Breast surgery consultants and doctors from as far away as Australia spent a day last week at the James Paget University Hospital taking an exam.

Some of the medics are students currently enrolled on e-learning masterships in oncoplastic breast surgery programme, which is the highest qualification in breast surgery there is worldwide. Exams for the programme have previously been at The Royal College of Surgeons of England in London, but for the first time they have taken place at the Paget.

Oncoplastic breast surgery is a new speciality that incorporates the technical aspects of plastic surgery with breast cancer surgery, aimed at improving the cosmetic outcomes following breast surgery. Poor cosmetic results following breast surgery is a daily reminder to patients of their cancer diagnosis and can have a significant effect on them.

The course was founded by Professor Jerome Pereira who is a consultant at the Paget and Professor Sam Leinster from the University of East Anglia, and is supported by The Royal College of Surgeons of England, Association of Breast Surgery and The British Association of Plastic Reconstructive and Aesthetic Surgery.

Consultants from the UK offer their time voluntarily to facilitate the programme using online forums.

One student, Chris Pyke, who is chairman of the Board at Foundation for Breast Cancer, had flown across the world from Australia to be in Gorleston for his examination.

He said: 'The course has been a revelation, It has the flexibility of a virtual learning environment and the structure and discipline of weekly learning tasks. It's a unique learning environment which allows adult education at distance.'

External examiner Professor Andrew Baildam of breast and oncoplastic surgery at Queen Mary University of London added: 'Students are also being taught the psychological effects of this type of surgery which makes it a highly innovative surgical speciality.'

This concept of blended learning, which is web based education with traditional national training programmes has the support of Health Education England and the Royal College of Surgeons.