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.

Strategic organisational skills predict surgical training success

2020 ◽  
pp. postgradmedj-2020-138763
Author(s):  
Osian Penri James ◽  
David Bryan Thomas Robinson ◽  
Luke Hopkins ◽  
Chris Bowman ◽  
Arfon Powell ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Surgical Training ◽  
Primary Outcome ◽  
Arrival Time ◽  
Neck Surgery ◽  
Annual Review ◽  
Arrival Times ◽  
Boot Camps ◽  
Operative Experience ◽  
National Training

IntroductionSurgical career progression is determined by examination success and Annual Review of Competence Progression (ARCP) outcome, yet data on organisational skills are sparse. This study aimed to determine whether organisational skills related to Core Surgical Training (CST) outcome. Primary outcome measures include operative experience, publications, examination success (Membership of the Royal College of Surgeons or the Diploma in Otolaryngology—Head and Neck Surgery (MRCS/DO-HNS)) and ARCP outcome.MethodsThe study was conducted prospectively at three consecutive CST induction boot camps (2017–2019) providing clinical and simulation training for 125 trainees. Arrival time at course registration was the selected surrogate for organisational skills. Trainees were advised to arrive promptly at 8:45 for registration and that the course would start at 9:00. Trainee arrival times were grouped as follows: early (before 8:45), on time (8:45–8:59am) or late (after 9:00). Arrival times were compared with primary outcome measures.SettingHealth Education and Improvement Wales’ School of Surgery, UK.ResultsMedian arrival time was 8:53 (range 7:55–10:03), with 29 trainees (23.2%) arriving early, 63 (50.4%) on-time and 33 (26.4%) late. Arrival time was associated with operative experience (early vs late; 206 vs 164 cases, p=0.012), publication (63.2% vs 18.5%, p=0.005), MRCS/DO-HNS success (44.8% vs 15.2%, p=0.029), ARCP outcome (86.2% vs 60.6% Outcome 1, p=0.053), but not National Training Number success (60.0% vs 53.3%, p=0.772).ConclusionsBetter-prepared trainees achieved 25% more operative experience, were four-fold more likely to publish and pass MRCS, which aligned with consistent desirable ARCP outcome. Timely arrival at training events represents a skills-composite of travel planning and is a useful marker of strategic organisational skills.

scholarly journals SP2.1.17Prognostic significance of competition ratios in surgical specialty training selection

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
Richard J Egan ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Multivariable Analysis ◽  
Scientific Publication ◽  
Primary Outcome Measure ◽  
Youden Index ◽  
Critical Ratio ◽  
Surgical Specialty ◽  
Surgical Trainees ◽  
Training Post ◽  
National Training

Abstract Aims A Competition Ratio (CR) indicates the ratio of total applications for a training post when compared with numbers of specialty posts available. This study aimed to evaluate CRs’ influence on National Training Number (NTN) selection in a single UK Statutory Education Body. Methods Consecutive Core Surgical Trainees numbering 154 (median years since graduation: four, 105 male, 49 female) were studied over a six-year period. Annual specialty specific CRs were obtained from Health Education England’s website, and primary outcome measure was UK National Training Number (NTN) appointment. Results Overall NTN appointment was 45.5%. Median CR was 2.36; range OMFS 0.70 (2020) to Neurosurgery 22.0 (2020). Multivariable analysis revealed that NTN success was associated with: CR (OR 0.46, p = 0.003), a single scientific publication (OR 6.25, p = 0.001), cohort year (2019, OR 12.65, p = 0.003), and Universal ARCP Outcome 1 (OR 45.24, p < 0.001). CRs predicted NTN appointment with a Youden index defined critical ratio of 4.42; 28.6% (n = 8) vs. 49.2% (n = 62), p = 0.018. Conclusions CRs displayed 30-fold variation, with CRs below 4.42 associated with two-fold better NTN promotion, but strong clinical competence and academic reach again emerged as the principal drivers of career advancement.

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 < 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.

scholarly journals Neurosurgical trainees' perceptions of course value and study leave budgets

2011 ◽  
Vol 93 (3) ◽  
pp. 94-95 ◽  
Author(s):  
Stephen Metcalfe
Keyword(s):  
Surgical Training ◽  
Specialty Training ◽  
Surgical Specialty ◽  
Medical Careers ◽  
Core Training ◽  
Training Programmes ◽  
Course Value

With the advent of Modernising Medical Careers (MMC) in 2007 neurosurgery adopted 'run-through' training, whereby trainees apply to a neurosurgical rotation that takes them through from foundation training to its completion and the award of the Certificate of Completion of Training (CCT). This is in contrast to the post-MMC training programmes for the rest of the surgical specialties, in which trainees apply to a core surgical training (CST) rotation, followed by open competition after their second core training (CT2) year for appointment into a specialty training (ST) rotation in the surgical specialty of their choice.

scholarly journals Differences in progression by surgical specialty: a national cohort study

2021 ◽  
Author(s):  
carla hope ◽  
Jon Lund ◽  
gareth griffiths ◽  
david humes
Keyword(s):  
Cohort Study ◽  
Surgical Training ◽  
General Surgery ◽  
Primary Outcome Measure ◽  
Older Age ◽  
Annual Review ◽  
Surgical Specialty ◽  
Surgical Trainees ◽  
National Cohort ◽  
To Receive

The aim of surgical training across the ten surgical specialties is to produce competent day one consultants. Progression through training is assessed by the Annual Review of Competency Progression (ARCP). Objective This study aimed to examine variation in ARCP outcomes within surgical training and identify differences between specialties. Design A national cohort study using data from United Kingdom Medical Education Database (UKMED) was performed. ARCP outcome was the primary outcome measure. Multi-level ordinal regression analyses were performed, with ARCP outcomes nested within trainees. Participants Higher surgical trainees (ST3-ST8) from 9 UK surgical specialties were included (vascular surgery was excluded due to insufficient data). All surgical trainees across the UK with an ARCP outcome between 2010 to 2017 were included. Results Eight thousand two hundred and twenty trainees with an ARCP outcome awarded between 2010 and 2017 were included, comprising 31,788 ARCP outcomes. There was substantial variation in the proportion of non-standard outcomes recorded across specialties with general surgery trainees having the highest proportion of non-standard outcomes (22.5%) and urology trainees the fewest 12.4%. After adjustment, general surgery trainees were 1.3 times more likely to receive a non-standard ARCP outcome compared to trainees in T&O (OR 1.33 95%CI 1.21-1.45). Urology trainees were 36% less likely to receive a non-standard outcome compared to T&O trainees (OR 0.64 95%CI 0.54-0.75). Female trainees and older age were associated with non-standard outcomes (OR 1.11 95%CI 1.02-1.22; OR 1.04 95%CI 1.03-1.05). Conclusion There is wide variation in the training outcome assessments across surgical specialties. General surgery has higher rates of non-standard outcomes compared to other surgical specialities. Across all specialities, female sex and older age were associated with non-standard outcomes.

scholarly journals The perceived global impact of the COVID-19 pandemic on doctors’ medical and surgical training: an international survey

2021 ◽  
Author(s):  
. TMS Collaborative ◽  
Ryan Laloo ◽  
Rama Santhosh Karri ◽  
Kasun Wanigasooriya ◽  
William Beedham ◽  
...  
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Multivariable Analysis ◽  
Global Network ◽  
International Survey ◽  
Surgical Specialty ◽  
Middle Income ◽  
Middle Income Countries ◽  
Significant Burden ◽  
Training Post

Abstract Introduction The COVID-19 pandemic has resulted in a significant burden on healthcare systems causing disruption to medical and surgical training of doctors globally. Aims and objectives This is the first international survey assessing the perceived impact of the COVID-19 pandemic on training of doctors of all grades and specialties. Methods An online global survey was disseminated using Survey Monkey® between 4th August 2020 and 17th November 2020. A global network of collaborators facilitated participant recruitment. Data was collated anonymously with informed consent and analysed using univariate and adjusted multivariable analysis. Results 743 doctors of median age 27 (IQR: 25-30) were included with the majority (56.8%, n=422) being male. Two-thirds of doctors were in a training post (66.5%, n=494), 52.9% (n=393) in a surgical specialty and 53.0% (n= 394) in low- and middle-income countries. 69.2% (n=514) reported an overall perceived negative impact of the COVID-19 pandemic on their training. A significant decline was noted among non-virtual teaching methods such as face-to-face lectures, tutorials, ward-based teaching, theatre sessions, conferences, simulation sessions and morbidity and mortality meetings (p≤0.05). Doctors from low or middle-income countries were associated with perceived inadequate supervision while performing invasive procedures under general, local or regional anaesthetic. (p≤0.05) Conclusion In addition to the detrimental impact of the COVID-19 pandemic on healthcare infrastructure, there has been an indirect consequence of disrupted training within medical and surgical subspecialties. A focus on reconfiguration of training programs through a variety of additional resources will become imperative to reduce the long-term sequalae of COVID-19 on doctors’ training.

Transition from Chief Residency to Specialty Training: Issues and Solutions

2010 ◽  
Vol 76 (1) ◽  
pp. 85-90
Author(s):  
Don K. Nakayama ◽  
Linda G. Phillips ◽  
R. Edward Newsome ◽  
George M. Fuhrman ◽  
John L. Tarpley
Keyword(s):  
General Surgery ◽  
Chief Resident ◽  
Program Directors ◽  
Specialty Training ◽  
Orientation Programs ◽  
Surgical Specialty ◽  
Specialty Training Program ◽  
Care Problems ◽  
Academic Year ◽  
Administrative Problem

Three fourths of chief residents in general surgery receive further specialty training. The end to start-of-year transition can create administrative conflicts between the residency and the specialty training program. An Internet-based questionnaire surveyed general surgery and surgical specialty program directors to define issues and possible solutions associated with end to start-of-year transitions using a Likert scale. There was an overall response rate of 17.5 per cent, 19.6 per cent among general surgery directors, and 15.8 per cent among specialty directors. Program directors in general surgery felt strongly that the transition is an administrative problem ( P < 0.001). They opposed extra days off at the end of the chief resident year or ending in mid-June, which specialty directors favored ( P < 0.001). Directors of specialty programs opposed starting the year 1 or 2 weeks after July 1, a solution that general surgery directors favored ( P < 0.001). More agreement was reached on whether chief residents should take vacation week(s) at the end of the academic year, having all general surgery levels start in mid-June, and orientation programs in July for specialty trainees. Program directors acknowledge that year-end scheduling transitions create administrative and patient care problems. Advancing the start of the training year in mid-June for all general surgery levels is a potential solution.

scholarly journals Impact of the COVID-19 Pandemic on Surgical Training and Learner Well-Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators

2020 ◽  
Vol 231 (6) ◽  
pp. 613-626 ◽  
Author(s):  
E Christopher Ellison ◽  
Kathryn Spanknebel ◽  
Steven C. Stain ◽  
Mohsen M. Shabahang ◽  
Jeffrey B. Matthews ◽  
...  
Keyword(s):  
Surgical Training ◽  
General Surgery ◽  
Well Being ◽  
Surgical Specialty

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 (&lt;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 Outcome of surgical fellow ships: road to nowhere or highway to higher surgical training?

2007 ◽  
Vol 89 (6) ◽  
pp. 218-219
Author(s):  
MA Morgan ◽  
AN Hopper ◽  
WG Lewis
Keyword(s):  
United Kingdom ◽  
Surgical Training ◽  
General Surgery ◽  
Principal Measure ◽  
The United Kingdom ◽  
Higher Surgical Training ◽  
National Training

Compliance with the raft of recent legislation regarding surgical training in the United Kingdom has spawned a new breed of junior surgeon, the clinical fellow. Advertised and promoted by NHS Trusts with CV-strengthening potential, fellowships are in practice often of questionable training benefit, with a heavy service commitment. The aim of this study, therefore, was to assess the outcomes of such fellowships in one UK deanery. The principal measure of outcome was appointment to an SpR post in general surgery, with type 1 national training number (NTN).

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