Continuing surgical education


As surgical science advances at an extraordinary rate, all surgeons have a duty to keep up to date to offer their patients treatment based on the latest research.

To support the professional development of general surgeons of all specialties, Continuing surgical education provides a wealth of formal digital courses, specialty digests and much more.

A myriad of skills and qualities are required to sustain a career in this field, including personal sacrifice, dedication and resilience. In this section, surgeons can access a series of publications exploring this important topic.


How to avoid being sued

How to avoid being sued

Jonothan J Earnshaw DM FRCS

This is part of a series on the medicolegal aspects of surgery, in collaboration with the Association of Surgeons of Great Britain and Ireland (ASGBI), which you can also find on www.bjsacademy.com. This article aims to discuss simple and straightforward ways to avoid you having to make any contact with your hospital legal department. My qualifications for giving this podcast include a 30 year career as a general and subsequently a vascular surgeon. In the last 15 years of my career I started writing expert reports from the perspective of a vascular surgeon on medicolegal cases, which I can tell you was an eye-opener. I have seen many patterns, some of which seem preventable. I hope to be able to communicate some of the things I've learned from the other side of the table.

4 February 2025
2024 ACPGBI BJS Lecture: Happy workforce, better surgery

2024 ACPGBI BJS Lecture: Happy workforce, better surgery

Tamzin Cuming presents her BJS Lecture "Happy workforce, better surgery" at the 2024 Annual Meeting of the Association of Coloproctology of Great Britain and Ireland.

31 January 2025
2024 ESES BJS Lecture: Current landscape and shifting paradigms in the management of thyroid cancer

2024 ESES BJS Lecture: Current landscape and shifting paradigms in the management of thyroid cancer

Julie Ann Sosa presents her BJS Lecture “Current landscape and shifting paradigms in the management of thyroid cancer” from the 2024 European Society of Endocrine Surgeons 10th Biennial Congress.

28 January 2025
2024 ESES BJS Prize: Circulating extracellular vesicles as diagnostic biomarkers of indeterminate thyroid nodules

2024 ESES BJS Prize: Circulating extracellular vesicles as diagnostic biomarkers of indeterminate thyroid nodules

Kevin Beatson, with first author Nada M Ahmed, presents his BJS Prize winning lecture “Circulating extracellular vesicles as diagnostic biomarkers of indeterminate thyroid nodules” from the 2024 European Society of Endocrine Surgeons 10th Biennial Congress.

9 January 2025
Informed consent: the pursuer's perspective - Montgomery v Lanarkshire Health Board

Informed consent: the pursuer's perspective - Montgomery v Lanarkshire Health Board

We are excited to share the second lecture in our medicolegal series, presented in collaboration with the Association of Surgeons of Great Britain and Ireland (ASGBI): "Informed consent: the pursuer’s perspective – Montgomery v Lanarkshire Health Board."
Through the lens of Nadine Montgomery's experience, this talk examines the landmark legal case that reshaped the principles of informed consent in medical practice.

28 December 2024
Medicolegal frameworks in surgical practice

Medicolegal frameworks in surgical practice

We are pleased to announce the launch of our new medicolegal lecture series in collaboration with the Association of Surgeons of Great Britain and Ireland (ASGBI). The series is led Parv Sains' insightful talk: "Medicolegal Frameworks in Surgical Practice."
As the first lecture in this series, Parv explores key legal principles that underpin modern surgical practice, highlighting essential medicolegal concepts relevant to surgeons at all stages of their careers. This series aims to equip surgical professionals with a deeper understanding of the legal landscape affecting their practice.

19 December 2024
Surgical research and publishing: Top ten tips to complete impactful collaborative research (part 5 of 5)

Surgical research and publishing: Top ten tips to complete impactful collaborative research (part 5 of 5)

Closing out our 5-part series on surgical research and publishing, Dimitri Nepogodiev, NIHR Academic Clinical Lecturer at the University of Birmingham, dives into the topic of collaborative group research.
This lecture was first presented at our BJS Academy Workshop in April 2024.

4 December 2024
2024 ASGBI BJS Prize Session: The ScotCap registry: An evaluation of 1000 colon capsule endoscopy procedures carried out in Scotland

2024 ASGBI BJS Prize Session: The ScotCap registry: An evaluation of 1000 colon capsule endoscopy procedures carried out in Scotland

Campbell Macleod presents his BJS Prize session lecture “The ScotCap registry: An evaluation of 1000 colon capsule endoscopy procedures carried out in Scotland” from the 2024 Association of Surgeons of Great Britain and Ireland (ASGBI) International Surgical Congress, which placed 3rd in the prize session.

29 November 2024
Surgical research and publishing: Systematic reviews (part 4 of 5)

Surgical research and publishing: Systematic reviews (part 4 of 5)

In part four of our series focused on research and publication in the surgical world, Peter Vaughan-Shaw, Associate Editor at the BJS, explores systematic reviews.
This lecture was first presented at our BJS Academy Workshop in April 2024.

27 November 2024
Surgical research and publishing: Propensity score analysis (part 3 of 5)

Surgical research and publishing: Propensity score analysis (part 3 of 5)

In part three of our series focused on research and publication in the surgical world, Patricia Tejedor, Technology Advisor for BJS and Young BJS Lead for BJS Academy, explores propensity score analysis. This lecture was first presented at our BJS Academy Workshop in April 2024.

20 November 2024
Conference report: NIHR Global Surgery Unit: Mexico 2024

Conference report: NIHR Global Surgery Unit: Mexico 2024

Theophilus TK Anyomih, Antonio Ramos De La Medina, Laura Martinez

Acknowledgements: Many thanks to the Mexico Hub team for the organisation of the main event in Cancun and the side events in Veracruz.
Acknowledgements: Many thanks to the Mexico Hub team for the organisation of the main event in Cancun and the side events in Veracruz.
Acknowledgements: Many thanks to the Mexico Hub team for the organisation of the main event in Cancun and the side events in Veracruz.

15 November 2024

               <bold>Surgical research and publishing: RCT's (part 2 of 5)</bold>

Surgical research and publishing: RCT's (part 2 of 5)

In part two of our series on surgical research and publishing, Martyn Evans, BJS Editor, dives into RCTs. This lecture was first presented at our BJS Academy Workshop in April 2024.

14 November 2024
International Bariatric Club BJS Lecture 2024: Towards sustainability in the operating room and the future of single use instruments in bariatric surgery

International Bariatric Club BJS Lecture 2024: Towards sustainability in the operating room and the future of single use instruments in bariatric surgery

Robin Blackstone presents her BJS Lecture "Towards sustainability in the operating room and the future of single use instruments in bariatric surgery" from the 5th World Congress of the International Bariatric Club (IBC) held at Oxford University from 17-19 September 2024.

8 November 2024
Surgical research and publishing: Statistics and surgery - friends or foes? (part 1 of 5)

Surgical research and publishing: Statistics and surgery - friends or foes? (part 1 of 5)

Jonathan Cook, statistician for the BJS, kicks off our 5-part series on surgical research and publishing - first presented at our BJS Academy Workshop in April 2024.

6 November 2024
Time to tackle tobacco smoking in surgical patients

Time to tackle tobacco smoking in surgical patients

Emma Sewart, Kitty H. F. Wong

The recent submission of the Tobacco and Vapes Bill to parliament has shone a spotlight on British public health legislation. If passed, anyone born after 2009 will be banned from buying tobacco products. Despite the success of other public health policies in reducing smoking over the past 20 years, tobacco remains the leading cause of premature, preventable death in the UK and worldwide, killing about half of lifelong smokers.1 Smoking is particularly common among surgical patients, reported in up to 50% of trauma patients in North America.2 In Britain, approximately 25% of patients admitted to hospital under surgical specialties currently smoke, compared to 13% of the general population.3,4 Worryingly, the prevalence appears to be rising in some cohorts, such as vascular surgery, and is as high as 33% in those undergoing lower limb bypass surgery.5 This may reflect increased risk of surgical pathology in smokers, but nonetheless highlights an opportunity to improve surgical health outcomes and to reach a population that seems more resistant to the available community-based smoking cessation interventions. As the demand for surgical care increases globally, and surgical populations become older and increasingly comorbid, there is an urgent need to optimise perioperative care pathways. For many patients, this now involves a preoperative assessment clinic and access to prehabilitation. The Royal College of Anaesthetists Centre for Perioperative Care (CPOC) has identified smoking cessation as one of seven key perioperative interventions to improve efficiency and tackle waiting lists, but cessation support services are often poorly integrated into current pathways.6 Substantial geographical and socioeconomic variation in smoking prevalence also represents a clear quality improvement target.5

26 July 2024
Top tips for publishing your Global Surgery research

Top tips for publishing your Global Surgery research

Dhananjaya Sharma, MBBS, MS, PhD, DSc, FRCS, FCLS (Hon), FRCST (Hon)

1. Preferably write about the solution rather than the challenge: Global Surgery (GS) is all about finding affordable solutions to challenges in resource-constrained situations. The challenges (the famous 5S – staff, stuff, space, systems and support) are well known and the editors are more likely to publish a paper which provides a solution rather than the one which dwells upon the challenges. The significance of such a research project and the benefits associated cannot be emphasized enough.1,2 Focusing on addressing knowledge plus evidence gaps in access to surgical care, surgical capacity building, epidemiology of surgical conditions, health economics of surgery, quality and safety in surgery, surgical innovation, surgical education and training, and health systems strengthening is crucial for making meaningful contributions.  Paraphrasing U.S. President Abraham Lincoln’s famous Gettysburg Address: any research ‘by the people, for the people and with the people’ cannot go wrong and will always provide value.3,4

24 April 2024
Vascular Society 2023 BJS Lecture: Translational vascular surgery: from the operating theatre to the lab and back to the patient

Vascular Society 2023 BJS Lecture: Translational vascular surgery: from the operating theatre to the lab and back to the patient

The first video in our CLTI miniseries is a BJS Lecture from the Vascular Societies’ Annual Scientific Meeting 2023, Translational vascular surgery: from the operating theatre to the lab and back to the patient, presented by Dr. Kak Khee Yeung, MD, PhD, FEBVS.
Translational vascular surgery: from the operating theatre to the lab and back to the patient

29 March 2024
Chronic limb-threatening ischaemia: current knowledge and future perspectives

Chronic limb-threatening ischaemia: current knowledge and future perspectives

Fabio Stocco, Jing Yi Kwan, Marc A. Bailey, Patrick A. Coughlin

The incidence of peripheral arterial disease (PAD) has risen dramatically, and it is estimated to affect around 200 million people worldwide. This rise can be explained by an ageing population, persisting high rates of tobacco smoking and the increasing incidence of diabetes mellitus (DM).1,2 Chronic limb-threatening ischaemia (CLTI) is the most severe manifestation of PAD and is characterized by rest pain and/or tissue loss (e.g. ulceration or gangrene).1 It is estimated that CLTI affects about 10% of all patients with PAD.3 Figure 1. Typical critical ischaemia of the left foot. Patients with CLTI are at high risk of major limb amputation (MLA) and major adverse cardiovascular events (MACE – myocardial infarction and stroke)1 with a significant reduction in life expectancy. Overall mortality rates are similar to that of advanced cancers.3 They also commonly experience poor quality of life.

27 March 2024
Conference report: The Royal Free x ASiT x PLASTA Hackathon – hacking the future of sustainability and chatbots in surgery 

Conference report: The Royal Free x ASiT x PLASTA Hackathon – hacking the future of sustainability and chatbots in surgery 

Zahra Ahmed, Alexander Zargaran, Matthew Harris, Angela Lam, Christian Asher, Allan Ponniah, Ali Esmaeili, Afshin Mosahebi

Sustainable surgery, healthcare efficiency and the use of MedTech and Artificial Intelligence (AI) are three major focus points for healthcare systems worldwide. In the United Kingdom, the National Healthcare Service accounts for a quarter of UK public sector emissions 1. With the UK government targeting net zero by 2050, there is an urgent need for increased sustainability in surgery and healthcare to meet this target 2. Furthermore, healthcare costs are rising; governmental healthcare expenditure grew 9.6% between 2020 and 2021, the fastest year-on-year growth rate since records began in 1997 3. This emphasises the need to improve efficiency to make budgets stretch further. AI in healthcare has the potential to increase efficiency and it has been reported that generative AI will grow faster in health care than any other sector 4. In order to tackle the questions that come with these changes to healthcare systems, innovations and innovators are needed.
A collaborative Hackathon between the Royal Free Plastic Surgery Department, the Association of Surgeons in Training (ASiT) and the Plastic Surgery Trainees Association (PLASTA) was held on the 9-10 th October 2023 at the Royal Free Hospital. This was following the successful Royal Free*PLASTA Hackathon in November 2022. In attendance were 58 talented and entrepreneurial-minded delegates, speakers and mentors from ground-breaking start-ups including CMR Surgical and judges from a range of backgrounds including Professors of Plastic Surgery, Business Professors and the founder of Proximie.
The Royal Free Hackathon had three main aims for delegates to focus their innovations revolving around (i) making surgery more sustainable, (ii) the use of ChatBots to improve healthcare outcomes and (iii) how to improve operating room efficiency.

28 February 2024
How to referee a paper &#x2013; Part 4 of 4

How to referee a paper – Part 4 of 4

Short BJS Course – Part 4 of 4 Frank McDermott, Consultant Colorectal Surgeon and Editor, BJS Open. Part 1 of 4 can be viewed here:

6 December 2023
Conference report: NIHR Global Surgery Unit: Lagos, Nigeria 2023

Conference report: NIHR Global Surgery Unit: Lagos, Nigeria 2023

Adesoji O. Ademuyiwa, Maria Picciochi

Purpose
The NIHR Global Surgery Unit annual meeting is the highlight of the network, giving the chance for face-to-face contact between the leadership and delivery teams from around the world. This year, it took place in the city of Lagos in Southern Nigeria. We met for 3 days with over 150 participants predominantly from Nigeria, but with representation from 13 other countries: Benin, Canada, Ghana, Guatemala, India, Mexico, Philippines, Rwanda, Senegal, South Africa, Switzerland, UK, and the USA. Although there is a financial and carbon cost to such a meeting, it is incredibly high value in-terms of communication, direction, strategy setting, and capacity building for the future.
Policy change

19 October 2023
Resident selection in surgery

Resident selection in surgery

Kristine Hagelsteen, MD PhD, Chris Mathieu

There is a global interest in and growing knowledge about how best to select residents in surgery. In 2010, Paice et al claimed that selection was “the missing link in patient safety work”1. The starting point for collegial discussions on the matter and opinions about selection are things we know and have experience of; and we know that there is a spectrum running from excellent to unsuitable surgeons. Some continue to ask, are surgeons “born or made”, i.e., is it innate talent, or their training that matters? Is competence-based education better than the apprenticeship model?2,3.  Further, it is well-established that all facets of competence matter for patient outcomes, not only technical skill4-6. The detrimental effect a less competent or even dysfunctional colleague can have on patients and the workplace environment is also widely recognised7. Attrition from surgical residency programs has been reported to be up to 20%, reflecting bad investments of resources8. Another challenge is that surgery accounts for most adverse events in health care, and that up to 15 % of patients in elective surgery suffer a treatment-related injury9,10. We all want the next generation to be better than us. Selection is thus a foundational factor in raising the standard level of treatment and care, reducing adverse events, improving workplace collaboration and heightening the reputation of the profession.
Some characteristics have been found important for surgeons to be successful, such as having a strong academic background and commitment to lifelong learning; possessing sufficient manual dexterity and fine motor skills to reach proficiency; displaying emotional stability; extroversion and conscientiousness; good communication skills and ability to work in teams; critical thinking ability; situational awareness; robust decision-making and problem-solving skills11-14. A more recent addition to the list is “technical orientation”, i.e. willingness and ability to work in a technology-based environment15.

11 July 2023
The role of artificial intelligence in diagnostic medical imaging and next steps for guiding surgical procedures

The role of artificial intelligence in diagnostic medical imaging and next steps for guiding surgical procedures

Barbara Seeliger MD, PhD, FACS, Alexandros Karargyris PhD, Didier Mutter MD, PhD, FACS, FRSM

Funding: This work was supported by the French Agence Nationale de la Recherche (ANR) under the project references ANR-22-CE17-0019-01 and ANR-10-IAHU-02, as well as French state funds managed within the “Plan Investissements d’Avenir”.

7 June 2023
Biomarkers for pancreatic cancer: going beyond the impossible?

Biomarkers for pancreatic cancer: going beyond the impossible?

Daniel Ansari, Roland Andersson

Despite major advances in modern medicine, pancreatic cancer remains for the most part a death sentence. If we are to change the trajectory of pancreatic cancer, early diagnosis is probably the most effective tool at hand. Patients diagnosed with pancreatic cancer at an early stage have the best chance of curative treatment and long-term survival. For example, localized cancer confined to the pancreas has a 5-year survival rate of 42%1. Once the disease has spread to regional structures or lymph nodes, the 5-year survival drops to 14% and only 3% of those diagnosed with distant metastases survive beyond 5 years. However, developing early detection methods for pancreatic cancer remains an elusive task and still today, only around 13% of patients have their tumour detected at a localized stage. The striking difference in survival between early- and late stage tumours has spawned decades-long efforts to find biomarkers that will enable earlier detection of pancreatic cancer. The US National Institutes of Health (NIH) defines a biomarker as “a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention.”2 Carbohydrate antigen 19-9 (CA 19-9), discovered in 19793, is the only FDA-approved serum biomarker for pancreatic cancer. CA 19-9 has a sensitivity of 79-81% and specificity of 82-90%4. However, CA 19-9 has a limited sensitivity in early-stage disease. False positive values may occur in patients with benign biliary obstruction and several inflammatory conditions in the pancreas and hepatobiliary system. Furthermore, approximately 5-10% of the general population are Lewis antigen negative and lack the enzyme necessary to produce CA 19-9, leading to potentially false negative results. For these reasons, CA 19-9 cannot be used for screening purposes and the indication is mainly restricted to treatment monitoring. The recent revolution in genomic, transcriptomic, proteomic and metabolomic technologies have contributed to the discovery of thousands of potential biomarker candidates for pancreatic cancer. These biomarkers are measurable in blood as liquid biopsies and have been evaluated either as single markers or as multimarker combinations, including protein panels5, 6, metabolites7, autoantibodies to tumour antigens8, 9, exosomes10, microRNAs11, nucleosomes12, circulating tumour cells13 and circulating tumour DNA14-16. Despite initial promise, no investigational biomarker has yet entered routine clinical practice. The question remains: Why do so many initially promising biomarkers fail to reach the clinic?

26 May 2022