Paediatric minimal access surgery

What is it in children?

Minimal access surgery means operating through small incisions with a camera: laparoscopy in the abdomen and thoracoscopy in the chest. It isn't a separate part of the syllabus; it runs through the other areas of paediatric surgery ^[3]. The British Association of Paediatric Endoscopic Surgeons (BAPES) has promoted minimally invasive surgery for children since 1999 ^[8].

Typical conditions and operations

• Pyloromyotomy, most often done laparoscopically ^[9].
• Appendicectomy, open or laparoscopic ^[3].
• Laparoscopy for impalpable testes ^[3].
• Laparoscopic fundoplication ^[3].
• Thoracoscopic pleural debridement for empyema ^[3].

How to get there

Every BAPS sub-speciality is reached the same way: by training as a paediatric surgeon. In England, paediatric surgery is now entered at ST3, after core surgical training. NHS England stopped recruiting to paediatric surgery run-through for posts starting in August 2026, and the 2026 national recruitment was for ST3 ^{[1, 2]}.

1. 5 to 6 yearsMedical school

   A medical degree. To apply for the Foundation Programme you need to be eligible for provisional registration with the GMC ^[10].

2. 2 yearsFoundation Programme

   The two-year UK Foundation Programme ^[10].

3. CT1 to CT2Core surgical training

   Two years, which count as phase 1 of the paediatric surgery curriculum ^[3]. To apply for ST3 you need the MRCS by exam ^[11].

4. ST3 to ST6Paediatric surgery, phase 2

   Four years covering the whole syllabus, including general surgery of childhood, gastrointestinal, urology, neonatal, oncology, endocrine, airway and thoracic, and trauma. By the end you should be ready for the Intercollegiate Specialty Board exam, FRCS (Paeds), which you take once phase 2 is signed off ^[3].

5. ST7 to ST8Phase 3

   Two years to consolidate. To finish, you need experience in at least one specialty interest ^[3].

6. CCT, then a fellowship

   Keyhole skills are built throughout training. BAPS has advertised posts such as a one-year senior clinical fellowship in paediatric minimally invasive surgery ^{[3, 12]}.

Good to know

• Indicative length is eight years including core training ^[3]. With Foundation, that's about ten years after medical school.
• It's competitive: in 2025 there were 109 applications for 16 ST3 posts, a ratio of 6.81 ^[4]. A 2022 BAPS careers page says only about 40% of trainees at the time got their post at the first attempt ^[5].
• For 2027 entry, paediatric surgery is again listed at ST3 ^[6]. Some careers pages, including NHS Health Careers, still suggest you apply straight after the Foundation Programme without mentioning core surgical training, so check the recruitment pages ^[7].

Getting involved as a student

• BAPS student membership costs £25 for medical students studying in the British Isles ^[13].
• BAPS meetings. The 2026 Congress had a medical student rate. Coming up are the Winter Meeting in Cambridge on 03/12/2026 to 04/12/2026, and the 73rd Congress in Glasgow on 07/07/2027 to 09/07/2027 ^{[14, 15]}.
• Research. Projects run by the paediatric surgical trainees' research network (PSTRN) include everyone from medical students to post-CCT fellows ^[16].
• Tasters and electives. BAPS suggests student selected components, projects and electives at medical school, and taster weeks with your local paediatric surgery unit during Foundation ^[17].
• The surgical colleges. RCS England affiliate membership is £15 a year for UK medical students, and RCS Edinburgh's affiliate membership is free ^{[18, 19, 20]}.