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Surgical specialties

Colorectal Surgery Diploma

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A live online diploma in colorectal surgery, built around the decisions you make in clinic, in the multidisciplinary team (MDT) meeting and in theatre: bowel cancer from screening to advanced disease, inflammatory bowel disease, and benign anorectal and pelvic floor conditions.

Twenty-five weekly sessions across five modules are anchored on guidance from the UK's National Institute for Health and Care Excellence (NICE) and the European colorectal and cancer societies, with US differences flagged where they change practice, and are taught live by practising colorectal surgeons you can question.

Course director
To be announced
Format
25 live weekly sessions on Zoom, in 5 modules
Dates
Confirmed when enrolment opens

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Double-contrast barium enema X-ray showing gas-filled loops of colon outlined by barium.
Image: double-contrast barium enema by © Nevit Dilmen via Wikimedia Commons, licensed under CC BY-SA 3.0.

Who it is for

Senior trainees, fellows and early-career consultants in colorectal and general surgery, and surgeons who run colorectal services, worldwide.

The programme

25 one-hour sessions in 5 modules, each with its learning objectives. This is the draft programme: the course director reviews and refines it before enrolment opens, so session titles may change.

Module 1 · Sessions 1 to 5Colorectal cancer: detection, diagnosis and staging

  1. 1. Bowel cancer screening and polyps

    • Explain how faecal immunochemical test screening works and how UK and US screening ages differ
    • Decide between endoscopic removal and surgery for a large or malignant colorectal polyp
    • Identify the histological features of a malignant polyp that predict lymph node spread
    • Apply current surveillance guidance after polypectomy and after cancer resection

  2. 2. Hereditary and early-onset colorectal cancer

    • Identify patients who need genetic assessment for hereditary colorectal cancer
    • Interpret mismatch repair and microsatellite instability results and plan referral for germline testing
    • Choose the extent of colectomy for a patient with Lynch syndrome or polyposis
    • Recognise symptoms in younger adults that warrant colorectal investigation

  3. 3. Staging colon and rectal cancer and the multidisciplinary team

    • Interpret a rectal MRI report for circumferential margin, extramural venous invasion and nodal status
    • Assign a clinical stage to colon and rectal cancer from CT and MRI findings
    • Present a colorectal cancer case to the MDT with the information needed for a decision
    • Identify staging findings that should change the planned treatment pathway

  4. 4. Enhanced recovery and preventing anastomotic leak

    • Apply the colorectal enhanced recovery pathway from referral to discharge
    • Decide when to use oral antibiotic bowel preparation and a defunctioning stoma
    • Interpret the current evidence on fluorescence perfusion assessment of an anastomosis
    • Recognise an anastomotic leak early and choose between drainage, defunctioning and takedown

  5. 5. Stomas, parastomal hernia and stoma reversal

    • Site and construct an end colostomy and a loop ileostomy that minimise complications
    • Manage a high-output stoma, including fluid and electrolyte replacement
    • Weigh the evidence for prophylactic mesh when forming an end colostomy
    • Plan the timing of ileostomy reversal and counsel the patient on bowel function afterwards
Module 2 · Sessions 6 to 10Treating colon and rectal cancer

  1. 6. Colon cancer surgery

    • Plan a colectomy with the correct lymphovascular clearance for the tumour site
    • Select patients with locally advanced colon cancer for neoadjuvant chemotherapy
    • Compare open, laparoscopic and robotic colectomy for a given patient
    • Assess the quality of a colectomy specimen with the pathologist

  2. 7. Rectal cancer: total mesorectal excision and neoadjuvant treatment

    • Choose between upfront surgery, short-course radiotherapy, chemoradiotherapy and total neoadjuvant therapy from MRI staging
    • Explain the trade-offs between local control, distant recurrence and function shown in the trials
    • Identify where US practice differs, including omission of radiotherapy
    • Time surgery after neoadjuvant treatment and plan restaging

  3. 8. Organ preservation: watch and wait and local excision

    • Define a clinical complete response using endoscopy and MRI
    • Plan a surveillance schedule for watch and wait and act on local regrowth
    • Select early rectal cancers for local excision and decide when completion surgery is needed
    • Counsel a patient with mismatch repair deficient rectal cancer about immunotherapy before surgery

  4. 9. Operative approaches to rectal cancer

    • Choose between anterior resection, intersphincteric resection and abdominoperineal excision
    • Compare laparoscopic, robotic and transanal approaches using trial evidence
    • Decide when lateral pelvic lymph nodes need treatment
    • Grade the quality of a mesorectal excision specimen

  5. 10. Function, survivorship and follow-up

    • Assess low anterior resection syndrome with a validated score and plan treatment
    • Recognise urinary and sexual dysfunction after pelvic surgery and refer appropriately
    • Design a follow-up schedule using the current evidence
    • Advise survivors on physical activity and long-term health
Module 3 · Sessions 11 to 15Advanced, recurrent and anal cancer

  1. 11. Liver and lung metastases

    • Select patients with colorectal liver metastases for resection with the liver team
    • Choose a bowel-first, liver-first or simultaneous strategy for synchronous metastases
    • Interpret the tumour biomarkers that guide systemic therapy
    • Recognise when local treatment of lung metastases is appropriate

  2. 12. Peritoneal metastases and appendiceal neoplasms

    • Assess the extent of peritoneal disease and refer suitable patients for cytoreductive surgery
    • Explain the randomised evidence on hyperthermic intraperitoneal chemotherapy
    • Manage an appendiceal mucinous neoplasm found at appendicectomy
    • Plan follow-up for a low-grade appendiceal mucinous neoplasm

  3. 13. Locally advanced and recurrent rectal cancer

    • Identify rectal cancers that need surgery beyond the total mesorectal excision plane
    • Assess the resectability of locally recurrent rectal cancer on MRI
    • Explain the morbidity and outcomes of pelvic exenteration to a patient
    • Refer to a specialist pelvic oncology centre with the right investigations

  4. 14. Anal cancer and anal intraepithelial neoplasia

    • Diagnose and stage anal cancer and refer for chemoradiotherapy
    • Plan follow-up after chemoradiotherapy and recognise persistent or recurrent disease
    • Select patients for salvage abdominoperineal excision
    • Identify patients at high risk of anal intraepithelial neoplasia who need surveillance

  5. 15. Systemic therapy for the colorectal surgeon

    • Explain who benefits from adjuvant chemotherapy after colon and rectal cancer surgery
    • Interpret mismatch repair status and its effect on treatment choices
    • Discuss the current role and limits of circulating tumour DNA testing
    • Coordinate the timing of surgery with systemic therapy in the MDT
Module 4 · Sessions 16 to 20Inflammatory bowel disease and intestinal failure

  1. 16. Acute severe ulcerative colitis and colectomy

    • Assess acute severe ulcerative colitis using validated severity criteria
    • Decide with the gastroenterologist when rescue therapy has failed
    • Perform the decision steps of an emergency subtotal colectomy
    • Counsel a patient on long-term surgical options after colectomy

  2. 17. Restorative proctocolectomy and the ileal pouch

    • Select patients for ileal pouch-anal anastomosis or a permanent ileostomy
    • Diagnose and manage pouchitis and other pouch complications
    • Apply surveillance guidance for dysplasia in colitis and after pouch surgery
    • Counsel a patient on fertility, pregnancy and pouch function

  3. 18. Surgery for Crohn's disease

    • Discuss early ileocaecal resection as an alternative to biologic therapy
    • Optimise nutrition, steroid use and sepsis before Crohn's surgery
    • Choose between resection, strictureplasty and different anastomotic techniques
    • Plan postoperative monitoring to prevent recurrence with the gastroenterologist

  4. 19. Perianal Crohn's disease

    • Assess perianal Crohn's disease with examination under anaesthesia and MRI
    • Combine seton drainage with medical therapy in a joint plan
    • Choose a fistula repair technique once disease is controlled
    • Explain the current evidence on stem cell therapy for complex fistulas

  5. 20. Enterocutaneous fistula and intestinal failure

    • Control sepsis and protect the skin in a patient with an enterocutaneous fistula
    • Plan nutrition support, including parenteral nutrition, for intestinal failure
    • Decide the timing of definitive fistula surgery
    • Refer patients to a specialist intestinal failure unit
Module 5 · Sessions 21 to 25Benign anorectal disease and the pelvic floor

  1. 21. Haemorrhoids and anal fissure

    • Choose a treatment for haemorrhoids that matches grade and symptoms
    • Counsel a patient on the recurrence and pain trade-offs between haemorrhoid procedures
    • Treat chronic anal fissure in a stepwise way
    • Recognise atypical fissures that need investigation

  2. 22. Anorectal abscess and anal fistula

    • Classify an anal fistula and decide when MRI is needed
    • Select patients for fistulotomy based on the risk to continence
    • Choose between seton, advancement flap and intersphincteric ligation for a complex fistula
    • Explain the healing and continence outcomes of each option to a patient

  3. 23. Faecal incontinence and obstetric anal sphincter injury

    • Assess faecal incontinence with history, examination and anorectal tests
    • Plan conservative treatment, including biofeedback and medication
    • Select patients for sacral nerve stimulation or sphincter repair
    • Manage the late consequences of obstetric anal sphincter injury with the obstetric team

  4. 24. Rectal prolapse, obstructed defaecation and pelvic mesh

    • Choose between perineal and abdominal repair for external rectal prolapse
    • Select patients with internal prolapse for ventral mesh rectopexy
    • Explain mesh-related risks honestly and record the consent discussion
    • Assess obstructed defaecation within a multidisciplinary pelvic floor service

  5. 25. Complex case review and professional practice

    • Apply the course to complex colorectal cases in a panel discussion
    • Present a complication at a morbidity and mortality meeting to drive learning
    • Use national audit data to compare and improve a unit's outcomes
    • Plan your own development towards a specialist colorectal practice

What the diploma includes

  • 25 live sessions on Zoom, one evening a week, with recordings for the weeks you miss.
  • Practising specialists teaching live, so you can put your questions to them.
  • Weekly MCQs and a final written assessment.
  • A digital certificate carrying your final classification.

Lead or teach the Colorectal Surgery Diploma

We are looking for a course director and faculty from the specialty. Sessions are one hour in the UK evening, live on Zoom, and paid.

Apply to teach