The Basic Surgical Skills Course: Past, present and future

22 Sep 2023

Bill Thomas and Pranav Somaiya

We are incredibly proud to celebrate 30 years of the Basic Surgical Skills (BSS) course this year. In this blog, BSS founder and past RCS England Vice-President, Bill Thomas and current Surgical Skills Clinical Lead, Pranav Somaiya reflect on the past, present and future of the course.

W E G (Bill) Thomas – former Surgical Skills Tutor, Head of Education, and Senior Vice-President RCS England

In 1992, the then Senate of Surgery of all four surgical royal colleges decided that there should be a Basic Surgical Skills course which would ‘teach, test and certify’ basic surgical skills for all UK surgical trainees. There had been similar ad hoc courses but nothing formal. At that time, the Head of Education at the English College, Professor Jack Hardcastle, asked me to get involved in the design of such a course, as for many years, I had been a faculty member of a similar international skills course headed up by Professor Martin Allgöwer in Davos, Switzerland, which this year celebrated its 40th anniversary. 

I was able to liaise with the other college representatives, including Joseph Duignan from Ireland, David Smith from Edinburgh and Graham Sunderland from Glasgow. After several pilot courses, together we decided on a programme but left each college to decide on how to deliver it.

At RCS England, we worked on a Participant and a Faculty Handbook and a video. With the help of senior AV technician Tom Keller and a willing laboratory technician from the College, we made the first BSS video, which won the BMA educational film award in 1998. Things were so simple then, and its production now appears quite naïve, but a version of the course was launched in 1993 and was a great success. In 1996, the BSS course became mandatory for surgical training and the granting of the MRCS; later, that formal mandatory requirement was dropped, but the course was so appreciated that it became almost mandatory without it being a legal requirement for training.

Over the years, the course has evolved, and I pay tribute particularly to the late Rory McCloy, who assisted me in introducing many new aspects, especially that of minimal access surgery. A new BSS edition is produced every three to four years, and the course spawned several other courses, including 'Surgical Skills for Students', which is still very popular.

One of the most important courses that developed from BSS was the international course 'Introduction to Surgical Skills'. I was assisted in the development of this course by Professor Arjuna Aluwihare from Kandy in Sri Lanka. The course was sponsored by 'The Commonwealth of Learning' and went worldwide. Taking such skills courses internationally has been one of my greatest privileges, and I have had the privilege of convening such surgical skills workshops in 51 different countries. 

I am so grateful for all the faithful faculty members over the years who have supported BSS and, in particular, Frank Smith, Rory McCloy and Eric Drabble, who followed me as the Surgical Skills Tutor at the College. I would also pay great tribute to John Weston Underwood, who so brilliantly provided the commentary for the third to sixth editions of the video and brought a wonderful sense of humour to the course as well. It has always been a vital aspect of the course that the participants should enjoy the experience, as one learns and remembers so much more from an enjoyable experience.

I have valued the privilege of being involved in developing and maintaining BSS over the years. However, no course can stand still, and I am personally delighted that Pranav Somaiya has taken over the mantle of Surgical Skills Clinical Lead. I know that the course and its future development are in very good hands. When I think of the thousands of surgical trainees in the UK and internationally who have benefitted from the course, I am so grateful that the future of the BSS course is ensured in Pranav’s hands and that surgical trainees in the future will be able to continue to benefit and start their surgical training on such a firm foundation of 'safe and sound surgical techniques'.

Pranav Somaiya, Clinical Lead, Surgical Skills Programme, RCS England

My association with the BSS started in 2008. In the 15 years that have followed (half of its lifetime), it’s been an honour to work with BSS tutors and the intercollegiate committee on three revisions of the course until taking on the lead position at the College in 2022. As the years have gone by, surgery has evolved, and so has the world around us. I hope this is accurately reflected in the next edition of the course with its engagement with newer fields of surgery, such as robotics. I also hope that the presentation of this course in its next edition gives an inspirational representation of our rich diaspora of excellent surgeons. The challenges of cost and the pressures of training continue to have an impact on our trainees, and we are making every effort to ensure that our trainees get the best opportunities to get onto this course. 

Carrying on the rich tradition of spreading our good work from Bill (whose SHO I once was), we will have taken the course to Kuwait, Egypt, and Carlisle this year. We have hosted a contingent from Iraq who will set up and run BSS in Bagdad, Basra, and Kurdistan. Talks are ongoing with several partner centres to set up the course, and we hope to expand our network of course centres around the country and internationally. 

I sincerely hope that when we celebrate 50 years of the course, we will have spread our wings nationally and internationally to cover most of the surgical world. It is my hope that BSS will have become like the driving lessons that everyone will have taken to make certain they pass their surgical life (driving) test with flying colours. This will be one of the key lynchpins ensuring safe surgical care for our patients.