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Governance Framework:

Academic, Clinical, Operational, and Financial

1. Status and Institutional Authority

This document constitutes the formal Academic, Clinical, Operational, and Financial Governance Framework for the Doctors Academy FRCS (General Surgery) Section 2 Intensive Preparation Programme. It is issued under the authority of the Educational Board and Director of Programmes, and it is subject to annual review and institutional oversight. The programme prepares senior surgical trainees for Section 2 of the Intercollegiate Specialty Examination in General Surgery, which assesses candidates at the level expected of a Day 1 Consultant across both General Surgery and the declared Special Interest domain. This framework establishes the mechanisms by which academic integrity, patient safety, operational effectiveness, financial transparency, and quality assurance are maintained.

2. Academic Governance

2.1 Curriculum Integrity and Examination Alignment

The programme is explicitly mapped to the JCIE syllabus blueprint and the Capabilities in Practice required at ST8 level. The teaching content reflects consultant-level knowledge, judgement, prioritisation, and professional maturity. All viva questions, case scenarios, and academic discussion frameworks are prepared by consultant faculty and constructed to be reflective of the depth, structure, and rigour of the questioning encountered within Section 2 of the Intercollegiate Examination. The curriculum integrates elective and emergency general surgery domains, subspecialty practice, applied anatomy and physiology, oncological principles, trauma, critical care, radiological and pathological interpretation, and academic critique including discussion of statistical methodology and evidence-based practice. A formal curriculum review is undertaken annually by the Educational Board to ensure continued alignment with JCIE standards and regulatory updates.

3. Faculty Governance

All theoretical and face-to-face teaching is consultant-planned, consultant-led, and consultant-delivered. Faculty members are selected based on active consultant practice, subspecialty expertise, and demonstrable commitment to postgraduate surgical education. Viva stations are designed internally by consultant faculty and undergo review to ensure consistency of standard and structured questioning. Faculty are required to adhere to the institutional Code of Conduct and uphold professional standards consistent with the General Medical Council’s Good Medical Practice.

4. Clinical Governance and Patient Welfare

Patient safety and dignity are fundamental to the delivery of the clinical examination component of the course. Only patients who are clinically stable and free from acute illness or active deterioration are selected to participate. All patients are assessed and evaluated in advance for safety, suitability, and capacity to engage in clinical examination. Registered nursing staff are present during patient-attended sessions. Nurses oversee patient welfare, provide clinical supervision, and assist patients in moving safely between rooms. Patients are supported in entering and exiting examination areas, and mobility assistance is provided where required. Patients attend only the Sunday afternoon session and are not required to participate beyond this period. No invasive procedures are performed. Interactions are limited strictly to examination and case presentation. Patients are provided lunch and refreshments during their attendance. Gifts are provided in recognition of their contribution to postgraduate surgical education.

5. Programme Structure and Delivery Governance

The course is delivered as a six-day hybrid programme, comprising four theoretical sessions followed by a two-day face-to-face component. The theoretical component is delivered via a secure professional Zoom infrastructure between 1815 and 2200 hours over four evenings. Sessions are interactive and case-based rather than didactic. The face-to-face component is conducted at the Royal Liverpool University Hospital, Liverpool. It is dedicated entirely to structured mock vivas and clinical examination practice; no lectures are delivered during the weekend. Lunch and refreshments are provided throughout the day for faculty and candidates during the weekend sessions.

6. Assessment Simulation and Feedback Governance

Saturday consists of four formal viva circuits covering General Surgery, Trauma and Critical Care, Subspecialty Surgery, and Academic Viva. Sunday morning involves full individual mock vivas, replicating the timing and intensity of the real examination. Sunday afternoon involves clinical examination practice with real patients. Delegates receive immediate formative verbal feedback during the sessions on Saturday and structured written feedback following the mock vivas on Sunday. All feedback data are archived securely and reviewed for quality improvement purposes.

7. Financial Governance and Allocation of Fees

The FRCS (General Surgery) Section 2 Course is delivered strictly on a non-profit basis. The course fees are structured to ensure the sustainability of the provision of high-quality education and safe clinical delivery rather than commercial gain. The financial model is designed to support consultant-led teaching, robust clinical governance, appropriate patient welfare arrangements, and high-fidelity examination simulation. The course fees are allocated to cover essential operational, educational, and clinical expenditures, including but not limited to the following categories:

Faculty-Related Expenditure:

includes consultants’ travel costs, accommodation where required, and appropriate honoraria in recognition of professional time commitment, preparation of academic materials, development of viva questions, and delivery of structured feedback.

Clinical Governance and Patient-Related Expenditure:

includes patient transportation, gifts in recognition of voluntary participation, and welfare provisions such as refreshments during attendance. Fees also cover the remuneration of registered nursing staff who are present during patient-attended sessions to oversee safety, support patient movement between rooms, and ensure clinical welfare throughout participation.

Administrative Staffing Expenditure:

includes remuneration of administrative personnel responsible for course coordination, registration management, attendance verification, documentation control, certificate processing, secure feedback administration, and overall programme logistics.

Venue and Operational Costs:

include room hire within the host NHS teaching hospital, clinical space allocation, logistical support, and on-site coordination to ensure safe and efficient delivery of the course.

Catering and Hospitality Provisions:

include lunch and refreshments for faculty and delegates during the face-to-face component, refreshments for participating patients during their attendance, and the course dinner held on the Saturday evening at a local restaurant for all faculty and delegates. The dinner is included within the course fee and is intended to facilitate professional networking, collegial discussion, and academic exchange in an appropriate setting.

Digital and IT Infrastructure Expenditure:

includes professional Zoom licensing and secure virtual delivery systems for the theoretical component, digital hosting, audio-visual support, secure data storage, and contingency IT arrangements to ensure continuity of delivery.

Educational Infrastructure and Digital Systems:

includes maintenance of a dedicated course webpage, digital registration systems, secure feedback platforms, attendance verification systems, and online course administration tools.

Academic Resources Expenditure:

includes preparation and distribution of structured pre-course and post-course academic reading materials designed to support examination-focused revision.

Printing and Course Materials Expenditure:

includes production of mock viva scenarios, structured marking frameworks, feedback documentation, examination-style materials, and handouts for delegates. Financial accounts relating to the course are maintained in accordance with UK statutory and regulatory requirements. Transparent accounting practices are upheld. Any surplus generated following legitimate operational expenditure is reinvested into educational development, infrastructure enhancement, technological upgrades, and simulation resources to ensure continuous improvement of the course.

8. Eligibility Governance

Eligibility is restricted to ST6 or above, or SpR Year 4 or above, in General Surgery. The programme is strongly advised for trainees who have completed Section 1 or who are intending to sit it in the near future. The course is particularly beneficial for candidates intending to sit Section 2 within four to six weeks, although earlier participation may provide structured preparation.

9. Risk Management and Operational Assurance

A structured risk framework governs delivery of the course. Identified risk domains include faculty availability, patient welfare, digital platform reliability, and delegate concerns. Mitigation strategies include contingency faculty arrangements, advance patient screening, professional IT backup systems, and formal escalation pathways for concerns. All incidents are documented and reviewed by the Director of Programmes.

10. Review and Continuous Quality Improvement

This governance framework is subject to formal annual review by the Educational Board. The review process evaluates curriculum alignment, faculty performance, delegate feedback trends, financial transparency, clinical governance compliance, and operational safety. Amendments are implemented where required to maintain the highest standards of postgraduate surgical education.

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Frequently Asked Questions (FAQs)

1. What is the purpose of this course?

This six-day intensive programme is designed to prepare candidates comprehensively for Section 2 of the Intercollegiate FRCS (General Surgery) examination. Section 2 assesses candidates at the level expected of a Day 1 Consultant in both General Surgery and their declared Special Interest. The course focuses on consultant-level clinical reasoning, structured viva articulation, academic critique, radiological and pathological interpretation, and performance under examination conditions through high-fidelity mock simulation.

2. How is the course structured?

The programme follows a hybrid format which comprises four theoretical sessions delivered virtually from Monday to Thursday (1815 to 2200 hours), followed by a two-day face-to-face component over the weekend at the Royal Liverpool University Hospital, Liverpool. Attendance at the full six-day programme is strongly recommended. However, delegates may elect to attend either the online theoretical component alone or the face-to-face practical component alone.

3. What is covered during the theoretical online component?

The four online sessions are consultant-led and delivered as interactive case-based discussions rather than traditional lectures. The subspecialties covered include Upper GI Surgery, Colorectal Surgery, Breast Surgery, Endocrine Surgery, Hepatopancreatobiliary Surgery, Transplant Surgery, Trauma, and Critical Care. Emphasis is placed on applied anatomy, physiology and pathology, oncological principles, management of complications, radiological interpretation, pathological discussion, and critical appraisal of current evidence. The theoretical component attracts 12 CPD points.

4. What happens during the face-to-face component?

The entire weekend (0830 to 1700 hours on both days) is dedicated to high-intensity mock vivas and clinical examination practice. There are no lectures during the weekend. Saturday comprises four structured viva circuits: General Surgery Viva, Trauma and Critical Care Viva, Subspecialty Viva, and Academic Viva. Candidates are examined individually in short-case scenarios and long-case discussions. Radiology, pathology, and critique of published literature are integrated throughout.

5. Is there a full mock examination?

Yes. Sunday morning consists of individual full mock vivas which replicate the timing, questioning style, and intensity of the actual examination. These stations assess multiple domains tested in Section 2, including depth of knowledge, judgement, communication, academic reasoning, and consultant-level decision making.

6. Will there be clinical examination practice with real patients?

Yes. On Sunday afternoon, delegates examine real patients with authentic clinical findings. Candidates present cases in the format of the exam and refine systematic examination technique. Commonly tested cases are selected to maximise relevance. This component addresses both short- and long-case elements of Section 2.

7. How is patient safety ensured during the clinical sessions?

Only clinically stable patients without acute illness or active deterioration are selected. All patients are assessed beforehand for safety and suitability. Registered nurses are present throughout patient-attended sessions to oversee welfare and provide clinical support. Patients are assisted whilst moving between rooms and are treated with dignity and respect at all times. No invasive procedures are performed.

8. For how long do patients attend the course?

Patients attend only the designated Sunday afternoon session. They are not required to attend the full weekend. Lunch and refreshments are provided during their attendance, and gifts are offered in recognition of their contribution to postgraduate surgical education.

9. What type of feedback will delegates receive?

Delegates receive immediate formative verbal feedback during the viva stations on Saturday. Following Sunday’s mock vivas, formal written feedback is provided. Written feedback highlights strengths, identifies areas for development, and provides structured recommendations to optimise performance before the examination.

10. Who prepares the viva questions?

All viva questions, scenarios, and discussion frameworks are prepared by consultant faculty. The content is designed to be reflective of what is tested in the Intercollegiate FRCS Section 2 examination, including clinical reasoning, academic critique, and radiological and pathological interpretation.

11. Who is eligible to attend the course?

Eligibility is restricted to ST6 or above, or SpR Year 4 or above, in General Surgery. The course is strongly advised for trainees who have completed Section 1 of the examination or who are intending to sit it in the near future. It is particularly beneficial for candidates sitting Section 2 within four to six weeks, although earlier attendance may also provide strategic benefit.

12. How does the course align with the JCIE curriculum?

The programme is explicitly mapped to the JCIE syllabus blueprint and the Capabilities in Practice required at ST8 level. The teaching and mock assessments are structured to reflect the expected standard of a Day 1 Consultant across elective and emergency general surgery and the declared Special Interest domain.

13. How many CPD points are awarded?

The course attracts a total of 24 CPD points. The four theoretical evenings attract 12 CPD points, and the two-day face-to-face component attracts a further 12 CPD points. CPD certification is issued following verification of attendance and completion of the course feedback.

14. What do the course fees cover?

The course operates on a non-profit basis. Fees are used to cover the travel and accommodation of the faculty, venue charges, administrative costs, IT infrastructure and professional Zoom delivery, maintenance of a dedicated course webpage, preparation and distribution of pre-course and post-course academic reading materials, printing of course documentation, catering and refreshments, and patient-related expenses which include transportation and gifts. Fees also cover remuneration for registered nursing staff who oversee patient welfare during clinical sessions and administrative staff responsible for coordination, documentation, registration, and certification processes. In addition, the course fee includes a dinner for faculty and delegates on Saturday evening at a local restaurant. This dinner provides an opportunity for informal academic discussion, networking, and professional engagement in a collegial environment. Any surplus generated is reinvested into educational infrastructure and future course development.

15. What makes this course particularly intensive?

The weekend component contains no lectures and is entirely dedicated to mock viva practice and clinical simulation. Delegates undergo multiple individual viva encounters, structured questioning by consultants, and examination practice with real patients within a concentrated timeframe. The structure is intentionally designed to replicate the pressure of the real examination and enhance performance confidence in the final weeks before Section 2.