In the mid 1980s it was perceived within the Section of Colon and Rectal Surgery* of the RACS that there were diminishing opportunities for good colorectal training overseas, yet there existed within Australia colorectal units that could provide high standard training.
In 1985 a Fellowship in Colorectal Surgery was established at St Vincent's Hospital in Melbourne and comparison of the workload with four American colorectal units confirmed that there was an adequate caseload. In 1986 Jack Mackay presented a paper at the Melbourne CME on a proposal for Post Fellowship Colorectal Surgical Training, based loosely on the vascular training programme within the RACS. The Section of Colon and Rectal Surgery* of the RACS established a subcommittee to prepare a position paper on Post Fellowship Training in Colorectal Surgery in Australasia to be presented to the annual College Meeting in 1987. In the meantime, an informal meeting had been called in Sydney under the chairmanship of Jon Cohen, to prepare guidelines on a training programme but agreement was not reached. A subsequent position paper with proposed guidelines was prepared by Andrew McLeish and this document provided the basis for a proposal which was passed at the Section AGM in Brisbane in 1988 without dissension, although three fellows abstained. Subsequently the proposal was refined by A. McLeish, J. Mackay and E. Durham Smith (President of the RACS) and the Section of Colon and Rectal Surgery* accepted the proposals for a programme in colorectal surgical training at the Section meeting in Wellington in 1988, recognising that there would need to be a reasonable degree of flexibility in the initial years of the programme.
The regulations of the Post Fellowship Training Programme were formally approved by the Council of the RACS in 1992 and these regulations have been revised and subsequently ratified several times since 1992. In 1996 the Training and Accreditation Committee (TAC) was reconstituted to involve equal membership between the Section of Colon and Rectal Surgery* of the RACS, and the Colorectal Surgical Society of Australia. The Training and Accreditation Committee was renamed to the Training Board in Colon and Rectal Surgery (TBCRS). Previous Chairmen of the TAC/TBCRS include Jack Mackay, Jim Sweeney, Andrew McLeish, Philip Douglas, Michael Solomon, Frank Frizelle and Andrew Hunter. In 1998 the then TAC guidelines were altered to allow up to one year of pre-approved overseas training or up to one year of approved research in a colorectal unit in Australasia. The training programme requires two years of training in two one-year terms. A "Certificate" of satisfactory completion is awarded at the end of the Programme.
In 1999 the RACS Council decided to change General Surgical Training from a four year programme to a five year programme, with the final two years of training being in a "sub-specialty" of General Surgery, such as colorectal surgery. The TBCRS was concerned that the period of training in colorectal surgery would be two years, following the three years of general surgical training, and submitted their concerns to the board in general surgery and the college council. Following representation by members of the TBCRS, the College Council agreed to a three year programme in colon and rectal surgery (Provisional Fellowship).
Subsequently, the Board in General Surgery and the College Council decided to revert to the four year training programme in General Surgery and this recommenced in 2004. The Provisional Fellowship Training Programme continue to be provided until 2008. Specialist colorectal training in Australia and New Zealand is now a Post Fellowship Programme.
Regulations and guidelines for the Post Fellowship Programme are available elsewhere on the website.
Previously the Certificate of Completion of Training was issued following submission of satisfactory referees reports, log books and progress and exit interviews. The TBCRS decided to introduce a more formal yearly assessment of the trainees by means of a written exam.The assessment was trialled in 2005 and then fully introduced in 2006. Since 2010 second (or final) year trainees sit the exam.
In 2003 an annual education weekend for trainees was introduced. The first meeting was held in Sydney in 2003. These training weekends have been extremely well received by the trainees. The success of the weekends is due to the excellent preparation and presentations by the trainees, members of the Training Board and other invited colorectal surgeons. Copies of the trainees presentations are circulated to members of the CSSANZ. We are very appreciative of the generous support of Johnson & Johnson Medical for their ongoing sponsorship of these training weekends.
The Training Board continues to administer a Research Scholarship in Colorectal surgery, which is sponsored by Medtronic (previously Covidien). In addition, in 2003 the Notaras Fellowship was established following a very generous gift from Dr Mitchell Notaras to the University of Sydney. This Fellowship was established to encourage a young surgeon to pursue an academic colorectal surgical career. This is a three year programme, to be run in conjunction with the Post Fellowship Programme, and a Notaras Fellow is appointed every second year. In 2021, a three year Fred Stephens Fellowship, (Maquarie Uni/Concord Hospital), was introduced.
A Travelling Fellowship was generously provided by the Association of Coloproctology of Great Britain and Ireland at the Tripartite Meeting in 2002, and the Council of the CSSANZ and the Executive of the Section of Colon and Rectal Surgery* of the RACS asked the TBCRS to administer this fellowship. This fellowship has been keenly sought after by trainees and young colorectal surgeons. More comprehensive details of these fellowships are found elsewhere on this website.
In late 2015, the TBCRS changed its name to “Australia and New Zealand Training Board in Colon and Rectal Surgery”, ANZTBCRS.
There are now twenty-eight accredited training units on the ANZTBCRS program, each of which is inspected five yearly by members of the Training Board.
Over the years the intake onto the programme has risen from two per year to around twelve per year. To date, over 100 surgeons have successfully completed the programme and the large majority have been appointed to Colorectal Units in teaching hospitals.
*now the Colon and Rectal Surgery Section