Surgical training: an objective assessment of recent changes for a single health board

The reduction in doctors' hours and the introduction of specialist training have reduced general surgical training by 60%. This study assessed the implications for a single health board. A questionnaire listing 13 representative operations was sent to 44 trainees and 52 trainers to determine th...

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Bibliographic Details
Published in:	BMJ Vol. 314; no. 7084; pp. 891 - 895
Main Authors:	Crofts, T J, Griffiths, J M T, Sharma, S, Wygrala, J, Aitken, R J
Format:	Journal Article
Language:	English
Published:	London British Medical Journal Publishing Group 22-03-1997 British Medical Association BMJ Publishing Group LTD BMJ Publishing Group
Edition:	International edition
Subjects:	Biological and medical sciences Consultants Continuing education Education and Debate Education, Medical, Continuing - trends Educational opportunities General Surgery - education Health education Health participants Humans Job training Laparoscopic cholecystectomy Medical audits Medical sciences Medical specialists Medical Staff, Hospital - education Physicians Public health Public health. Hygiene Public health. Hygiene-occupational medicine Questionnaires Scotland State Medicine - organization & administration Surgeons Surgery Surgery Department, Hospital - statistics & numerical data Surgical Procedures, Operative - economics Surgical Procedures, Operative - statistics & numerical data Surgical specialties Surveys and Questionnaires Training devices Training objectives Workforce United Kingdom UK Human Survey Professional practice Public health Surgeon Dragging
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Summary:	The reduction in doctors' hours and the introduction of specialist training have reduced general surgical training by 60%. This study assessed the implications for a single health board. A questionnaire listing 13 representative operations was sent to 44 trainees and 52 trainers to determine the number of operations a trainee should perform. The total number of operations required for training was compared against the total actually performed across the health board. Operating times for five representative operations were audited prospectively. Trainers and trainees recommended a similar and conservative number of operations. The total number of operations available for training (4913) was 38% less than the number recommended (7946). Trainees required 50-75% more operating time than consultants. To increase the proportion of operations undertaken by trainees from the current 30% to 70% would require an extra 270 theatre days (or £1.3m) yearly. The minimum number of operations required for training must be defined and the proportion of supervised operations undertaken by trainees substantially increased. Service and financial implications will have to be addressed. Action is needed urgently, as the first trainees will become consultants in less than five years.
Bibliography:	PMID:9093109 local:bmj;314/7084/891 Correspondence to: Mr Crofts href:bmj-314-891.pdf istex:CCA02ACC0AE87E54052369BF216AB732A6AF28CF ark:/67375/NVC-WR03PN01-N ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0959-8138 0959-8146 1468-5833 1756-1833
DOI:	10.1136/bmj.314.7084.891