scholarly journals Does the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination predict ‘on-the-job’ performance during UK higher specialty surgical training?

2018 ◽  
Vol 100 (8) ◽  
pp. 669-675 ◽  
Author(s):  
DSG Scrimgeour ◽  
PA Brennan ◽  
G Griffiths ◽  
AJ Lee ◽  
FCT Smith ◽  
...  
Keyword(s):  
Job Performance ◽  
Royal College ◽  
Multinomial Logistic Regression ◽  
Annual Review ◽  
Specialty Training ◽  
Insufficient Evidence ◽  
Surgical Specialty ◽  
Surgical Trainees ◽  
Level Of Training ◽  
The Uk

Introduction The Intercollegiate Membership of the Royal College of Surgeons (MRCS) is a mandatory examination to enter higher surgical specialty training in the UK. It is designed to help to ensure that successful candidates are competent to practice as higher surgical trainees. The annual review of competence progression (ARCP) assesses trainees’ competence to progress to the next level of training and can be interpreted as a measure of ‘on-the-job’ performance. We investigated the relationship between MRCS performance and ARCP outcomes. Materials and methods All UK medical graduates who passed MRCS (Parts A and B) from 2007 to 2016 were included. MRCS scores, attempts and sociodemographics for each candidate were crosslinked with ARCP outcomes (satisfactory, unsatisfactory and insufficient evidence). Multinomial logistic regression was used to identify potential independent predictors of ARCP outcomes. Results A total of 2570 trainees underwent 11,064 ARCPs; 1589 (61.8%) had only satisfactory outcomes recorded throughout training; 510 (19.9%) had at least one unsatisfactory outcome; and 471 (18.3%) supplied insufficient evidence. After adjusting for age, gender, first language and Part A performance, ethnicity (non-white vs white, OR 1.36, 95% CI 1.08 to 1.71), Part B passing score (OR 0.98, 95% CI 0.98 to 1.00) and number of attempts at Part B (two or more attempts vs one attempt, OR 1.50, 95% CI 1.16 to 1.94) were found to be independent predictors of an unsatisfactory ARCP outcome. Conclusions This is the first study to identify predictors of ARCP outcomes during higher surgical specialty training in the UK and provides further evidence of the predictive validity of the MRCS examination.

A report from the ASiT conference

2011 ◽  
Vol 93 (7) ◽  
pp. 228-228
Author(s):  
ED Fitzgerald
Keyword(s):  
College Presidents ◽  
Royal College ◽  
Surgical Trainees ◽  
The Uk

The 2011 Association of Surgeons in Training (ASiT) conference in April saw nearly 500 delegates attending from across the UK and Ireland. The opportunity to meet and socialise with other surgical trainees, attend clinical updates and trainee prize presentations, and question royal college presidents and surgical leaders was not to be missed.

scholarly journals UK nationals who received their medical degrees abroad: selection into, and subsequent performance in postgraduate training: a national data linkage study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023060 ◽  
Author(s):  
Paul A Tiffin ◽  
James Orr ◽  
Lewis W Paton ◽  
Daniel T Smith ◽  
John J Norcini
Keyword(s):  
Postgraduate Training ◽  
Medical Specialty ◽  
Linkage Study ◽  
Annual Review ◽  
Educational Performance ◽  
Specialty Training ◽  
Subsequent Performance ◽  
Satisfactory Outcome ◽  
Training Programmes ◽  
The Uk

ObjectivesTo compare the likelihood of success at selection into specialty training for doctors who were UK nationals but obtained their primary medical qualification (PMQ) from outside the UK (‘UK overseas graduates’) with other graduate groups based on their nationality and where they gained their PMQ. We also compared subsequent educational performance during postgraduate training between the graduate groups.DesignObservational study linking UK medical specialty recruitment data with postgraduate educational performance (Annual Review of Competence Progression (ARCP) ratings).SettingDoctors recruited into national programmes of postgraduate specialist training in the UK from 2012 to 2016.Participants34 755 UK-based trainee doctors recruited into national specialty training programmes with at least one subsequent ARCP outcome reported during the study period, including 1108 UK overseas graduates.Main outcome measuresOdds of being deemed appointable at specialty selection and subsequent odds of obtaining a less versus more satisfactory category of ARCP outcome.ResultsUK overseas graduates were more likely to be deemed appointable compared with non-EU medical graduates who were not UK citizens (OR 1.29, 95% CI 1.16 to 1.42), although less so than UK (OR 0.25, 95% CI 0.23 to 0.27) or European graduates (OR 0.66, 95% CI 0.58 to 0.75). However, UK overseas graduates were subsequently more likely to receive a less satisfactory outcome at ARCP than other graduate groups. Adjusting for age, sex, experience and the economic disparity between country of nationality and place of qualification reduced intergroup differences.ConclusionsThe failure of recruitment patterns to mirror the ARCP data raises issues regarding consistency in selection and the deaneries’ subsequent annual reviews. Excessive weight is possibly given to interview performance at specialty recruitment. Regulators and selectors should continue to develop robust processes for selection and assessment of doctors in training. Further support could be considered for UK overseas graduates returning to practice in the UK.

scholarly journals BJS.02Graduates from different medical schools vary in their performance on the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examinations

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ricky Ellis ◽  
Duncan Scrimgeour ◽  
Jennifer Cleland ◽  
Amanda Lee ◽  
Peter Brennan
Keyword(s):  
Medical School ◽  
Royal College ◽  
Univariate Analysis ◽  
Medical Schools ◽  
Sociodemographic Factors ◽  
Pass Rates ◽  
Medical Graduates ◽  
Surgical Trainees ◽  
Socio Demographic Factors ◽  
The Uk

Abstract Aims UK medical schools vary in their mission, curricula and pedagogy, but little is known of the effect of this on postgraduate examination performance. We explored differences in outcomes at the Membership of the Royal College of Surgeons examination (MRCS) between medical schools, course types, national ranking and candidate sociodemographic factors. Methods A retrospective longitudinal study of all UK medical graduates who attempted MRCS Part A (n = 9730) and MRCS Part B (n = 4645) between 2007 and 2017, utilising the UK Medical Education Database (https://www.ukmed.ac.uk). We examined the relationship between medical school and success at first attempt of the MRCS using univariate analysis. Logistic regression modelling was used to identify independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P < 0.001). Russell Group graduates were more likely to pass MRCS Part A (Odds Ratio (OR) 1.79 [95% Confidence Interval (CI) 1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])).  Trainees from Standard-Entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses, Part A OR 3.72 [2.69-5.15]; Part B (OR 1.67 [1.02-2.76]. Non-graduates entering medical school were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]) than graduate-entrants. Conclusion Medical school, course type and socio-demographic factors are associated with success on the MRCS. This information will help to identify surgical trainees at risk of failing the MRCS in order for schools of surgery to redistribute resources to those in need.

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 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 <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 < 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 < 0.0001). Quality of life and financial prospects (both P-corrected<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.

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

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.

scholarly journals SP10.2.6 The Quantitative Impact of COVID-19 on surgical training in the United Kingdom

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Joshua Clements ◽  
Joshua Burke ◽  
Carly Hope ◽  
Deirdre Nally ◽  
Gareth Griffiths ◽  
...  
Keyword(s):  
United Kingdom ◽  
Surgical Training ◽  
Elective Surgery ◽  
Outcome Data ◽  
Annual Review ◽  
Surgical Specialty ◽  
The United Kingdom ◽  
Surgical Trainees ◽  
Rate Ratios ◽  
The Impact

Abstract Aims COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. This study aimed to quantify the impact of COVID-19 on operative case numbers recorded by surgeons in training, and annual review of competency progression (ARCP) outcomes in the United Kingdom. Methods Anonymised operative logbook numbers were collated from e-logbook and ARCP outcome data were collated from the Intercollegiate Surgical Curriculum Programme (ISCP) database for trainees across core and the ten higher surgical specialities. Operative logbook numbers and ARCP outcomes were compared between pre-COVID dates. Effect sizes are reported as incident rate ratios (IRR) with 95% confidence intervals (CI). Results 5599 surgical trainees in 2019 and 5310 in 2020 in surgical specialty training were included. The IRR was reduced across all subspecialties because of the COVID-19 pandemic (0.55; 95% CI 0.53-0.57). Elective surgery (0.60; 95% CI 0.59-0.61) was affected more than emergency surgery (0.88; 95% CI 0.86-0.89). Regional variance with reduced operative activity was demonstrated across all specialities. 1 in 8 in their final year of training have not been able to achieve curriculum requirements and have had training extended. 1 in 4 trainees entering their final year of training are behind their expected training trajectory. Conclusion COVID-19 continues to have a significant impact on surgical training in the UK. Urgent, co-ordinated action is required by key stakeholders to mitigate for these effects and maintain future surgical training.

Paediatric otolaryngology services in the UK: a postal questionnaire survey of ENT consultants

2005 ◽  
Vol 119 (4) ◽  
pp. 259-263 ◽  
Author(s):  
E Z Osman ◽  
M K Aneeshkumar ◽  
R W Clarke
Keyword(s):  
Surgical Treatment ◽  
Royal College ◽  
Questionnaire Survey ◽  
Current Practice ◽  
Postal Questionnaire ◽  
Day Case ◽  
Surgical Specialty ◽  
Surgical Services ◽  
The Uk ◽  
Year 2000

Approximately half a million children in England and Wales receive in-patient or day-case surgical treatment annually. Otolaryngology is the surgical specialty that provides the greatest number of episodes of such care. As 30–50 per cent of our total volume of work is paediatric, we feel it is important to assess current attitudes to paediatric otolaryngological practice. In its year 2000 document Children’s Surgery: a First Class Service, The Royal College of Surgeons (RCS) of England sets out recommendations on how children’s surgical services should be delivered in the UK. A postal questionnaire was sent to all UK-based ENT consultant members of the British Association of Otorhinolaryngologists-Head and Neck Surgeons (BAO-HNS). The questionnaire was designed to assess the current practice of paediatric otolaryngology in the UK with an emphasis on the RCS recommendations. Wide variations were found, and they are discussed with reference to the recommendations.

Prognostic significance of competition ratios in surgical specialty training selection

2021 ◽  
pp. postgradmedj-2020-139491
Author(s):  
Katie Mellor ◽  
David B Robinson ◽  
Oliver Luton ◽  
Osian P James ◽  
Arfon GMT Powell ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Prognostic Significance ◽  
Multivariable Analysis ◽  
Scientific Publication ◽  
Primary Outcome Measure ◽  
Youden Index ◽  
Annual Review ◽  
Critical Ratio ◽  
Surgical Specialty ◽  
Surgical Trainees

BackgroundA 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.MethodsConsecutive core surgical trainees numbering 154 (105 men, 49 women; median years since graduation: four) were studied over a 6-year period. Annual specialty specific CRs were obtained from Health Education England’s website, and primary outcome measure was UK NTN appointment.ResultsOverall NTN appointment was 45.5%. Median CR was 2.36; range Oral & Maxillofacial Surgery 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 Annual Review of Competence Progression 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) versus 49.2% (n=62), p=0.018.ConclusionCRs displayed 30-fold variation, with CRs below 4.42 associated with twofold better NTN promotion, but strong clinical competence and academic reach again emerged as the principal drivers of career advancement.

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