Historically, transplant surgeons have come to the speciality from backgrounds in General Surgery, Vascular Surgery and Urology. Recent changes in surgical training have meant that the predominant route into transplant surgery is now via the General Surgery curriculum, with specific exit exams in transplantation.
The current ISCP curriculums for both Vascular Surgery and Urology contain no competencies pertaining to transplantation, although some trainees in these specialities may rotate through a transplant unit as part of their training.
Surgical trainees interested in Transplant Surgery would be expected to follow a career pathway as follows:
The training opportunities available vary widely across the country depending on the services offered by particular transplant centres (see below). However, the specific transplant competencies from ISCP expected by CCT for all transplant trainees are as follows:
As such, it is not expected that trainees would be competent to perform live donor nephrectomy, pancreas transplantation or liver transplantation at the completion of training. It is likely that the majority of trainees would have to undertake post-CCT fellowships to gain competence in these areas.
Organ retrieval is currently a part for the transplant surgical curriculum and experience is required for CCT. Those trainees who are training in a centre that does not offer experience in multi-organ retrieval will need to spend some time out of programme in a designated retrieval centre to gain the necessary competencies for CCT.
Retrieval competency is governed by NHSBT. In order to obtain competency to lead a multi-organ retrieval team (as part of the National Organ Retrieval service), you will have to provide evidence that you have participated in the NHSBT organ retrieval workshop and e-learning module, and have retrieved 10 of each abdominal organ (kidney, liver and pancreas) (see the guidance document for more information). We therefore recommend that all trainees record their retrievals along with the ODT donor number in order to aid validation.
Transplant surgery has always had a strong academic basis, and as such there are a number of opportunities to complete a higher research degree, and, potentially, pursue a career in academic surgery. A number of the UK transplant units have positions for academic clinical fellows (ACFs) and academic clinical lecturers (ACLs). Further general information on academic training is available from the NIHR.
Below is a summary of the training opportunities available in each transplant centre in the UK.
|Centre||Kidney||Liver||Pancreas||Small bowel||Retrieval||Local educational training board|
|Cambridge||East of England|
|Great Ormond St||London|
|Leeds||Yorkshire & Humber|
|Royal Free, London||London|
|Sheffield||Yorkshire & Humber|