scholarly journals 602 Specialty Training Progression from Core Surgical Training: Is There Evidence from Plastic Surgery of The Importance of Location, Location, Location?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Vinnicombe ◽  
M Little ◽  
K Johal
Keyword(s):  
Plastic Surgery ◽  
Surgical Training ◽  
Specialty Training ◽  
Surgical Trainees ◽  
Significant Difference ◽  
National Training ◽  
Competitive Nature

Abstract Introduction Obtaining a National Training Number (NTN) in Plastic Surgery is highly competitive (<40 posts per year), with applicant:post ratios between 3.73 to 4.19 in 2017-2019. Our aim was to compare deaneries for numbers successfully progressing directly from CT2 into a ST3 post in Plastic Surgery. Method Data for surgical trainees progressing directly from CT2 to ST3 (2017-2019) in all specialties was obtained from the GMC. The percentage of those directly progressing that obtained a Plastic Surgery NTN and the total number progressing was calculated. Results A total of 840 trainees obtained a NTN directly from CT2 between 2017 and 2019, 61 of whom did so in plastic surgery. Of those directly progressing, there was no significant difference between deaneries for the percentage of plastic surgery posts obtained. The highest number of trainees progressed from London deaneries (16 total (26%); 7 South, 6 NC&E, 3 NW) and the lowest number from Yorkshire and Humber (1). Conclusions Higher numbers of those undertaking core surgical training in London progress directly from CT2 to ST3 in Plastic Surgery. Low total numbers highlight the competitive nature of obtaining a Plastic Surgery NTN, necessitating many to undertake additional experience prior to obtaining a training number.

scholarly journals Autonomy in the Operating Room: A Multicenter Study of Gender Disparities During Surgical Training

2021 ◽  
Vol 13 (5) ◽  
pp. 666-672
Author(s):  
Jenny X. Chen ◽  
Edward H. Chang ◽  
Francis Deng ◽  
Shari Meyerson ◽  
Brian George ◽  
...  
Keyword(s):  
Surgical Training ◽  
Gender Disparities ◽  
Training Level ◽  
Surgical Performance ◽  
Surgical Trainees ◽  
Significant Difference ◽  
Multivariable Regression ◽  
Operative Performance ◽  
And Performance ◽  
Multivariable Regression Models

ABSTRACT Background Gender disparities are prevalent in medicine, but their impact on surgical training is not well studied. Objective To quantify gender disparities in trainee intraoperative experiences and explore the variables associated with ratings of surgical autonomy and performance. Methods From September 2015 to May 2019, attending surgeons and trainees from 71 programs assessed trainee autonomy on a 4-level Zwisch scale and performance on a 5-level modified Dreyfus scale after surgical procedures. Multivariable regression models were used to examine the association of trainee gender with autonomy and performance evaluations. Results A total of 3255 trainees and attending surgeons completed 94 619 evaluations. Attendings gave lower ratings of operative autonomy to female trainees than male trainees when controlling for training level, attending, and surgical procedure (effect size B = −0.0199, P = .008). There was no difference in ratings of autonomy at the beginning of training (P = .32); the gap emerged as trainees advanced in years (B = −0.0163, P = .020). The gender difference in autonomy was largest for the most complex cases (B = −0.0502, P = .002). However, there was no difference in attending ratings of surgical performance for female trainees compared to male trainees (B = −0.0124, P = .066). Female trainees rated themselves as having less autonomy and worse performance than males when controlling for training level, attending, procedure, case complexity, and attending ratings (autonomy B = −0.0669, P < .001; performance B = −0.0704, P < .001). Conclusions While there was no significant difference in ratings of operative performance, a small difference between ratings of operative autonomy for female and male surgical trainees was identified.

An out-of-programme experience: plastic surgery in Uganda

2011 ◽  
Vol 93 (5) ◽  
pp. 179-180
Author(s):  
Jonathan Cubitt
Keyword(s):  
Developing Countries ◽  
Plastic Surgery ◽  
Surgical Training ◽  
Global Burden ◽  
Surgical Disease ◽  
Surgical Trainees ◽  
Clinical Diagnoses ◽  
Developed World ◽  
Humanitarian Work ◽  
Surgical Journals

The global burden of surgical disease has become a popular topic in surgical journals and at conferences over the last few years. As a result more and more surgeons and surgical trainees are volunteering for humanitarian work in developing countries. The experiences gained by a surgeon abroad improve clinical and surgical skills, introduce clinical diagnoses rarely seen in the developed world and help to provide perspective. Recent publications go so far as to suggest that surgical missions should become an intrinsic part of surgical training.

SP2.2.1Improving surgical training: core programme performance related to rotation theme, design, and trainee protocol engagement

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Performance Management ◽  
Outcome Measures ◽  
Surgical Training ◽  
General Surgery ◽  
Primary Outcome ◽  
Multivariable Analysis ◽  
Scientific Article ◽  
Specialty Training ◽  
Surgical Specialty ◽  
National Training

Abstract Aims Core Surgical Training (CST) and Improving ST (IST) programmes are in flux and their design controversial. This study aimed to evaluate the relative performance of a single Statutory Education Board’s (SEB) CST and IST programmes related to rotation design, theme, and protocol engagement. Methods Individual rotations numbering 181 were analysed prospectively over six-years (2014 to 2020). Primary outcome measures were MRCS pass and specialty National Training Number (NTN) appointment. Results Overall MRCS pass was 68.5% and NTN appointment 39.2%. NTN appointment related to rotation design varied from zero to 100% (median 40.0%). Conversion to NTN varied by specialty theme and ranged from: General surgery CST 35.6% to General surgery (IST pilot) 87.5% (p = 0.004). Multivariable analysis revealed NTN appointment was associated with: operative logbook caseload >464 (OR 3.02, p = 0.068), scientific article publication (OR 4.82, p = 0.006), and universal ARCP Outcome 1 (OR 37.83, p < 0.001), and IST (OR 55.54, p = 0.006). Conclusions Focused rotational design allied to enhanced performance management, and protocol engagement, were associated with improved conversion to higher surgical specialty training.

Improving Core Surgical Training in Plastic Surgery

2012 ◽  
Vol 94 (9) ◽  
pp. 304-306
Author(s):  
O Gilleard ◽  
N Segaren ◽  
D Markeson ◽  
R Uppal ◽  
Y Tavsanoglu ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Surgical Training ◽  
Outpatient Clinic ◽  
Service Provision ◽  
Operating Theatre ◽  
Outpatient Clinics ◽  
Medical Careers ◽  
Surgical Trainees ◽  
European Working

Since the introduction of the European Working Time Regulations (EWTR) and Modernising Medical Careers (MMC), concerns have been raised regarding the quality of early surgical training. Recurring issues include the lack of time spent in the operating theatre and outpatient clinic with increased time spent on service provision. As a means of restoring the quality of early surgical training, the Joint Committee on Surgical Training (JCST) has devised a set of SMART (specific, measurable, attainable, relevant, time-framed) standards to be met by core surgical trainees (CSTs). These include the following scheduled weekly activities: four half-day sessions (18 hours) supervised in the operating theatre, one half-day session (4.5 hours) in supervised outpatient clinics and two hours of structured teaching.

scholarly journals The Impact of COVID-19 on Plastic Surgery Training in the United Kingdom, Canada and Australia—A Cross-Sectional Study

2021 ◽  
Author(s):  
Curtis R Budden ◽  
Francesca Rannard ◽  
Joanna Mennie ◽  
Neil Bulstrode
Keyword(s):  
Plastic Surgery ◽  
Statistical Tests ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Surgical Trainees ◽  
Significant Difference ◽  
The Uk ◽  
The Impact

Abstract Background Surgical trainees worldwide have been thrust into a period of uncertainty, with respect to the implications COVID-19 pandemic will have on their roles, training, and future career prospects. It is currently unclear how plastic surgery trainees are being affected by COVID-19. This study examined the experience of plastic surgery trainees in Canada, the UK, and Australia to determine trainee roles during the early COVID-19 emergency response and how training changed during this time. Methods A cross-sectional survey-based study was designed for plastic surgery trainees in the UK, Canada and Australia. In total, 110 trainees responded to the survey. Statistical tests were conducted to determine differences in responses, based on year of training and country of residence. Results In total, 9.7% (10/103) of respondents reported being deployed to cover another service. There was a significant difference between redeployment based on country (p = 0.001). Within the UK group, 28.9% of respondents were redeployed. For trainees not deployed, 95.5% (85/89) reported that there has been a reduction in operative volume. Ninety-seven (94.1%) respondents reported that there were ongoing teaching activities offered by their program. The majority of trainees (66.4%) were concerned about their training. There was a significant difference between overall concern and country (p < 0.05). Conclusion In these unprecedented times, training programs in plastic surgery should be aware of the major impact that COVID-19 has had on trainees and will have on their training. The majority of plastic surgery trainees have experienced a reduction in surgical exposure but have maintained some form of regular teaching.

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

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?

SP2.1.16Prognostic significance of Drivers at Work and Learning Styles in surgical training

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
Luke Hopkins ◽  
Osian P James ◽  
Oliver Luton ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Learning Styles ◽  
Outcome Measures ◽  
Surgical Training ◽  
Primary Outcome ◽  
Response Rate ◽  
Career Progression ◽  
Training Assessment ◽  
Boot Camps ◽  
Surgical Trainees ◽  
National Training

Abstract Aims Drivers at Work (DW) and Learning Styles (LS) refer to a range of contentious theories that aim to account for differences in career progression, yet seldom feature in training assessment. This study aimed to quantify the influence of Core Surgical Trainees’ (CST) DW and LS on career progression. Methods Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single Statutory Education Body. Primary outcome measures were MRCS and National Training Number (NTN) success. Results Of 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p = 0.003). The spectrum of DW was: Please People (25%), Be Perfect (21.3%), Hurry Up (18.5%), Be Strong (13.9%), and Try Hard (0%, p &lt; 0.001). DW was either unequivocal or not provided by 23 CSTs (21.3%). The spectrum of LS was: Converging (34.3%), Accommodating (28.7%), Diverging (23.1%), and Assimilating (13.9%, p = 0.021). MRCS success was not associated with DW (p = 0.703) or LS (p = 0.598). Men were more likely to have Converging LS (29/70, 41.4%), and women Diverging LS (15/38, 39.5%, p = 0.018) and to have team-based LS (Accommodating / Diverging, 26/38 vs. 30/70, p = 0.010). NTN success was associated with LS (p = 0.038) with Convergers achieving most NTNs (65.4%). Conclusions LS are associated with important differences in career progression with Converging LS three-fold more likely to achieve NTNs than Diverging LS.

Prognostic significance of drivers at work and learning styles in surgical training

2021 ◽  
pp. postgradmedj-2021-140930
Author(s):  
Katie Mellor ◽  
Luke Hopkins ◽  
David Bryan Thomas Robinson ◽  
Osian Penri James ◽  
Oliver Luton ◽  
...  
Keyword(s):  
Learning Styles ◽  
Surgical Training ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Training Programme ◽  
Scholarly Activity ◽  
Boot Camps ◽  
Surgical Trainees ◽  
National Training ◽  
Career Progress

Purpose of the studyDrivers at work (DW) and Learning Styles (LS) refer to contentious theories that aim to account for differential career development yet seldom feature in assessment. This study aimed to quantify the influence of core surgical trainees’ (CST) DW and LS on career progress.Study designDW questionnaires and Kolb LS inventories were distributed to 168 CSTs during five consecutive induction boot camps in a single-statutory education body. Primary outcome measures were membership of the Royal College of Surgeons (MRCS) examination and national training number (NTN) success.ResultsOf 108 responses received (response rate 64.3%), 64.8% were male and 35.2% female (p=0.003). DW spectrum was: please people (25.0%), be perfect (21.3%), hurry up (18.5%), be strong (13.9%) and try hard (0%, p<0.001). DW was either equivocal (n=14) or not provided (n=9) by 21.3% of CSTs. LS were: converging (34.3%), accommodating (28.7%), diverging (23.1%) and assimilating (13.9%, p=0.021). Men were more likely to be convergers (29/70, 41.4%), and women divergers (15/38, 39.5%, p=0.018) also preferring team-based LS (accommodating/diverging, 26/38 (68.4%) vs 30/70 (42.9%), p=0.010). MRCS success was not associated with DW (p=0.329) or LS (p=0.459). On multivariable analysis, NTN success was associated with LS (accommodators 64.5%, divergers 32.0%, OR 10.90, p=0.014), scholarly activity (OR 1.71, p=0.001), improving surgical training programme (OR 36.22, p=0.019) and universal ARCP 1 outcome (OR 183.77, p<0.001).ConclusionsLS are associated with important differences in career progress with accommodator twofold more likely than diverger to achieve NTN.

scholarly journals Otoskills training during covid-19 pandemic: a before-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxime Fieux ◽  
Antoine Gavoille ◽  
Fabien Subtil ◽  
Sophie Bartier ◽  
Stéphane Tringali
Keyword(s):  
Surgical Training ◽  
Rating Scale ◽  
Surgical Simulation ◽  
Global Rating Scale ◽  
Middle Ear Surgery ◽  
Global Rating ◽  
Training Requirements ◽  
Significant Difference ◽  
Before And After ◽  
Total Performance

Abstract Background The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator. Methods In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively. Results Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40–0.64], p < 0.001), without a significant difference between novice and intermediate residents. Conclusions This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.

scholarly journals An analysis of the cost of postgraduate training in surgery in Ireland compared to other specialties

2021 ◽  
Author(s):  
Earley H. ◽  
Mealy K.
Keyword(s):  
Surgical Training ◽  
Financial Support ◽  
Postgraduate Training ◽  
Medical Training ◽  
Medical Council ◽  
List Type ◽  
Training Costs ◽  
Considerable Cost ◽  
Surgical Trainees ◽  
The Cost

Abstract Introduction Postgraduate specialty training in Ireland is associated with considerable cost. Some of these are mandatory costs such as medical council fees, while others are necessary to ensure career progression, such as attendance at courses and conferences. In particular, surgical specialities are believed to be associated with high training costs. It is unknown how these costs compare to those borne by counterparts in other specialities. Aims The aims of this study were to Quantify the amount that trainees in Ireland spend on postgraduate training Determine whether a difference exists between surgery and other non-skill-based specialties in terms of expenditure on training Methods A standardised non-mandatory questionnaire was circulated to trainees across two training centres in Ireland. Trainees at all levels were invited to participate. Results Sixty responses were obtained. Fifty-seven questionnaires were fully completed and included for analysis. The median expenditure on training was higher for surgical than non-surgical specialities. Subgroup analysis revealed surgical training was associated with higher expenditure on higher degrees and courses compared to medical training (p = 0.035). > 95% of trainees surveyed felt that greater financial support should be available for trainees during the course of their training. Conclusions This study demonstrated that a career in surgery is associated with higher ongoing costs for higher degrees and courses than counterparts in non-surgical training. All surgical trainees surveyed felt that better financial support should be available. Increasing financial support for may be a tangible way to mitigate against attrition during training.

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