key thingabout surgical training,’ he says. ‘You pickand choose the best ways to do things fromeach of them and their input moulds you intothe surgeon you become.’

Previous winners2009 David Khoo2008 Ajith Siriwardena2007 Ian Gunn2006 Fiona MacNeill2005 David Jaffrey2004 Ray Clarke2003 Christopher Curwen2002 Henry Sue-Ling2001 Mike Hershman

Details on how to nominate trainers forthe 2011 Silver Scalpel award will beavailable on the ASiT website(www.asit.org) in the autumn.

Adel Helmy

YOU CHOOSE THE BEST WAYS TO DOTHINGS FROM EACH TRAINER ANDTHEIR INPUT MOULDS YOU INTO THESURGEON YOU BECOME.

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