Paediatric Surgery CESR Portfolio Guide

Able to perform all the administrative and clinical tasks required of a consultant surgeon in order that all patients presenting as outpatients in the specialty are care for safely and appropriately

• Assesses and prioritises GP and inter-departmental referrals and deals correctly with inappropriate referrals
• Assesses new and review patients using a structured history and a focused clinical examination
• Carries out syllabus defined practical investigations or procedures within the out-patient setting
• Adapts approach to accommodate all channels of communication
• Takes co-morbidities into account
• Requests appropriate investigations, does not investigate when not necessary
• Selects patients with urgent conditions who should be admitted from clinic
• Manages potentially difficult or challenging interpersonal situations, including breaking bad news and complaints

All patients with an emergency condition requiring management within the specialty. Able to perform all the administrative and clinical tasks required of a consultant surgeon in order that all patients presenting as emergencies in the specialty are cared for safely and appropriately

• Promptly assesses acutely unwell and deteriorating patients, delivers resuscitative treatment and initial management
• Makes a full assessment of patients by taking a structured history and by performing a focused clinical examination
• Identifies, accounts for and manages co-morbidity in the context of the surgical presentation
• Selects patients for conservative and operative treatment plans as appropriate
• Demonstrates effective communication with colleagues, patients and relatives
• Makes appropriate peri- and post-operative management plans in conjunction with anaesthetic colleagues
• Delivers ongoing post-operative surgical care in ward and critical care settings

Manages all hospital in-patients with conditions requiring management within the specialty. Able to perform all the administrative and clinical tasks required of a consultant surgeon in order that all inpatients requiring care within the specialty are cared for safely and appropriately

• Identifies at the start of a ward round if there are acutely unwell patients who require immediate attention
• Ensures that all necessary members of the multi-disciplinary team are present
• Ensures that all documentation will be available when required and interprets them appropriately
• Identifies when the clinical course is progressing as expected and when medical or surgical complications are developing
• Identifies and initially manages co-morbidity and medical complications
• Contributes effectively to level 2 and level 3 care
• Summarises important points at the end of the ward rounds

All patients with conditions requiring operative treatment within the specialty. Able to perform all the administrative and clinical tasks required of a consultant surgeon in order that all patients requiring operative treatment receive it safely and appropriately

• Selects patients appropriately for surgery, taking the surgical condition, co-morbidities, medication and investigations into account
• Negotiates reasonable treatment options and shares decision-making with patients
• Takes informed consent in line with national legislation
• Arranges anaesthetic assessment as required
• Prepares the operating list, accounting for case mix, skill mix, operating time, clinical priorities, and patient co-morbidity
• Leads the brief and debrief and ensures all relevant points are covered
• Ensures the WHO checklist (or equivalent) is completed
• Undertakes the operation in a technically safe manner, using time efficiently
• Writes a full operation note for each patient

Manages all patients with conditions requiring interdisciplinary management including care within the specialty. Able to perform all the administrative and clinical tasks of a consultant surgeon in order that safe and appropriate multi-disciplinary decisions are made on all patients with conditions requiring care within the specialty.

• Appropriately selects patients who require discussion at the multi-disciplinary team
• Follows the appropriate administrative process
• Deals correctly with inappropriate referrals for discussion
• Presents relevant case history, recognising important clinical features, co-morbidities and investigations
• Engages constructively with all members of the multi-disciplinary team in reaching an agreed management decision
• Effectively manages potentially challenging situations such as conflicting opinions
• Develops a clear management plan and communicates discussion outcomes

Able to assess infants and children on neonatal and intensive care units, recognise conditions that are best expectantly managed, and the indications and timing for surgical intervention.

• Demonstrates knowledge of normal physiology in premature infant, term infant and child
• Demonstrates knowledge and experience of index neonatal conditions, and recognises indications and urgency for surgical intervention
• Makes a full assessment of patients by taking a structured history and by performing a focused clinical examination
• Communicates with parents and families in a clear and understandable way
• Recognises co-morbidity and medical complications, discussing their management with neonatologists/intensivists
• Identifies when further therapeutic manoeuvres are not in the patient’s best interests, holds discussions about palliative care
• Ensures the management plan is explicit and agreed with other members of the multidisciplinary team

Currency Window

Evidence drawn from the last six years of clinical practice prior to submission (WTE, does not need to be consecutive). If you have had a break in practice in the last six calendar years, 50% of your evidence of competency in the critical conditions (CBDs) and emergency index procedures (PBAs) should be drawn from the last 2 years clinical practice.

Evidence Volume

800-1000 pages