Surgical training in the UK: is cost a barrier to entry?

2021 ◽  
pp. postgradmedj-2020-139170
Author(s):  
Zak Vinnicombe ◽  
Max Little ◽  
Jonathan Super ◽  
Raymond Anakwe
Keyword(s):  
Medical Students ◽  
Surgical Training ◽  
Student Loan ◽  
Socioeconomic Background ◽  
Training Costs ◽  
Surgical Trainees ◽  
Important Relationship ◽  
Surgical Career ◽  
Barrier To Entry ◽  
The Uk

BackgroundThere is good quality evidence linking socioeconomic background and the likelihood of a surgical career. Additionally, training in surgery is more expensive than in other specialties. Our aim was to assess the awareness and perceptions of trainees and medical students of the relative costs of surgical training and to determine whether perceptions of cost deter potential surgical trainees.MethodsMedical students, foundation doctors and core trainees in England were surveyed over a 2-week period. χ2 tests of independence were used to assess statistically significant associations between measured variablesMain findingsA total of 284 responses were received. More than half of respondents (54%) were not previously aware of the high costs of surgical training. More than a quarter of respondents (27%) did not take out a student loan. There was a significant association (p=0.003) between familial income and being less likely to consider a surgical career due to the costs. Respondents who reported receipt of a student loan were also significantly less likely to consider a surgical career due to the costs (p=0.033).ConclusionOur study demonstrates an important relationship between perceived costs of surgical training and future career aspirations. This suggests that access to surgical training may still be difficult for many. This study also highlights a general lack of awareness of high surgical training costs. It is important that surgical training is accessible. Financial status should not be a significant disincentive and widening access to surgical training can only serve to enrich and advance the specialty.

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

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018086 ◽  
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.

Maximizing opportunities at medical school to support a career in surgery

2019 ◽  
Vol 80 (11) ◽  
pp. 670-673
Author(s):  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Surgical Training ◽  
Nominal Group ◽  
Annual Conference ◽  
School Students ◽  
The Core ◽  
Surgical Career ◽  
Competency Based ◽  
The Uk

Introduction: During medical school, students have numerous opportunities to develop their portfolios for a career in surgery, such as undertaking additional surgical placements and participating in surgical research. However, at present, there is little guidance available for medical students on how to build a strong portfolio for the UK core surgical training application. This article outlines work undertaken to provide concise guidance to support future surgeons, via application of the competency-based CanMEDS framework to the current UK core surgical training specification. Materials and methods: A pre-conference meeting was arranged for medical students at the Society of Academic and Research Surgeons annual conference in January 2018. Self-selected research enthusiasts from different university years discussed practical approaches to pair the CanMEDS model with the core surgical training specification, with support from the STARSurg Collaborative committee to facilitate discussion. A nominal group-based method was adopted in order to reach areas of consensus. Results: Practical tips and recommendations for each respective CanMEDS domain (communicator, collaborator, leader, health advocate, scholar, professional) were made in relation to the core surgical training specification. These included key action points and named opportunities that are currently available to UK medical students. Conclusions: A consensus approach was taken to address key areas of competence across each CanMEDS domain. This informed the development of a guidance framework to support students to develop a strong portfolio for a core surgical training application. This framework can be followed by medical students, equipping them with the skills necessary to succeed in their future surgical career.

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.

Outcomes following a dedicated period of research during surgical training

2011 ◽  
Vol 56 (4) ◽  
pp. 206-209 ◽  
Author(s):  
B M Stutchfield ◽  
E M Harrison ◽  
S J Wigmore ◽  
R W Parks ◽  
O J Garden
Keyword(s):  
Surgical Training ◽  
Academic Outcomes ◽  
Online Survey ◽  
Career Progression ◽  
Working Time ◽  
Research Interest ◽  
Surgical Trainees ◽  
Surgical Career ◽  
Training Structure ◽  
Research Period

With recent ‘working-time'-related changes to surgical training structure, the value of dedicated research during surgical training has been questioned. Online survey examining career and academic outcomes following a period of surgically related dedicated research at a Scottish University between 1972 and 2007. Of 58 individuals identified, contact details were available for 49 and 43 (88%) responded. Ninety-five percent ( n = 41) of respondents continue to pursue a career in surgery and 41% ( n = 17) are currently in academic positions. Ninety-one percent ( n = 39) had published one or more first-author peer-reviewed articles directly related to their research, with 53% ( n = 23) publishing three or more. Respondents with a clinical component to their research published significantly more papers than those with purely laboratory-based research ( P = 0.04). Eighty-one percent ( n = 35) thought that research was necessary for career progression, but only 42% ( n = 18) felt research should be integral to training. In conclusion, the majority of surgical trainees completing a dedicated research period, published papers and continued to pursue a surgical career with a research interest. A period of dedicated research was thought necessary for career progression, but few thought dedicated research should be integral to surgical training.

scholarly journals Military General Surgical Training Opportunities on Operations in Afghanistan

2009 ◽  
Vol 91 (5) ◽  
pp. 417-419 ◽  
Author(s):  
Adam J Brooks ◽  
Arul Ramasamy ◽  
David Hinsley ◽  
Mark Midwinter
Keyword(s):  
Surgical Management ◽  
Surgical Training ◽  
Trauma Surgery ◽  
Organ Injury ◽  
Surgical Trauma ◽  
Training Opportunity ◽  
Injury Management ◽  
Surgical Trainees ◽  
Specific Organ ◽  
The Uk

INTRODUCTION In the UK, general surgical specialist trainees have limited exposure to general surgical trauma. Previous work has shown that trainees are involved in only two blunt and one penetrating trauma laparotomies per annum. During their training, nearly half of trainees will not be involved in the surgical management of liver injury, 20% will not undertake a trauma splenectomy and only a quarter will see a trauma thoracotomy. Military general surgical trainees require training in, and exposure to, the surgical management of trauma and specifically military wounding patterns that is not available in the UK. The objective of this study was to determine whether operative workload in the sole British surgical unit in Helmand Province, Afghanistan (Operation HERRICK) would provide a training opportunity for military general surgical trainees. PATIENTS AND METHODS A retrospective theatre log-book review of all surgical cases performed at the Role 2 (Enhanced) treatment facility at Camp Bastion, Helmand Province on Operation HERRICK between October 2006 and October 2007, inclusive. Operative cases were analysed for general surgical trauma, laparotomy, thoracotomy, vascular trauma and specific organ injury management where available. RESULTS A total of 968 operative cases were performed during the study period. General surgical procedures included 51 laparotomies, 17 thoracotomies and 11 vascular repairs. There were a further 70 debridements of general surgical wounds. Specific organ management included five cases of liver packing for trauma, five trauma splenectomies and four nephrectomies. CONCLUSIONS A training opportunity currently exists on Operation HERRICK for military general surgical specialist trainees. If the tempo of the last 12 months is maintained, a 2-month deployment would essentially provide trainees with the equivalent trauma surgery experience to the whole of their surgical training in the UK NHS. Trainees would gain experience in military trauma as well as specific organ injury management.

scholarly journals Attracting medical students and doctors into surgical training in the UK and Ireland

2019 ◽  
Vol 67 ◽  
pp. 107-112 ◽  
Author(s):  
N.R. Walker ◽  
P. Deekonda ◽  
J.C. Glasbey ◽  
S. Rashid ◽  
V.J. Gokani ◽  
...  
Keyword(s):  
Medical Students ◽  
Surgical Training ◽  
The Uk

scholarly journals The NHS reforms: good, bad or neutral? Medical students debate at the College

2012 ◽  
Vol 94 (3) ◽  
pp. 88-89
Author(s):  
Fiona McClenaghan ◽  
Finn Stevenson
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical Schools ◽  
Positive Change ◽  
Undergraduate Medical Students ◽  
The Future ◽  
Surgical Career ◽  
The Uk

The Professor Harold Ellis Medical Student Prize for Surgery, held at the close of 2011, threw open to debate the question of whether the reforms currently under way in the NHS are 'good, bad or neutral'. Sixteen undergraduate medical students with hopes of a surgical career were invited to the College from medical schools all across the UK to present their case either for or against Andrew Lansley's proposed reforms. After giving a five-minute presentation to fellow students, participants were questioned by fellows of the College and Professor Ellis himself. The conclusions reached represented a complete range of opinion from great anticipation of positive change to great concern over the future of the NHS. Both authors were highly commended for their presentations and here we aim briefly to set out our differing opinions on the reforms of the NHS.

Basic surgical training outcomes in the era of the EWTD

2006 ◽  
Vol 88 (6) ◽  
pp. 206-207 ◽  
Author(s):  
BM Frost ◽  
C Beaton ◽  
AN Hopper ◽  
MR Stephens ◽  
WG Lewis
Keyword(s):  
Surgical Training ◽  
Medical Profession ◽  
Junior Doctors ◽  
Training Outcomes ◽  
Mixed Response ◽  
Surgical Trainees ◽  
European Working ◽  
The Uk ◽  
Working Time Directive ◽  
The New Deal

The European Working Time Directive (EWTD) represents the latest challenge to surgical training in the UK, following Calmanisation and the implementation of the New Deal on junior doctors' hours. Compliance with the EWTD in the UK demands shift working patterns and as such it has received a mixed response from the UK medical profession. While physicians in training are relatively content with the regulations of the EWTD, surgical trainees have voiced concerns regarding the potential impact of an altered working week on their clinical experience and training as well as quality of life.

scholarly journals 1559 Motivations of Medical Students and Doctors Leaving the NHS Explored in a Residency Training Application Webinar Series

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Z Y Ooi ◽  
R Ooi ◽  
A Godoi ◽  
E F Foo ◽  
T Woo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Students ◽  
Medical Training ◽  
Junior Doctors ◽  
Specialty Training ◽  
Motivating Factors ◽  
Surgical Trainees ◽  
The Difference ◽  
The Uk

Abstract Aim Traditionally, the UK has been highly regarded as a place for doctors to pursue undergraduate medical training and postgraduate training. However, recent reports show that more than 40% of UK-graduate doctors leave the country to pursue specialty training elsewhere. This paper aims to identify and evaluate the motivating factors for UK graduates to leave the NHS. Method An anonymised questionnaire was disseminated at a webinar series regarding the application process to pursue residency overseas. The data was independently analysed by two reviewers. A one-way ANOVA (with Tukey’s Post Hoc test) was utilised to compare the difference between motivating factors. Results were considered statistically significant for p-values &lt;0.05. Results 1,118 responses from the UK medical students and doctors were collected; of which, 1,001 (89.5%) were medical students, and 88 (7.9%) were junior doctors. There was a higher preference for leaving after the Foundation Programme compared to the other periods (p &lt; 0.0001). There was no difference between leaving after core surgical/medical training and specialty training (p = 0.549). However, both were significantly higher than leaving the NHS after medical school (p &lt; 0.0001). Quality of life and financial prospects (both P-corrected&lt;0.0001 compared individually and to other groups) were the most agreed reasons to leave the NHS, followed by clinical and academic opportunities and, subsequently, family reasons. Conclusions Future work on the quality of life for doctors in the UK, especially for prospective surgical trainees, should be explored. Policymakers should focus on assessing the difference in working hours, on-call hours or wages that may differ among the healthcare systems.

Sign in / Sign up

Export Citation Format

Share Document