Transfusion knowledge of medical and surgical specialty board residents: a cohort study

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.

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Can ACGME Milestones predict surgical specialty board passage: an example in Obstetrics and Gynecology

Clinical and Experimental Obstetrics & Gynecology ◽

10.31083/j.ceog4805168 ◽

2021 ◽

Vol 48 (5) ◽

pp. 1048

Keyword(s):

Obstetrics And Gynecology ◽

Surgical Specialty ◽

Specialty Board

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Facility type and surgical specialty are associated with suboptimal surgical antimicrobial prophylaxis practice patterns: a multi-center, retrospective cohort study

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-019-0503-9 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 5

Author(s):

Westyn Branch-Elliman ◽

Steven D. Pizer ◽

Elise A. Dasinger ◽

Howard S. Gold ◽

Hassen Abdulkerim ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Practice Patterns ◽

Antimicrobial Prophylaxis ◽

Surgical Specialty ◽

Facility Type ◽

Surgical Antimicrobial Prophylaxis

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O46 Differences in ARCP outcome by surgical specialty: a longitudinal cohort study

British Journal of Surgery ◽

10.1093/bjs/znab282.051 ◽

2021 ◽

Vol 108 (Supplement_5) ◽

Author(s):

C Hope ◽

J Lund ◽

G Griffiths ◽

D Humes

Keyword(s):

Cohort Study ◽

General Surgery ◽

Primary Outcome Measure ◽

Older Age ◽

Longitudinal Cohort Study ◽

Annual Review ◽

Surgical Specialty ◽

Longitudinal Cohort ◽

The Uk ◽

To Receive

Abstract Introduction Surgical training in the UK is comprised of ten specialties: cardiothoracic, general, neurosurgery, oral and maxillofacial (OMFS), otolaryngology, paediatric, plastic, trauma and orthopaedics, urology and vascular surgery. Progression through training is assessed by the Annual Review of Competency Progression (ARCP). The aim is to examine ARCP outcomes within UK surgical specialty training and identify differences between specialties. Method A longitudinal cohort study using data from United Kingdom Medical Education Database (UKMED) was performed across surgical specialities. ARCP outcome was the primary outcome measure. Multi-level univariate and multiple ordinal regression analyses were performed. Result 8,220 trainees with an ARCP outcome between 2010 and 2017 were included, comprising 31,788 ARCP outcomes. There was substantial variation in the proportion of non-standard outcomes 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 outcome compared to T&O trainees (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 outcomes of surgical ARCP’s across specialties. General surgery has higher rates of non-standard ARCP outcomes compared to other surgical specialities. Across all specialities, female sex and older age were associated with non-standard outcomes. Further studies are required to explore these associations. Take-home Message There is significant variation in ARCP outcomes between specialities. Women and older trainees receive significantly more non-standard outcomes.

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Case Exercise: Toxic Exposure-Related Illness: Causation, Diagnosis, and Permanent Impairment

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.marapr02 ◽

2007 ◽

Vol 12 (2) ◽

pp. 4-8

Author(s):

Frederick Fung

Keyword(s):

Concentration Level ◽

Treatment Plan ◽

Toxic Exposure ◽

Dose Response Relationship ◽

Specialty Board ◽

History Of ◽

Subjective Complaints ◽

Based Medicine ◽

Illness Causation ◽

Rule Out

Abstract A diagnosis of toxic-related injury/illness requires a consideration of the illness related to the toxic exposure, including diagnosis, causation, and permanent impairment; these are best performed by a physician who is certified by a specialty board certified by the American Board of Preventive Medicine. The patient must have a history of symptoms consistent with the exposure and disease at issue. In order to diagnose the presence of a specific disease, the examiner must find subjective complaints that are consistent with the objective findings, and both the subjective complaints and objective findings must be consistent with the disease that is postulated. Exposure to a specific potentially causative agent at a defined concentration level must be documented and must be sufficient to induce a particular pathology in order to establish a diagnosis. Differential diagnoses must be entertained in order to rule out other potential causes, including psychological etiology. Furthermore, the identified exposure at the defined concentration level must be capable of causing the diagnosis being postulated before the examiner can conclude that there has been a cause-and-effect relationship between the exposure and the disease (dose-response relationship). The evaluator's opinion should make biological and epidemiological sense. The treatment plan and prognosis should be consistent with evidence-based medicine, and the rating of impairment must be based on objective findings in involved systems.

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