Membership Of The Royal College Of Surgeons Research Articles

320 Views and Awareness of Egyptian Surgical Trainees on Pursuing Membership of the Royal College of Surgeons (MRCS) in the UK: A Single-Institutional Study

Abstract Aim International surgical trainees view training overseas as an attractive pathway for achieving excellence in surgery. The internationally recognised MRCS examinations provide a benchmark that trainees can use to meet this aspiration while also benefitting from great international mobility. We aimed to look at the awareness and views of Egyptian surgical trainees to training in the UK and pursuing MRCS. The motivations for and the barriers to these aspirations were explored. Method An observational cross-sectional study of interns, residents, and assistant lecturers at Ain Shams University Hospitals was conducted from October to December 2023 using a 26-item paper-based survey. This was designed to assess understanding of UK surgical training and ascertain views on UK surgical training and pursuing the MRCS examinations. Results 194 participants were involved in this study, with 58.76% being male and the mean age being 26.84 ± 2.58 years. 73.4% generally agree that pursuing surgical training in the UK is an attractive career option. 55.85% generally agree that it is a financially viable career option, and 31.38% remain neutral. 66.5% personally know someone who has trained in the UK and/or sat MRCS. 51.59% report it is easy to find information on UK training and the MRCS exams. Conclusions It is evident that surgical training in the UK and pursuing MRCS is an attractive option for Egyptian surgical trainees. However, many barriers and a lack of information make these aspirations hard to achieve. Further work is required to improve support structures and to assess if these sentiments are shared with trainees elsewhere.

The performance of large language models in intercollegiate Membership of the Royal College of Surgeons examination.

Large language models (LLM), such as Chat Generative Pre-trained Transformer (ChatGPT) and Bard utilise deep learning algorithms that have been trained on a massive data set of text and code to generate human-like responses. Several studies have demonstrated satisfactory performance on postgraduate examinations, including the United States Medical Licensing Examination. We aimed to evaluate artificial intelligence performance in Part A of the intercollegiate Membership of the Royal College of Surgeons (MRCS) examination. The MRCS mock examination from Pastest, a commonly used question bank for examinees, was used to assess the performance of three LLMs: GPT-3.5, GPT 4.0 and Bard. Three hundred mock questions were input into the three LLMs, and the responses provided by the LLMs were recorded and analysed. The pass mark was set at 70%. The overall accuracies for GPT-3.5, GPT 4.0 and Bard were 67.33%, 71.67% and 65.67%, respectively (p = 0.27). The performances of GPT-3.5, GPT 4.0 and Bard in Applied Basic Sciences were 68.89%, 72.78% and 63.33% (p = 0.15), respectively. Furthermore, the three LLMs obtained correct answers in 65.00%, 70.00% and 69.17% of the Principles of Surgery in General questions (p = 0.67). There were no differences in performance in the overall and subcategories among the three LLMs. Our findings demonstrated satisfactory performance for all three LLMs in the MRCS Part A examination, with GPT 4.0 the only LLM that achieved the pass mark set.

The hidden costs of the intercollegiate membership of the Royal College of surgeons examinations: Can trainees afford it?

BackgroundThe Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is a mandatory requirement for higher specialty surgical training in the UK. However, there is a significant economic impact on trainees which raises the question of whether the costs of this exam hinder surgical career progression. This study explores the burden of these exams on trainees. MethodsA 37-point questionnaire was distributed to all trainees who were preparing for or have sat MRCS examinations. Univariate analyses included the cost of the preparatory resources, extra hours worked to pay for these and the examinations, and the number of annual leave (AL) days taken to prepare. Pearson correlation coefficients were used to identify possible correlation between monetary expenditure and success rate. ResultsOn average, trainees (n ​= ​145) spent £332.54, worked 31.2 ​h in addition to their rostered hours, and used 5.8 AL days to prepare for MRCS Part A. For MRCS Part B/ENT, trainees spent on average £682.92, worked 41.7 extra hours, and used 5 AL days. Overall, the average trainee spent 5–9% of their salary and one-fifth of their AL allowance to prepare for the exams. There was a positive correlation between number of attempts and monetary expenditure on Part A preparation (r(109)=0.536, p ​< ​0.001). ConclusionsThere is a considerable financial and social toll of the MRCS examination on trainees. Reducing this is crucial to tackle workforce challenges that include trainee retention and burnout. Further studies exploring study habits can help reform study budget policies to ease this pressure on trainees.

A retrospective cohort study of differential attainment, COVID and Chaos: taking the difference out of a terrible trinity.

This study aimed to evaluate Core Surgical Training (CST) differential attainment related to COVID-19, gender, and ethnicity. The hypothesis was that COVID-19 adversely influenced CST outcomes. A retrospective cohort study of 271 anonymised CST records was undertaken at a UK Statutory Education Body. Primary effect measures were: Annual Review of Competency Progression Outcome (ARCPO), Membership of the Royal College of Surgeons (MRCS) examination pass, and Higher Surgical Training National Training Number (NTN) appointment. Data was collected prospectively at ARCP and analysed with non-parametric statistical methods in SPSS®. CSTs numbering 138 completed training pre- and 133 peri-COVID. ARCPO 1,2&6 were 71.9% pre- vs. 74.4% peri-COVID (P=0.844). MRCS pass rates were 69.6% pre- versus 71.1% peri-COVID (P=0.968) but NTN appointment rates diminished (pre- 47.4% vs. peri- 36.9%, P=0.324); none of the above varied by gender or ethnicity. Multivariable analyses by three models revealed: ARCPO was associated with gender (m: f 1:0.87, OR 0.53, P=0.043) and CST theme (Plastics vs. General OR 16.82, P=0.007); MRCS pass with theme (Plastics vs. General OR 8.97, P=0.004); NTN with the Improving Surgical Training run-through program (OR 5.00, P<0.001). Program retention improved peri-COVID (OR 0.20, P=0.014) with pan University Hospital rotations performing better than Mixed or District General-only rotations (OR 6.63, P=0.018). Differential attainment profiles varied 17-fold, yet COVID-19 did not influence ARCPO or MRCS pass rates. NTN appointment fell by one fifth peri-COVID, but overall training outcome metrics remained robust despite the existential threat.

What are the concerns of second-degree medical students entering specialty OMFS training?

Oral and maxillofacial surgery (OMFS) applicants are faced with numerous challenges. Previous research has demonstrated that financial burden, length of OMFS training, and impact on personal life are cited as major drawbacks to pursuing the specialty, with trainees having concerns about the Membership of the Royal College of Surgeons (MRCS) examinations. The current study aimed to explore second-degree medical students’ concerns about obtaining a specialty training post in OMFS. An online survey was distributed via social media to second-degree students across the United Kingdom and 106 responses were received. A lack of publications and lack of involvement in research (54%) as well as attaining accreditation with the Royal College of Surgeons (27%) were cited as the primary and secondary concerns in relation to securing a higher training post. Seventy-five per cent of respondents had no first-author publications, 93% expressed concerns about passing the MRCS examination, and 73% had more than 40 OMFS procedures within their logbook. Second-degree medical students reported having ample clinical and operative experience in OMFS. Their main concerns were about research and MRCS examinations. To alleviate these concerns, BAOMS could provide educational initiatives and dedicated mentorship programmes for second-degree students, and could adopt a collaborative approach with discussion with major postgraduate training stakeholders.

Prognostic value of interview rank when hiring for health: staff and nonsense or significant metric?

Introduction Core surgical training recruitment works via a centralised national selection process, during which each applicant is assigned an interview performance rank. The aim of this study was to evaluate the relative performance of core surgical trainees related to interview rank (CSTIR) in a single UK statutory education body. Methods Data for two cohorts of core surgical trainees (87 individuals) were analysed prospectively over two years (2018–2021). The primary outcome measures were Membership of the Royal College of Surgeons (MRCS) examination pass and specialty national training number (NTN) appointment. Results The overall MRCS pass rate was 67.8% and the NTN success rate was 43.7%. CSTIR &lt;332 was associated with MRCS pass (88.0% vs 59.7%, odds ratio [OR]: 4.90, p = 0.017) and CSTIR &lt;550 with NTN success (57.4% vs 42.6%, OR: 3.56, p = 0.006). Multivariate analysis revealed that NTN appointment was associated with audit completion (OR: 1.49, p = 0.045), scientific publication (OR: 2.08, p = 0.008), CSTIR (OR: 6.02, p = 0.014), universal annual review of competence progression Outcome 1 (OR: 25.10, p = 0.002) and Improving Surgical Training programme (OR: 108.96, p &lt; 0.001). Conclusions CSTIR was independently associated with conversion to higher surgical specialty NTN, suggesting that the current recruitment process predicts likely success in training.

Differential attainment, socioeconomic factors and surgical training.

Differential attainment (DA) is the gap in levels of achievement between different groups; socioeconomic factors are thought to play a significant role in DA. The aim of this study was to review and assess the evidence for DA in early surgical training and to examine the potential influence of socioeconomic status. Data were obtained from the General Medical Council GMC for those taking Membership of the Royal College of Surgeons (MRCS) examinations between 2016 and 2019 and core surgical training annual review of competency progression (ARCP) outcomes between 2017 and 2019. The index of multiple deprivation (IMD) was used as a measure of socioeconomic background. Trainees were then divided into deprivation quintiles (DQ1=most deprived, DQ5=least deprived). MRCS and ARCP outcomes were compared between DQ groups using 95% confidence intervals and chi-square tests. Those from lower socioeconomic backgrounds had significantly lower overall MRCS pass rates (DQ1=45.5%, DQ2=48.9% vs DQ4=59.6%, DQ5=61.5%, p<0.05) and 1st time pass rates (DQ1&2=46.6% vs DQ4&5=63.5%, p<0.001). Additionally, they had a significantly higher number of attempts required to pass MRCS (DQ 1&2=1.86 vs DQ 4&5=1.54, p<0.01). Those from lower socioeconomic backgrounds had a significantly greater proportion of unsatisfactory ARCP outcomes (DQ1&2=24.4% vs DQ 4&5=14.2%, p<0.05). There is clear evidence of the influence of socioeconomic background on DA in early surgical training. However, the reasons for this are likely complex and more work is required to investigate this relationship.

7 Differential Attainment at the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examination

Abstract Aim The recent Kennedy review on diversity and inclusivity highlighted concerns that some groups of individuals are facing barriers to progression in surgical careers. Differential attainment in performance at MRCS has been identified but not investigated. This study aimed to explore the relationship between socio-demographic differences and MRCS success. Method UK graduates attempting MRCS Part A (n=5,780) and Part B (n=2,600) from 2013-2019 were identified using the UKMED database. Univariate associations with MRCS performance were identified using chi-squared tests. Multiple logistic regression identified independent predictors of MRCS success at first attempt, adjusted for medical school performance. Results Differences in MRCS pass rates were statistically significant according to graduate status, sex, ethnicity, socio-economic status, and educational background (all P&amp;lt;0.05). After adjusting for prior academic attainment, men (odds ratio [OR] 2.34, 95%CI 1.87–2.92) and non-graduates (OR 1.98, 95%CI 1.44–2.74) were significantly more likely to pass MRCS Part A. Non-graduates (OR 1.77, 95%CI 1.15–2.71) and those who attended a fee-paying school (OR 1.51, 95%CI 1.08–2.10) were significantly more likely to pass MRCS Part B. Black and minority ethnic groups were significantly less likely to pass MRCS Part B at their first attempt (OR 0.41, 95%CI 0.18 to 0.92 for Black candidates and OR 0.49, 95%CI 0.35 to 0.69 for Asian candidates) compared to White candidates. Conclusions We found significant differential attainment at MRCS that cannot be attributed to learner deficit. Training institutions and Royal Colleges now have a responsibility to identify and address the causes of these attainment differences to facilitate equitable career progression for surgical trainees.

A cross-sectional study examining MRCS performance by core surgical training location

Background In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery. Methods A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 (n = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery. Results MRCS Part A and Part B pass rates were associated with CST deanery (p < 0.001 and p = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00–6.42), North Central and East London (OR 2.37 [95% CI 1.04–5.40]) or South London (OR 2.36 [95% CI 1.09–5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23–51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST. Conclusion MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality.

MRCS Performance by OMFS trainees: an update and call to action

Completion of the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is a prerequisite for completion of specialty surgical training in UK. The aim of this study was to compare MRCS performance of OMFS trainees to trainees in other specialities over the past 13 years. Differential attainment (DA) was noted in MRCS Part A (MCQ) pass rates. There was no statistically significant difference in MRCS Part B pass rates. The reasons for this DA are currently unknown and require further investigation. It has been suggested that this may be due at least in part to competing time, family and financial obligations, which increase over time.

BJS.02Graduates from different medical schools vary in their performance on the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examinations

Abstract Aims UK medical schools vary in their mission, curricula and pedagogy, but little is known of the effect of this on postgraduate examination performance. We explored differences in outcomes at the Membership of the Royal College of Surgeons examination (MRCS) between medical schools, course types, national ranking and candidate sociodemographic factors. Methods A retrospective longitudinal study of all UK medical graduates who attempted MRCS Part A (n = 9730) and MRCS Part B (n = 4645) between 2007 and 2017, utilising the UK Medical Education Database (https://www.ukmed.ac.uk). We examined the relationship between medical school and success at first attempt of the MRCS using univariate analysis. Logistic regression modelling was used to identify independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P &amp;lt; 0.001). Russell Group graduates were more likely to pass MRCS Part A (Odds Ratio (OR) 1.79 [95% Confidence Interval (CI) 1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Trainees from Standard-Entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses, Part A OR 3.72 [2.69-5.15]; Part B (OR 1.67 [1.02-2.76]. Non-graduates entering medical school were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]) than graduate-entrants. Conclusion Medical school, course type and socio-demographic factors are associated with success on the MRCS. This information will help to identify surgical trainees at risk of failing the MRCS in order for schools of surgery to redistribute resources to those in need.

TP8.2.8 Medical School Selection scores correlate with MRCS Part A performance

Abstract Aims Selection into UK medical school involves a combination of three measures: prior academic attainment, selection tests (e.g. the University Clinical Aptitude Test (UCAT), Biomedical Admissions Test (BMAT), or Graduate Medical School Admissions Test (GAMSAT)) followed by interview. We investigated the predictive power of current UK medical selection tests and measures of prior attainment on success in the Membership of the Royal College of Surgeons (MRCS) examination. Methods The UKMED database was used to analyse A-Levels and medical school selection data for all UK graduates who attempted the MRCS Part A written examination (n = 9729) and Part B clinical examination (n = 4644) between 2007 and 2017. Univariate analysis and Pearson correlation coefficients examined the relationship between selection scores and first attempt MRCS success. Results Successful MRCS Part A candidates scored higher in A-Levels, UCAT, BMAT and GAMSAT examinations (p &amp;lt; 0.05) than their unsuccessful peers, but no differences were observed for MRCS Part B. Statistically significant positive correlation was found between MRCS Part A, BMAT (r = 0.32, p &amp;lt; 0.001) and GAMSAT scores (r = 0.35, p = &amp;lt;0.001). While a weaker statistically significant correlation was found between Part A, A-Level (r = 0.14, p &amp;lt; 0.001) and UCAT scores (r = 0.25, p &amp;lt; 0.001). Conclusions This, the first study to investigate the relationship between all UK medical school selection tests and success in a postgraduate examination found statistically significant correlations between selection test scores and performance on Part A of the MRCS. The strength of correlations found in this study are similar to those of other validated selection tests used in the United States.

TP8.2.5 Taking the virtual plunge: delivering an intensive curriculum at the 'St Thomas' MRCS course' in the COVID era

AimsThe Covid-19 global pandemic changed the world. Disruption to teaching and training has been felt across medicine, but more acutely in craft specialities such as surgery. The Royal College of Surgeons has raised concerns and started a campaign: ‘no training today, no surgeons tomorrow’. Innovation and adaptation are required in this new normal.We assess the effectiveness of adapting an intensive face-to-face revision course covering essential skills and knowledge required for the Membership of the Royal College of Surgeons (MRCS) examination to the virtual world.MethodsOver five days interactive lectures, small-group teaching (clinical examination, communication, procedural skills), and a complete mock examination were delivered by a faculty of expert lecturers, consultants and actors live over Zoom. Feedback was collected on all aspects of the course by online survey. Sessions were marked for presentation, clarity, relevance and overall quality.Results19 participants attended 35 sessions and six mock stations, with a total of 597 candidate sessions and 108 candidate mock stations. 94% of ratings were at least very good; 63% were excellent. Participants reported significantly improved levels of skill and knowledge (p < 0.001). Most felt skills improved from fair to very good. All candidates felt the course was well organised and allowed full participation.ConclusionIncreasingly, medical education is occurring in the virtual world. Whilst this poses difficulty in craft specialities, particularly for skill acquisition, our data demonstrate high participant satisfaction. Moreover, significant improvements were seen in self-assessment of skills and knowledge as a consequence of this unique course.

Prognostic significance of drivers at work and learning styles in surgical training

Purpose of the studyDrivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study...

Does performance at medical school predict success at the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination? A retrospective cohort study

BackgroundIdentifying predictors of success in postgraduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty...

A cross-sectional study examining the association between MRCS performance and surgeons receiving sanctions against their medical registration

BackgroundFitness to practice (FtP) investigations by the General Medical Council (GMC) safeguard patients and maintain the integrity of the medical profession. The likelihood of FtP sanctions is influenced by specialty and socio-demographic factors and can be predicted by performance at postgraduate examinations. This is the first study to characterise the prevalence of FtP sanctions in early-career surgeons and to examine the association with performance at the Membership of the Royal College of Surgeons (MRCS) examination. MethodsAll UK graduates who attempted MRCS between September 2007–January 2020 were matched to the GMC list of registered medical practitioners. Clinicians who had active FtP sanctions between 28th August 2018 and 28th August 2020 were identified. Data were anonymised by RCS England prior to analysis. ResultsOf 11,660 candidates who attempted MRCS within the study period, only 31 (0.3%) had FtP sanctions between 2018 and 2020. Of these, 12 had active conditions on registration, seven had undertakings and 14 had warnings. There was no statistically significant difference in MRCS performance in either Parts A or B of the examination for those with and those free from FtP sanctions (P > 0.05). ConclusionsIn this, the largest study of MRCS candidates to date, the prevalence of active FtP sanctions in early-career surgeons was 0.3%, significantly lower than the prevalence of sanctions across more experienced UK surgeons (0.9%). These data highlight early-career surgeons as a low-risk group for disciplinary action and should reassure patients and medical professionals of the rarity of FtP sanctions.

191 Performance at Medical School and Foundation Programme Selection Can Predict Success in The MRCS Examination

Abstract Background Identifying factors that predict success in the Membership of the Royal College of Surgeons (MRCS) examination can aid trainees’ exam preparation and help deaneries identify candidates likely to require additional support. We assessed whether performance at Medical School and UK Foundation Programme selection (Educational Performance Measurement (EPM) and Situational Judgement Test (SJT)) predicted MRCS success. Method We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B (n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first attempt. Logistic regression identified independent predictors of MRCS success. Results Each additional EPM decile increased the chances of passing MRCS by 52% for Part A (odds ratio 1.52 [95% confidence interval 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). Each EPM point awarded for degrees increased the likelihood of passing Part A by 29% (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS success (P&amp;gt;0.05). Conclusions This is the first study to investigate the relationship between UK medical school performance and postgraduate surgical exam success. Higher ranked students are more likely to succeed in the MRCS compared to their lower ranked peers.

220 Choice of UK Medical School Predicts Success in The Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination

Abstract Background UK medical schools vary in terms of factors such as mission, specific curricula and pedagogy. As relatively little is understood about the impact of these differences at a post-graduate level, we examined the relationship between medical school and MRCS success. Method Using the UKMED database we analysed data on UK medical graduates who attempted MRCS Part A (n = 9729) and MRCS Part B (n = 4644) between 2007-2017. Univariate analysis characterised the relationship between medical school and first attempt MRCS success. Logistic regression modelling identified independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P &amp;lt; 0.001). Trainees from standard-entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses ((Part A (Odds Ratio (OR) 3.72 [95% Confidence Interval (CI) 2.69-5.15]); Part B (OR 1.67 [1.02-2.76])). Non-graduates were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]). Russell Group graduates were more likely to pass MRCS Part A (OR 1.79 [1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Conclusions Medical programme and medical school are associated with MRCS success. Further research is needed to tease out the relationship between individual factors, medical school and MRCS performance.

221 UK Medical School Selection Criteria Predicts Success in Part A of The Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination

Abstract Background Selection into UK medical school typically involves a combination of three measures: prior academic attainment, selection tests (e.g., the University Clinical Aptitude Test (UCAT), Biomedical Admissions Test (BMAT), Graduate Medical School Admissions Test (GAMSAT)), and an interview. We investigated whether prior attainment and selection test scores can predict MRCS success. Method We used the UKMED database to analyse selection data for all UK graduates who attempted MRCS Part A (n = 9729) and Part B (n = 4644) between 2007-2017. Univariate analysis and Pearson correlation coefficients were used to examine the relationship between selection scores and first attempt MRCS success. Results Successful MRCS Part A candidates had better A-Levels and higher scores in UCAT, BMAT and GAMSAT examinations (p &amp;lt; 0.001) than their unsuccessful peers. No statistically significant difference was observed for MRCS Part B. A moderate positive correlation was found between Part A, BMAT (r = 0.315, p &amp;lt; 0.001) and GAMSAT scores (r = 0.346, p &amp;lt; 0.001). A weak positive correlation was found between Part A, A-Level (r = 0.144, p &amp;lt; 0.001) and UCAT scores (r = 0.246, p &amp;lt; 0.001). Conclusions A-level results and medical school selection tests predict success in the knowledge-based (Part A) MRCS examination.

John Hatton's manuscript record of the surgical and pathological lectures given by Joseph Jordan, FRCS, in 1837-1838.

John Hatton, LSA MRCS FRCS MD (1817-1871), was apprenticed from 1833 to Joseph Jordan, MRCS FRCS (1787-1873), a well-known Manchester surgeon. Jordan, who had been teaching anatomy since 1814, closed his Mount Street Medical School in 1834 and was elected as surgeon to the Manchester Royal Infirmary in 1835. He continued to lecture on surgery and surgical pathology at the Infirmary, and sometimes at the Pine Street Medical School run by Thomas Turner, LSA FRCS (1793-1873). During 1837-38 Hatton transcribed and illustrated these lectures in a bound manuscript and also added notes and drawings in his personal copy of The Dublin Dissector. He gained his Licentiate of the Society of Apothecaries (LSA) in 1836 and Membership of the Royal College of Surgeons (MRCS) in 1839 and set up in Manchester as surgeon from around 1840. This paper is based on three previously unrelated documents in the University of Manchester Archives: a handwritten catalogue of specimens in Jordan's Anatomy Museum, Hatton's annotated copy of The Dublin Dissector and his manuscript record of Jordan's lectures. These documents provide a valuable insight into medical education during the 1830s.