DOI: 10.

1308/147363510X514073

SURGICAL TRAINERS

S I LV E R S C A L P E L : AWA R D I N G O U T S TA N D I N G T E A C H I N G A N D TRAINING

Heather Casey Media Relations Officer

Mr Kirollos receiving his award from David ORegan

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; 92:230231

Fantastic, replies Mr Kirollos, when asked how he feels about being presented with the title. The consultant at Addenbrookes 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 Kirolloss general philosophy on a successful trainertrainee relationship. According to the consultant, successful surgical training is based on treating your trainees as your friends and future colleagues and ultimately on recognising

Mr Helmy explains that part of his motivation to nominate Mr Kirollos was his gratitude for the consultants 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

CHASING THE PAPERWORK TO PROVE THEY HAVE DONE SOMETHING MAKES TRAINEES FEEL LESS PROFESSIONAL.
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 its something Im 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 Addenbrookes, 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. 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

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days they are being given paper to count their hours on or they are being asked for evidence of training. Chasing the paperwork

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

YOU CHOOSE THE BEST WAYS TO DO THINGS FROM EACH TRAINER AND THEIR INPUT MOULDS YOU INTO THE SURGEON YOU BECOME.
to prove they have done something makes them feel less professional. more rounded view of how a patient has done, he says. This is important within neurosurgery as what you feel is a successful operation can often give you a skewed idea of what is a good clinical outcome. Without appropriate follow-up you dont see the impact that an operation has on a patient over time.

Mr Helmy says that Mr Kirollos stood out for nomination because of the emphasis he puts on the basic science and anatomy behind neurosurgery. Its refreshing that the whole department at Addenbrookes values anatomy so highly; sometimes within training it is neglected in favour of other more fashionable elements such as communications skills. Mr Kirollos in particular gives up a lot of his own time to teach us the anatomy behind the surgical approaches, he says. In addition to weekly teaching we benefit from his professional interest in developments in neurosurgical anatomy; for example, Mr Kirollos has created a successful international course called Cambridge Lectures in Neurosurgical Anatomy, which has brought 3D technology into our department a unique and valuable resource. He also cites Mr Kirolloss values and approach to professional conduct as another reason: Mr Kirolloss own professional practice encompasses proper follow-up of his patients, including understanding how complications have

Values

Adel Helmy

Care

The Silver Scalpel award also recognises that good trainers provide an element of pastoral care alongside operative training. Mr Kirollos explains that this is where a good trainertrainee relationship is essential. A trainee being stressed or overtired doesnt come as a surprise when you know your trainees well. You can predict it, he says. However, he adds that the hardest part of caring about your trainee is when something goes wrong and a patient is involved. This is a very difficult situation because patient safety is paramount in all training; however, if a trainee is facing difficulties it is vital that trainers intervene in a way that does not destroy his or her confidence forever. Mr Helmy concludes that all good surgical trainers, including Mr Kirollos, leave a lasting impression. All trainees are a

product of their trainers, thats the key thing about surgical training, he says. You pick and choose the best ways to do things from each of them and their input moulds you into the surgeon you become.

2009 2008 2007 2006 2005 2004 2003 2002 2001

Previous winners

David Khoo Ajith Siriwardena Ian Gunn Fiona MacNeill David Jaffrey Ray Clarke Christopher Curwen Henry Sue-Ling Mike Hershman

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

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