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Background The length of time dedicated to the undergraduate surgical curriculum is decreasing. With reduced time on surgical placements, students may be underexposed to their core learning needs. The aim of this study was to reach a national consensus on the core content of the undergraduate surgical curriculum in the UK. This will support medical students and medical schools in designing curricula to meet the core learning needs of students to prepare them for clinical practice. Materials and methods A proposed consensus document was created, using the Royal College of Surgeons of England undergraduate curriculum as a guide. This was circulated to an external advisory group for electronic suggestions of additional content not already described. Suggestions were discussed with the steering committee prior to inclusion within document. The resulting consensus document was presented to a face-face consensus meeting of medical students and foundation doctors at the Association of Surgeons in Training (ASiT) conference 2019 for live voting. Eighty percent agreement required to reach consensus. Any discussion of topics was transcribed to allow qualitative summary of discussion of those topics which did not reach consensus agreement. Results Electronic suggestions yielded an extra 8 topics for inclusion into the final consensus document. A total of 52 people participated in the consensus session. The consensus discussed a total of 69 knowledge topics, practical skills and clinical examinations; of which 10 did not reach consensus agreement. Areas failing to reach consensus included knowledge topics in Ear Nose and Throat surgery, Vascular surgery and Neurosurgery as the consensus concluded that these topics were supplementary to core needs. Conclusion This paper presents a national consensus of the undergraduate surgical curriculum. This document should be used in conjunction with the RCS of England undergraduate curriculum to ensure students have an adequate surgical education.

Amyand's hernia (AH) is a rare form of an inguinal hernia where the vermiform appendix is found within the hernia sac. Diagnosis is usually based on incidental finding intraoperatively. The AH makes up a small proportion of all inguinal hernia cases, and concurrent acute ischemic complication makes up an even smaller subset. We present an 85-year-old male who was referred to general surgery services for a growing mass on his right lower quadrant in the inguinal region. This was non-tender on palpation, and therefore there was no suspicion of ischaemic complications. An open hernioplasty was performed with resection of the appendix. The AH in this patient would be conventionally classified as type 1 AH, which would be managed with hernial reduction and mesh repair. The anatomical variance in our patient's AH increased the risk for hernial incarceration; hence an appendectomy was also performed despite the absence of acute appendicitis. This approach was also deemed necessary to avoid the recurrence of hernia due to its large size and adhesions within the hernial sac. This study reports a novel management approach for an incidentally discovered type 1 AH. It highlights that there is a lack of management guidance for the AH anatomical variants. The classification and management for AH under the conventional Losanoff and Basson's AH classification model have limitations that can be amended by incorporating the physical dimensions of the AH. This approach will enable surgeons to recognize and manage more variations of AH while mitigating downstream complications.