Education & Training

Exams & Training

A structured guide to every milestone in colorectal surgical training — from FRCS preparation and JAG colonoscopy accreditation through to robotic surgery and life as a consultant.

Where are you in your training?

1,200+

Members

240 SBA

Per section 1 paper

280+

Colonoscopies for JAG

2

Days — Section 2 exam

Fellowship of the Royal Colleges · JCIE

FRCS General Surgery

The Intercollegiate Specialty Examination in General Surgery is administered by the JCIE and consists of two sections. Section 1 must be passed before sitting Section 2. Candidates have up to 4 attempts at each section.

Section 1

Written examination · Computer-based

Paper 1: 120 Single Best Answer (SBA) questions · 2 hrs 15 min

Paper 2: 120 Single Best Answer (SBA) questions · 2 hrs 15 min

Questions span the full General Surgery curriculum — colorectal, upper GI, breast, vascular, endocrine, HPB, emergency, critical care, and basic sciences.

Access Question Bank →

Dukes' Club resources

  • 800+ colorectal-weighted SBA question bank, mapped to JCIE curriculum
  • Revision wiki covering all general surgery subspecialties
  • High-yield topic summaries and guideline digests
  • Timed mock exam mode with performance analytics
  • Video lecture library — consultant-led topic reviews
Members Only

SBA Question Bank

800+ questions

Members Only

Revision Wiki

Curriculum-mapped articles

Members Only

Viva Scenarios

Consultant-authored

Members Only

Video Lectures

47 recorded sessions

Exam Guides

Free · No login required

Advice from those who've been there

Exam Tips

Practical guidance gathered from Dukes' Club members and consultant faculty who have recently passed or examined at FRCS level.

01

Start Section 1 revision at ST5

Don't wait until you're eligible to sit. Build SBA practice into your weekly routine from ST5 onwards — the broad curriculum takes time to cover and familiarity with question style matters as much as raw knowledge.

02

Be broad, not deep

The single biggest mistake candidates make is going too deep on colorectal and neglecting the rest of the syllabus. Section 1 will test you on vascular surgery, parotid and submandibular gland disease, bariatric, endocrine, transplant, and trauma — in exactly the same proportion as colorectal. A solid pass across everything beats a perfect score in one area.

03

Read the syllabus — all of it

Download the JCIE General Surgery syllabus and read every line. Candidates are caught out every sitting by topics they assumed wouldn't come up. Pay particular attention to less obvious entries — salivary glands, detailed vascular surgery, bariatric physiology, renal transplant.

04

Read Colorectal Disease cover to cover

For Section 2 vivas with a colorectal special interest, the ACPGBI / BSG journal Colorectal Disease is essential reading. Aim for the last 2–3 years of issues, focusing on original articles and review papers on high-yield topics.

05

Do question banks relentlessly

SBA technique is a learnable skill. Doing hundreds of questions teaches you how to read stems, spot distractors, and manage time. Aim for at least 2,000 questions across multiple banks before sitting Section 1 — and review the explanations for every wrong answer, not just the score.

06

Know your guidelines cold

NICE, ACPGBI, ESCP, ERAS, and BSG guidelines are fair game at both sections. High-yield areas: rectal cancer (MRI staging, TNT, watch-and-wait), IBD, diverticular disease, bowel obstruction, acute pancreatitis, and upper GI bleeding.

07

Viva in pairs from day one of Section 2 prep

Start mock vivas as soon as Section 1 is done — don't wait. A daily viva with a revision partner, even 20 minutes on the ward, builds the structured thinking pattern that examiners are looking for.

08

Attend a dedicated viva prep course

A focused mock viva course 4–6 weeks before Section 2 is invaluable for calibrating your performance against the pass standard. Check the events page for Dukes'-endorsed courses.

ISCP General Surgery Curriculum 2021 · Colorectal Special Interest

CCT Requirements

CCT is awarded when you demonstrate Day-1 consultant level across all Capabilities in Practice (CiPs). The numbers below are indicative minimums from the 2024 Manchester, Lancashire & South Cumbria CCT checklist.

Elective & Emergency General Surgery

Indicative Operative Numbers — end of ST6

ProcedureMinimum
Appendicectomy60
Inguinal hernia50
Emergency laparotomy45
Cholecystectomy40
Segmental colectomy15

Operative Competency — end of ST6

PBA Requirements (3 different assessors)

ProcedureStandard
Hernia repair (all types)3 × Level 4 PBA
Cholecystectomy (lap or open)3 × Level 3 PBA
Segmental colectomy3 × Level 3 PBA

PBA Level 4 = independent. Level 3 = performed with minimal assistance. All PBAs must be from three different assessors.

5 Capabilities in Practice (CiPs) — Level III by end of Phase 2

Supervision levels required at Phase 2 critical progression point

CapabilityRequired Level
Outpatient clinicLevel III — independent
Emergency surgical takeLevel III — independent
Ward rounds & inpatient careLevel III — independent
Operating listLevel IIb — supervisor present for part of list
MDT workingLevel III — independent

The Phase 2 critical progression point (end of ST6) must be confirmed by ARCP before eligibility to sit FRCS Section 1 and Section 2.

Joint Advisory Group on GI Endoscopy · JETS

JAG Colonoscopy Certification

JAG colonoscopy certification is not a mandatory CCT requirement, but most colorectal consultant person specifications list it as essential.

Minimum colonoscopies

280

200 if already FS certified

Unassisted caecal intubation

>90%

averaged over 3 months

Polyp detection rate

>15%

BSG standard

Recent activity required

15+

procedures in last 3 months

Summative DOPS required

4

by 2 different assessors

Polypectomy assessment

SMSA

Level 1 & 2 DOPyS required

Step-by-step certification pathway

1

Register on JETS immediately

Log every colonoscopy from your very first list. Procedures performed before JETS registration cannot be counted retroactively. Set up your account at jets.nhs.uk at the start of each new rotation.

2

Attend the JAG Basic Skills in Colonoscopy course

Mandatory attendance at a JAG-approved Basic Skills course. Can be completed at simulation centres or dedicated endoscopy training units. Book early — places fill quickly.

3

Complete formative DOPS throughout training

Aim for a DOPS on every training list. The last 5 formative DOPS before summative assessment must all score competent without supervision in >90% of items.

4

Complete DOPyS for polypectomy (SMSA Level 1 & 2)

DOPyS is the polypectomy-specific DOPS. You need competency at SMSA Level 1 (small polyps) and Level 2 (larger / more complex). Log a DOPyS for every polypectomy.

5

Trigger summative DOPS assessment

Once you meet the KPI thresholds, procedure count, and course attendance, apply for summative assessment. 4 summative DOPS — by a minimum of 2 different assessors — all within one month.

6

Training Lead and JETS national sign-off

Your portfolio is reviewed by your local Training Lead, then submitted for JETS national review. Certificate issued by JAG on successful completion.

BSG performance standards required for certification

>90%

Caecal intubation rate (unassisted)

>90%

Rectal retroflexion

>15%

Polyp detection rate

>90%

Polyp retrieval rate

<10%

Moderate / severe patient pain

>60%

Terminal ileal intubation (IBD suspected)

Polypectomy SMSA scoring — what does it mean?

SMSA stands for Size, Morphology, Site, Access. Each factor is scored to give a total difficulty level:

  • Level 1 (4–5 pts) — small, pedunculated, accessible polyps. Cold snare technique.
  • Level 2 (6–9 pts) — larger or sessile. Hot snare / diathermy-assisted EMR required.
  • Level 3–4 — complex resections (ESD, piecemeal EMR). Post-certification development.

Practical tips from colorectal trainees

  • Meet the endoscopy lead on your first day of every new rotation
  • Request your own endoscopy training list, not just supervised lists
  • Raise endoscopy access issues at ARCP — it is not logged on ISCP so panels can overlook it
  • Don't aim for provisional certification as the endpoint — push through to full (280 procedures)
  • If your unit can't provide enough lists, contact your TPD — trusts can be flagged for training deficiencies

Members Only · Video Library

Basic Skills in Endoscopy

Consultant-led video guides covering the fundamental techniques of diagnostic colonoscopy and flexible sigmoidoscopy.

View full library
Members
18:42

Scope Handling

Scope handling, torque, and tip deflection

Grip technique, clockwise and counter-clockwise torque, up/down and left/right tip control.

JAG Domain 1 · DOPS item 1–3

Members
12:15

Patient Preparation

Patient positioning and pre-procedure check

Left lateral positioning, consent confirmation, equipment check, and sedation pathway.

JAG Domain 2 · DOPS item 4–6

Members
24:33

Insertion & Navigation

Colonoscope insertion and basic navigation

Anal canal insertion, rectal retroflexion, sigmoid loop reduction, and splenic flexure negotiation.

JAG Domain 3 · DOPS item 7–10

Members
19:08

Caecal Intubation

Achieving caecal intubation — tips and troubleshooting

Hepatic flexure technique, position changes, abdominal pressure, and confirming caecal landmarks.

JAG Domain 3 · DOPS item 11–12

ACPGBI Position Statement 2025 · Colorectal Disease, Evans et al.

Robotic Colorectal Surgery

Robotic-assisted colorectal surgery (RACS) has grown exponentially across the UK and Ireland. The NHS has committed to robotic-assisted surgery as the default for many operations, with projections of 500,000 robotic procedures per year by 2035.

200+

da Vinci systems in UK hospitals

300k+

UK & Ireland patients treated robotically

500k

operations/year projected by 2035

90%

of keyhole cancer ops robotic within 10 yrs

Platforms in UK NHS Practice

da Vinci

Intuitive Surgical

Dominant UK platform
  • Xi, X, SP & da Vinci 5 systems
  • New UK HQ & training centre, Reading (Oct 2025)
  • RCSEng-accredited training programme
  • TR100 → TR200 → TR300 → TR400 pathway

Versius

CMR Surgical · Cambridge, UK

Growing UK presence
  • Modular, portable design
  • Increasingly used in colorectal & HPB
  • UK-designed system with NHS expansion plans

Hugo RAS

Medtronic

Entering UK market
  • Open console, modular arm architecture
  • CE Mark received; UK rollout underway
  • Platform-agnostic training advocated by ACPGBI

ACPGBI 2025 Training Framework — Three Levels

Published in Colorectal Disease (Evans, Shakir, El-Sayed et al., on behalf of The Dukes' Club and ACPGBI Robotic Clinical Advisory Group).

Level 1

Basic Robotic Course

For all trainees — from core surgical training onwards

  • Theoretical & anatomical robotic knowledge
  • Platform-specific system training (online modules)
  • Simulator access — VR tasks and basic surgical tasks
  • Bedside assistance: cart docking, instrument loading
  • Observation of live RACS cases at expert centres
  • ACPGBI-accredited course delivered at selected UKI centres
  • Dukes' Club coordinates course registration
Start: Core training / early ST3
Level 2

Advanced Robotic Course

Component-based procedural training — ST6–8

  • Competency-based, step-wise procedure training
  • Key operations: right hemicolectomy, anterior resection
  • Objective measures of progress at each step
  • Dry/wet lab and proctored live case components
  • ACPGBI-accredited advanced course at selected UKI centres
  • ACPGBI robotic fellowship portal: educational curricula & procedure videos
  • ACPGBI industry-supported 6-month robotic fellowships at two expert UK centres
Browse the Fellowship Directory
Target: ST6–8 · Fellowships ST7–8
Level 3

Training the Trainers

Consultant-level trainer accreditation

  • For robotic-credentialled consultants who wish to train and proctor others
  • Formal faculty development and educational methodology
  • Typically industry-partnered through Intuitive, CMR or Medtronic
  • Feeds back into the training ecosystem — proctoring and mentoring trainees at Level 2
Post-credentialling · Consultant

da Vinci Training Pathway — Intuitive Surgical

Pre-clinical

Phase I

Online only

System Certification

  • Intuitive Learning online modules (da Vinci Xi / 5)
  • Console certificate — completed before any hands-on work
  • System anatomy: arms, instruments, vision tower, energy
  • First test drive at regional robotic centre
  • Case observation — bedside assistance & cart docking
Pre-clinical

Phase II — TR100 / TR200

2-day course · Intuitive Training Centre, Reading

Basic Robotic Skills

  • TR100 — Technology training by Intuitive trainer: port placement, docking, instrument loading, energy safe use, skills drills
  • TR200 — Surgeon-led procedural training on cadaveric / porcine / synthetic model
  • VR simulator: minimum 25–30 hours recommended before Phase III
Clinical

Phase III — TR300

Proctored live surgery

Initial Case Series

  • 10 bedside-assisted cases before console access
  • Proctored console cases — component-based progression
  • Objective robotic skills assessment (GEARS, procedure-specific metrics)
  • Proctor ideally same surgeon from TR200
  • Case log on ISCP with robotic-specific operative codes
Clinical

Phase IV — TR400

Independent practice

Credentialling & Mastery

  • 20 console cases (≥50% operative time as primary surgeon)
  • Intuitive Certificate of Equivalency on completion
  • RCSEng credentialling via good practice guide
  • Progression to complex cases (low AR, total mesorectal excision)
  • Eligible to proctor others once mastery demonstrated

The ACPGBI acknowledges trainee frustration

Many junior trainees feel training opportunities are being lost to consultants undergoing their own robotic learning curve, and are struggling to meet laparoscopic case numbers at robotic-only centres.

Reassurance from the ACPGBI

RACS is primarily an alternative platform for minimally invasive surgery — the key principles and techniques of colorectal surgery remain the same across open, laparoscopic, and robotic approaches.

Members Only · Dukes' Club Network

The Colorectal Community

Dukes' Club connects colorectal trainees and consultants across every deanery in the UK and Ireland — and increasingly worldwide.

Trainee & Consultant Network

Connect directly with consultants across all 17 NHS England deaneries, plus Wales, Scotland, Northern Ireland, and Republic of Ireland. Mentor matching, career advice, and peer support.

Global Reach

An expanding international membership spanning North America, Australasia, and the Middle East — connecting UK-trained colorectal surgeons wherever they practise.

Discussion & Peer Support

Ask questions, share cases, and get practical advice from peers navigating the same milestones.

Events & Webinars

Members-only access to live webinars, virtual journal clubs, FRCS revision sessions, and the annual Dukes' Club meeting.

Research Collaboration

Find co-investigators, recruit to multicentre audits, and connect with the ACPGBI research committee.

Ready to advance your training?

Join over 1,200 colorectal trainees with access to the full resource library, question bank, and events programme.

The Dukes' Club | Colorectal Surgery Trainee Network