Another key portfolio area is the hands-on surgical experience in performing common procedures specific to your specialty. To measure competency in General & Vascular Surgery, assessors tally the number of appendicectomies performed either independently or while your supervisor is scrubbed, or unscrubbed in theatre. The highest scores, a 4 out of 4, are awarded to those who have performed 25-39 procedures. However, the scores may shift to a negative with over-experience or too little experience, specifically with less than 9 or over 100 procedures.
It is critical to note that both open and laparoscopic procedures are equally counted in this assessment. To keep track of surgical experience, one can utilize the free pan-surgical e-logbook available in the UK and Ireland at https://www.elogbook.org/. This resource provides a record that can be consolidated and validated by hospital consultants – an essential step in demonstrating evidence.
In addition, the intercollegiate surgical curriculum (ISCP) e-portfolio at https://www.iscp.ac.uk/ is available. Though free for the first three months, a user must pay a £260 annual subscription thereafter. For evidence of one’s competency in this section, however, the free e-logbook is sufficient.
To score maximum points in this area, it’s crucial to understand the procedures being evaluated and focus on increasing your numbers and competency in those surgeries. When I decided to move and continue my training in the UK, I transferred all my surgical experience from Kenya to the online e-logbook. This process took several months, as I needed to consolidate and document all the surgeries I had performed over the years. Additionally, I had to have the consolidated report signed off by my supervising consultant before travelling from Kenya to the UK. After identifying the gaps in my surgical numbers, I spent the subsequent months improving these numbers before my application.
Once settled in the UK, I registered and paid for the ISCP e-portfolio. This tool provided a structured approach to developing my portfolio. A simple rule you can follow is to complete 2-3 Work-Based Assessments (WBAs) per week, adjusting the numbers based on your needs. It’s important to demonstrate skill progression, starting with a low competency score (e.g., 2 for assisting) and growing to a higher score (e.g., 4 for independently performing the procedure) over time, rather than just including procedures you are already proficient in. Case-Based Discussions (CBDs) and Procedure-Based Assessments (PBAs) are the most useful forms of assessment on the ISCP.
I achieved maximum points in this section by:
- Understanding the types of surgery evaluated by the interview selection criteria.
- I built out my portfolio in advance, including my experience in both Kenya and the UK.
- Setting clear, time-bound targets helped me achieve the necessary numbers. I spent more time in the theatre and took on more on-call shifts to catch up once I clearly understood what was needed.
By understanding the evaluation criteria and diligently building and documenting your surgical experience, you can maximize your score in this portfolio area.
KEY POINTS SUMMARY:
- Using the free pan-surgical e-logbook available at elogbook.org is sufficient for recording and validating your surgical experience.
- Understand the procedures being evaluated and focus on increasing numbers and competency in those surgeries.
- Transfer previous surgical experience to the e-logbook and have it validated by supervising consultants.
- Aim to complete 2-3 Work-Based Assessments (WBAs) per week on ISCP. Demonstrate skill progression from assisting to independently performing procedures.
- Set clear, time-bound targets and spend additional time in the theatre to meet required numbers.