West Midlands Postgraduate School of Surgery - Urology

Training Programme 

Number of trainees: 30 

Training Programme Director & STC Chair: Mr Herman Fernando 

SAC Liaison Member: Mr Ben Thomas

HST in Urology takes place over 5 years, from ST3-7. As per the new ISCP curriculum, Phase 2 is from ST3-5, and Phase 3 from ST6-7. The centres and numbers of trainees allocated to them are as follows:- 

Every March, trainees are invited to state their top 3 choice of rotations for the coming October. The placement schedule is released shortly afterwards in April/May (after the March ARCP), giving them nearly 6 months’ notice to plan their move if required. The vast majority of trainees get one of their 3 choices, if appropriate for their training requirement. Phase 2 trainees are encouraged to choose placements that offer good exposure to the Index Procedures (urodynamics, prostate biopsies, penoscrotal procedure, TURBT, TURP and ureteroscopy), allowing them to achieve the desired competencies and be signed off to sit the FRCS (Urol). For Phase 3 they are able to choose centres where they can pursue their Special Interest Modules and subspecialty choice, however all the centres offer core procedures.  

All trainees usually rotate at least once through the Birmingham centres – the Queen Elizabeth, Heartlands, Good Hope and Solihull rotation. These centres are regional tertiary referral centres for Female & Functional Urology, and Andrology. 

Teaching & Learning 

Deanery teaching is held on a monthly basis. These days are mandatory and a minimum of 70% attendance is required. The schedule is released every calendar year, and the individual training centres must release their trainees for it. Teaching is held across the region, with each centre (regardless of whether it is a DGH or tertiary centre) hosting each day, the topic dependent upon which area that particular department specialises in but pertaining to the syllabus. The trainees placed in each centre are responsible for organising the teaching days when it is their turn. 

There are a couple of annual regional meetings built into the teaching programme and which again are mandatory for trainees to attend – these are the West Midlands Endourology Day, and the Midlands Urology Club. Both meetings provide the opportunity for trainees to present work which is then recognised for ARCP requirements, with prizes available to trainees for the best presentation at each meeting. 

The monthly regional teaching days during the COVID-19 pandemic were maintained on a virtual basis via the Post Graduate Virtual Learning Environment (PGVLE) which was developed by Health Education England West Midlands, and provided to all its training specialties for free. These teaching days were recorded and uploaded onto the platform, along with links to multiple online resources with the aim of preparing trainees for the FRCS (Urol). The Urology pages on PGVLE are maintained and developed by trainees, with 2 roles of Digital Teaching Fellows (DTF) existing. Such preparation goes beyond what is available in other deaneries, with one of the consultants acting as the regional Exams Lead to thoroughly prepare trainees for both Sections of the FRCS. This includes an annual mock viva day which replicates the actual exam, and provides trainees preparation from the very start of ST3 for the conditions they will face in the exam; and the provision of mock viva sessions through a YouTube channel which is freely available to all to view. 

Research 

In the last 3 years the West Midlands Urology Research Collaborative (WMURC) has been re-established which is predominantly trainee-led, and has had success in terms of work being presented at national and international level, and published in peer-reviewed journals, with trainees as collaborative leads. Participation in this is strongly encouraged by the TPD, especially as involvement in projects that are presented or published counts towards ARCP and CCT requirements. 

Journal Club, led by a middle year trainee, is run on a quarterly basis, and allows trainees to keep up-to-date with the latest important publications and research in Urology. 

Paediatric Urology 

The Paediatric Urology organisation within the West Midlands, compared to other regions, is excellent. For the last 3 years an arrangement has been in place with the Urology department at Birmingham Childrens’ Hospital (BCH), a major tertiary referral centre, to allow adult trainees from the West Midlands to be placed at BCH for a period of 4 weeks, twice during their training – once at the start, and once towards the end. Trainees are therefore released from their normal daytime elective commitments in the Trusts they are placed in for those 4 weeks (apart from evening and weekend on-calls) and are able to dedicate their time towards fulfilling their Paediatric Urology requirements.  

BCH being a tertiary centre allows exposure to conditions which would normally not be encountered in a non-Paediatric centre, including upper tract conditions and hypospadias repairs. There are still some of the normal Urology training centres in the region which carry out Paediatric Urology surgery, but this is limited to penoscrotal conditions. Trainees in the vast majority of centres are still expected to operate on children presenting with acute scrotum (where such an operation is deemed necessary at the time). 

Out Of Programme Experience 

Out of Programme opportunities are encouraged by the programme. These include Urolink (through BAUS), and trainees more recently have taken on Chief Registrar posts in the Queen Elizabeth Hospital, and New Cross Hospital. In the past, with adequate notice and arrangements, trainees have also been to Australia for OOP training. 

Other things to know 

The West Midlands deanery has its own social event called the Orchid Club. This takes place on a quarterly basis and again provides a leadership and management role for one of the trainees. The very-well attended events consist of dinner and drinks accompanied by educational talks on urological topics outside of the training curriculum by both local and external speakers, and provide an excellent chance for trainees to network with consultants attending the meetings too.  

There are a number of leadership and management opportunities in the region for trainees to take on as outlined above – these include the Trainee Reps (2 roles) for the regional Specialist Training Committee; the Regional Rep for the BAUS Section of Trainees (BSoT); members of the WMURC committee; Journal Club lead; PGVLE DTFs; and Orchid Club secretary. The West Midlands has also delivered in recent years in terms of training excellence – in the last 5 years it has provided winners of the Keith Yeates Gold Medal (awarded to the top candidate in the FRCS (Urol) Section 2 exam); the Bronze Cystoscope (awarded to a trainee who has excelled in any area); and the Silver Cystoscope (awarded to a trainer for excellence in surgical teaching).  

Finally, the Urology trainee group for the West Midlands has its own Twitter account (@westmidsurol) which widely publicises all the positive work, meetings and achievements throughout the deanery, as well as educational events from elsewhere relevant to training. 

Page Last Updated 15th May 2023