Surgical trainee experience and opinion of robotic surgery in surgical training and vision for the future: a snapshot study of pan-specialty surgical trainees

One of the most significant changes to the structure of surgical training in the UK was the introduction of workplace-based assessments (WBAs). Since its integration into the Intercollegiate Surgical Curriculum Programme, we as surgical trainees became the children of WBAs. Procedure-based assessment (PBA) is one of the pillars of WBAs and no surgical trainee portfolio is complete without a significant number of PBAs completed. As a senior trauma and orthopaedics trainee myself, I have encountered PBA on a regular basis, both as a trainee and as an assessor to my junior colleagues. My journey in understanding and implementing PBAs has not been a smooth one. This is also a reflection of almost all surgical trainees across all specialties. In this review, I aim to shed some light on my perspective on PBA, its values, limitations and concerns that have risen as a result of its introduction. I also aim to use my experiences to highlight possible ways of improvement in PBA.

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P38 COVID-19 impact on Surgical Training And Recovery Planning (COVID-STAR) Survey

BJS Open ◽

10.1093/bjsopen/zrab032.037 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

◽

Joshua Clements

Keyword(s):

Surgical Training ◽

Negative Impact ◽

Healthcare Delivery ◽

Cross Sectional Study ◽

Surgical Trainee ◽

Surgical Specialty ◽

Cross Sectional ◽

Training Time ◽

Surgical Trainees ◽

And Training

Abstract Background The COVID-19 pandemic has resulted in dynamic changes to healthcare delivery. Surgery as a specialty has been significantly affected and with that the delivery of surgical training. Method This national, collaborative, cross sectional study comprising 13 surgical trainee associations distributed a pan surgical specialty survey on the COVID-19 impact on surgical training over a 4-week period (11th May - 8th June 2020). The survey was voluntary and open to medical students and surgical trainees of all specialties and training grades. All aspects of training were qualitatively assessed. This study was reported according to STROBE guidelines. Results 810 completed responses were analysed. (M401: F 390) with representation from all deaneries and training grades. 41% of respondents (n = 301) were redeployed with 74% (n = 223) redeployed > 4 weeks. Complete loss of training was reported in elective operating (69.5% n = 474), outpatient activity (67.3%, n = 457), Elective endoscopy (69.5% n = 246) with > 50% reduction in training time reported in emergency operating (48%, n = 326) and completion of work-based assessments (WBA) (46%, n = 309). 81% (n = 551) reported course cancellations and departmental and regional teaching programmes were cancelled without rescheduling in 58% and 60% of cases respectively. A perceived lack of Elective operative exposure and completions of WBA’s were the primary reported factor affecting potential training progression. Overall, > 50% of trainees (n = 377) felt they would not meet the competencies required for that training period. Conclusion This study has demonstrated a perceived negative impact on numerous aspects of surgical training affecting all training specialties and grades.

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982 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

British Journal of Surgery ◽

10.1093/bjs/znab259.884 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

K Khan ◽

G Torpiano ◽

N Galbraith ◽

M McLellan ◽

A Lannigan

Keyword(s):

Surgical Training ◽

Annual Review ◽

Surgical Trainee ◽

Training Groups ◽

Surgical Trainees ◽

The Impact

Abstract Aim The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Method All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

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Robotic Surgery in Surgical Training: A Cross-sectional Study of Pan-Specialty Surgical Trainees

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2021.07.475 ◽

2021 ◽

Vol 233 (5) ◽

pp. S230

Author(s):

Christine A. Fleming ◽

Joshua Burke

Keyword(s):

Robotic Surgery ◽

Surgical Training ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Surgical Trainees

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Visuospatial and Technical Ability in the Selection and Assessment of Higher Surgical Trainees in the London Deanery

Annals of The Royal College of Surgeons of England ◽

10.1308/003588407x187702 ◽

2007 ◽

Vol 89 (6) ◽

pp. 591-595 ◽

Cited By ~ 11

Author(s):

P Tansley ◽

S Kakar ◽

S Withey ◽

P Butler

Keyword(s):

Surgical Training ◽

Practical Skills ◽

Surgical Trainee ◽

Surgical Department ◽

Technical Ability ◽

Surgical Trainees ◽

Competency Based ◽

Higher Surgical Training ◽

Training Programmes ◽

Selection And Assessment

INTRODUCTION Despite awareness of the limitations of current selection and competency assessments, there is little consensus and alternatives have not been readily accepted. Essential surgical skills include visuospatial and technical ability. The aim of this study was to survey current methods of higher surgical trainee selection and assessment. We suggest ways to improve the process. MATERIALS AND METHODS Nine surgical training programmes in the London deanery were surveyed through questionnaires to programme directors, existing trainees and examination of deanery publications. RESULTS Testing of visuospatial and technical ability was piloted at selection only in a single general surgical department. Practical skills were assessed in 3/9 (33%) specialties (ENT, plastic and general surgery). Once selected, no specialty tested visuospatial and technical ability. Practical skills were tested in only 1/9 (11%) specialties (plastic surgery). The remaining 8/9 (89%) were ‘assessed’ by interview. CONCLUSIONS Lack of visuospatial and technical ability assessment was identified at selection and during higher surgical training. Airlines have long recognised early identification of these qualities as critical for efficient training. There is a need for more objective methods in this area prior to selection as time to assess surgical trainees during long apprenticeships is no longer available. We advocate a suitably validated competency-based model during and at completion of training.

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171 Surgical Trainee Suggestions to Improve Surgical Training and the Surgical Recruitment Process in View of the COVID-19 Pandemic

British Journal of Surgery ◽

10.1093/bjs/znab134.120 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Stoner ◽

S Catania

Keyword(s):

Academic Achievement ◽

Medical Education ◽

Surgical Training ◽

Recruitment Process ◽

Surgical Trainee ◽

Educational Activities ◽

Surgical Trainees

Abstract Introduction The COVID-19 pandemic has had a significant impact on medical education and surgical training. The experiences of surgical trainees were sought to seek feedback on how both training and recruitment can be adapted to reflect these changes. Method A survey was circulated amongst surgical trainees, to ask what changes to the recruitment process and surgical training they would suggest, in view of the changes related to the COVID-19 pandemic. Circulated amongst surgical trainees in London. 25 surgical trainees from London responded. Results were analysed and tabulated. Results Suggestions for the recruitment process include an appreciation by the recruitment panel about reduced academic achievement, relaxation of requirements, clinically oriented interviews and extension of training. Suggestions for surgical training include resumption of educational activities, ensured surgical activities and protected theatre time, mentorship and run through training. Conclusions The effects on surgical training due to COVID-19 must be appreciated, and trainees’ experience and feedback should be considered when adapting training and recruitment to this.

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TP8.2.15 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

British Journal of Surgery ◽

10.1093/bjs/znab362.086 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Khurram Khan ◽

Giuliana Torpiano ◽

Norman Galbraith ◽

Morag McLellan ◽

Alison Lannigan

Keyword(s):

Surgical Training ◽

Annual Review ◽

Surgical Trainee ◽

Training Groups ◽

Surgical Trainees ◽

The Impact

Abstract Aims The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Methods All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

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Dead Men's Shoes: The Employment Prospects for Welsh Surgical Trainees

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363513x13500508917053 ◽

2013 ◽

Vol 95 (1) ◽

pp. 1-3

Author(s):

DGY Adamson-Fisher ◽

PJ Billings

Keyword(s):

Surgical Training ◽

Clinical Service ◽

Market Forces ◽

Surgical Trainees ◽

The Future ◽

Higher Surgical Training ◽

National Training

Warnings have been issued regarding the recreation of the 'lost tribe' in the transition between core surgical training and higher surgical training. However, it is more likely that waiting to fill 'dead men's shoes' at the end of surgical training may become the major fear of the new Certificate of Completion of training (cct) holder. The majority of national training number (ntn) holders will receive a cct but market forces may preclude appointment. The projected increase in mismatch of cct holders and vacant posts is not a new phenomenon, nor is the emergence of a subconsultant grade. In the light of what is fast becoming a consultant delivered rather than a consultant led clinical service, are we training too many or too few surgeons for the future?

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1276 Is There Enough Time to Train? An Audit of Core Surgical Training Rotas

British Journal of Surgery ◽

10.1093/bjs/znab259.902 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

B Chandrasekar ◽

R Leatherby ◽

A Kausar ◽

A Waghorn

Keyword(s):

Surgical Training ◽

Quality Indicator ◽

Minimum Standard ◽

Surgical Trainee ◽

Training Time ◽

Medical Practitioners ◽

Supervised Training ◽

Surgical Trainees ◽

Minimum Number ◽

Academic Year

Abstract Aim This audit aims to compare Core Surgical Training (CST) rotas in our region against the Joint Committee on Surgical Training (JCST) Quality Indicator (QI) 10’s minimum standard of 5 consultant supervised training sessions per week. Method Core surgical trainees in one training region were contacted requesting their on-call rotas from rotations undertaken during the 2019/20 academic year. Rotas were analysed in a protocolised manner, with the number of potential training sessions available calculated and compared against the JCST QI 10 minimum recommendation. Results Twenty-four rotas were assessed across 17 hospitals. Only six (25%) rotas achieved the JCST QI 10 recommended minimum 5 training sessions per week. There was a mean deficit of 18.5 (+/-29.5) training sessions per 6-month rotation. Rotas compliant with JCST QI 10 used a mean rota pattern of 1 in 11 compared to 1 in 9 for those failing to meet the target. Sub-analysis, comprising of the addition of expected consultant supervised training whilst on call, led to an improvement in compliance. 9 (38%) rotas met JCST QI 10's minimum standard when 0.5 hours of consultant supervised training time per on-call session was included, and 13 (54%) rotas met the standard when 1 hour was included. Conclusions Core surgical trainee rotas in the region are failing to provide the minimum number of consultant supervised training sessions set out by JCST QI 10. A move to reduced on-call commitment, increased use of supporting medical practitioners and regular perceived consultant supervised training whilst on call should be considered to improve this.

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Cross-sectional study of the financial cost of training to the surgical trainee in the UK and Ireland

BMJ Open ◽

10.1136/bmjopen-2017-018086 ◽

2017 ◽

Vol 7 (11) ◽

pp. e018086 ◽

Cited By ~ 20

Author(s):

John O’Callaghan ◽

Helen M Mohan ◽

Anna Sharrock ◽

Vimal Gokani ◽

J Edward Fitzgerald ◽

...

Keyword(s):

Medical Students ◽

Surgical Training ◽

Postgraduate Training ◽

Maxillofacial Surgery ◽

Oral And Maxillofacial Surgery ◽

Surgical Trainee ◽

Cross Sectional ◽

Training Costs ◽

Surgical Trainees ◽

The Uk

ObjectivesApplications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training.DesignProspective, cross-sectional, questionnaire-based study.Setting/ParticipantsA non-mandatory online questionnaire for UK-based trainees was distributed nationally. A similar national questionnaire was distributed for Ireland, taking into account differences between the healthcare systems. Only fully completed responses were included.ResultsThere were 848 and 58 fully completed responses from doctors based in the UK and Ireland, respectively. Medical students in the UK reported a significant increase in debt on graduation by 55% from £17 892 (2000–2004) to £27 655 (2010–2014) (p<0.01). 41% of specialty trainees in the UK indicated that some or all of their study budget was used to fund mandatory regional teaching. By the end of training, a surgical trainee in the UK spends on average £9105 on courses, £5411 on conferences and £4185 on exams, not covered by training budget. Irish trainees report similarly high costs. Most trainees undertake a higher degree during their postgraduate training. The cost of achieving the mandatory requirements for completion of training ranges between £20 000 and £26 000 (dependent on specialty), except oral and maxillofacial surgery, which is considerably higher (£71 431).ConclusionsMedical students are graduating with significantly larger debt than before. Surgical trainees achieve their educational requirements at substantial personal expenditure. To encourage graduates to pursue and remain in surgical training, urgent action is required to fund the mandatory requirements and annual training costs for completion of training and provide greater transparency to inform doctors of what their postgraduate training costs will be. This is necessary to increase diversity in surgery, reduce debt load and ensure surgery remains a popular career choice.

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