scholarly journals Testicular torsion treatment: the horns of a dilemma?

2020 ◽  
Vol 102 (1) ◽  
pp. 49-53 ◽  
Author(s):  
S Lewis ◽  
L Hopkins ◽  
T Evans ◽  
W Lewis ◽  
R Harries
Keyword(s):  
General Surgery ◽  
Testicular Torsion ◽  
Questionnaire Response ◽  
Surgical Trainee ◽  
Surgical Specialty ◽  
Head Of School ◽  
Confidence Levels ◽  
Surgical Trainees ◽  
Self Administered Questionnaire ◽  
Confidence Rate

Introduction Testicular torsion treatment rests on the horns of a dilemma, with widespread national variation in whether the responsible surgical specialty is general surgery or urology, even in hospitals with both general surgery and urology emergency service assets. This study aimed to quantify higher surgical trainee operative experience and confidence in managing suspected testicular torsion in a single UK deanery (Wales). Materials and methods Anonymised logbook data were obtained via the Intercollegiate Surgical Curriculum Programme version 10 using the head of school report function for all general surgery (n=53) and urology (n=15) higher surgical trainees, which were combined with the distribution of an electronic self-administered questionnaire. Results Median operative scrotal explorations recorded for all general surgery higher surgical trainees and senior general surgery higher surgical trainees (ST7+) was 7 (range 1–22) and 10 (range 1–22), compared with 21 (range 9–64, p=0.00104) and 24 (19–64, p<0.001) for urology higher surgical trainees. The questionnaire response rate was 64.6% (general surgery 31/50, urology 11/15). Confidence levels in assessing adult and paediatric patients were lower in general surgery when compared with urology higher surgical trainees: median adult confidence rate 7/10 compared with 9/10, and paediatric confidence rate 7/10 compared with 8/10 (p<0.001 and p=0.053, respectively). All higher surgical trainees preferred urology as the accountable hospital specialty when both assets were available. Discussion and conclusion General surgery higher surgical trainees receive less than 50% of the operative exposure of urology higher surgical trainees in emergency scrotal surgery, which has important implications for curriculum competence development and patient safety.

scholarly journals P38 COVID-19 impact on Surgical Training And Recovery Planning (COVID-STAR) Survey

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Surgical Trainee ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Training Time ◽  
Surgical Trainees ◽  
And Training

Abstract Background The COVID-19 pandemic has resulted in dynamic changes to healthcare delivery. Surgery as a specialty has been significantly affected and with that the delivery of surgical training. Method This national, collaborative, cross sectional study comprising 13 surgical trainee associations distributed a pan surgical specialty survey on the COVID-19 impact on surgical training over a 4-week period (11th May - 8th June 2020). The survey was voluntary and open to medical students and surgical trainees of all specialties and training grades. All aspects of training were qualitatively assessed. This study was reported according to STROBE guidelines. Results 810 completed responses were analysed. (M401: F 390) with representation from all deaneries and training grades. 41% of respondents (n = 301) were redeployed with 74% (n = 223) redeployed &gt; 4 weeks. Complete loss of training was reported in elective operating (69.5% n = 474), outpatient activity (67.3%, n = 457), Elective endoscopy (69.5% n = 246) with &gt; 50% reduction in training time reported in emergency operating (48%, n = 326) and completion of work-based assessments (WBA) (46%, n = 309). 81% (n = 551) reported course cancellations and departmental and regional teaching programmes were cancelled without rescheduling in 58% and 60% of cases respectively. A perceived lack of Elective operative exposure and completions of WBA’s were the primary reported factor affecting potential training progression. Overall, &gt; 50% of trainees (n = 377) felt they would not meet the competencies required for that training period. Conclusion This study has demonstrated a perceived negative impact on numerous aspects of surgical training affecting all training specialties and grades.

Postoperative surgical trainee opioid prescribing practices (POST-OPP): A national survey

2019 ◽  
Vol 15 (4) ◽  
pp. 307-322 ◽  
Author(s):  
David J. Hall, MD ◽  
Juan C. Mira, MD ◽  
Melissa R. Hoffman, MD, ND ◽  
Hari B. Keshava, MD, MS ◽  
Kevin R. Olsen, MD ◽  
...  
Keyword(s):  
Pain Management ◽  
Medical School ◽  
General Surgery ◽  
Online Survey ◽  
Management Training ◽  
Prescribing Practices ◽  
Surgical Trainee ◽  
Opioid Prescribing ◽  
Surgical Trainees ◽  
The Impact

Background: Increasing opioid-related deaths have heightened focus on combating the opioid epidemic. The impact of surgical trainees on opioid-related deaths is unclear, and there is little data examining the association between trainee pain management education and opioid prescribing practices.Methods: An anonymous, online survey was distributed to members of the Resident and Associate Society of the American College of Surgeons. The survey covered five themes: education and knowledge, prescribing practices, clinical case scenarios, policy, and beliefs and attitudes. Linear mixed models were used to evaluate the influence of respondent characteristics on reported morphine milligram equivalents (MME) prescribed for common general surgery clinical scenarios.Results: Of 427 respondents, 54 percent indicated receiving training in postoperative pain management during medical school and 66 percent during residency. Only 35 percent agreed that they had received adequate training in prescribing opioids. There was a significant association between undergoing formal pain management training in medical school and prescribing fewer MME for common outpatient general surgery scenarios (94 ± 15.2 vs 108 ± 15.0; p = 0.003). Similarly, formal pain management training in residency was associated with prescribing fewer MME in the survey scenarios (92.6 ± 15.2 vs 109 ± 15.2; p = 0.002).Conclusion: In this survey, nearly two-thirds of surgical residents felt that they were inadequately trained in opioid prescribing. Our findings additionally suggest that improving education may result in increased resident comfort with managing surgical pain, potentially leading to more responsible opioid prescribing. Further work will facilitate residency programs’ development of educational curricula for opioid prescribing best practices.

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 982 Higher General Surgical Trainee preferences for Annual Review of Competency Progression during COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Khan ◽  
G Torpiano ◽  
N Galbraith ◽  
M McLellan ◽  
A Lannigan
Keyword(s):  
Surgical Training ◽  
Annual Review ◽  
Surgical Trainee ◽  
Training Groups ◽  
Surgical Trainees ◽  
The Impact

Abstract Aim The COVID-19 pandemic has caused significant disruption in surgical training. We aim to explore the preferences of higher general surgical trainees for Annual Review of Competency Progression (ARCP) also compare the responses across different training grades. Method All higher general surgical trainee in a single deanery were invited to participate in an online voluntary anonymous survey. The respondents were divided in two groups: junior (ST3-ST5) and senior higher surgical trainees (ST6-ST8) and responses compared. Results Sixty-four of 88 trainees responded. Thirty-three (51.6%) were ST3–ST5, 24 (37.5%) were ST6–ST8 and 7 (10.9%) were out-of-training. More trainees in ST3–ST5 group preferred to defer the next rotation for 12 months (18.2% vs 0%, p = 0.034), repeat current sub-specialty (33.3% vs 4.2%, p = 0.009), or add 12 months to training and delay predicted CCT date by 12 months (18.2% vs 0%, p = 0.034). Most trainees in both groups preferred the option of prolonging training should be offered to all trainees with an option to decline extension if ARCP competencies met (66.7% vs 50.0%, p = 0.276). Conclusions The preference for ARCP and length of training was different between two training groups, hence the need of trainees should be considered by training committees when addressing the impact of COVID-19.

scholarly journals TP8.2.10 Impact of COVID-19 on General Surgery Training in a University Hospital with Ring Fenced Elective Centre

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Tanzeela Gala ◽  
Quratul Ain ◽  
Chekwas Obasi ◽  
Hajar Rashid ◽  
Sarkhell Radha ◽  
...  
Keyword(s):  
General Surgery ◽  
Normal Activity ◽  
University Hospital ◽  
Surgical Trainees ◽  
Higher Surgical Training ◽  
Theatre Utilisation ◽  
The Impact ◽  
Second Wave ◽  
Training Opportunities ◽  
General Surgery Training

Abstract Aim Higher Surgical training was decimated by the COVID-19 pandemic with cessation of elective care. Trainees raised concerns that the elective restart and need for higher theatre activity to clear backlogs would impact on training opportunities. This study evaluated the resumption of training associated with a ring-fenced elective centre (EC). Methods The EC was established in July 2020 and three time periods were determined: pre-COVID (10/19-2/20), 1st wave of COVID (3/20-7/20) and post EC go-live (8/20-12/20). Data was collated from the E-Logbooks of General Surgery Registrars. Results The normal all-speciality pre COVID theatre-activity averaged 1052 cases/month. During the first wave elective activity decreased to 254 cases/month (24% of normal activity). Within 5 weeks of establishment of the EC, theatre activity was near normal despite a reduced number of theatres (with higher theatre utilisation). Pre COVID, trainees accessed 22.9 cases per month which then dropped to 7.7 cases during the first wave of COVID. Post the go live of the EC, trainees were able to operate on 20 cases per month almost back to normal training levels. Prior to the impact of the second wave, each trainee had developed a deficit of 90 cases during the 5 months pause. Conclusion The ring-fenced elective centre has protected training opportunities for higher surgical trainees. However, the pause in training requires a targeted training recovery plan to overcome the deficit secondary to the first and subsequent waves of COVID to ensure that the JCST target of 1200 cases can be met for CCT.

Ice-Cream Headache - A Large Survey of 8359 Adolescents

Cephalalgia ◽  
2003 ◽  
Vol 23 (10) ◽  
pp. 977-981 ◽  
Author(s):  
Jong-Ling Fuh ◽  
Shuu-Jiun Wang ◽  
Shiang-Ru Lu ◽  
Kai-Dih Juang
Keyword(s):  
High Schools ◽  
Response Rate ◽  
Junior High ◽  
Ice Cream ◽  
Target Population ◽  
Junior High Schools ◽  
Questionnaire Response ◽  
Large Survey ◽  
Self Administered Questionnaire

We conducted a self-administered questionnaire to investigate ice-cream headache in school adolescents aged 13-15 in Taiwan. The target population was 8789 students in 6 public junior high schools. A total of 8359 students completed the questionnaire (response rate 95.1%). The prevalence of ice-cream headache was 40.6%. It was significantly higher in boys than in girls, and increased with grade. Students with migraine had a higher frequency of ice-cream headache compared with the students without migraine (55.2% vs. 39.6%, P < 0.0001). The prevalence of ice-cream headache increased among students with more migrainous features. Approximately one third of students decreased their intake of ice cream, or abstained completely, especially the younger students. Our study suggests icecream headache is very common in Taiwanese adolescents, and it is more common in students who experienced migraine.

scholarly journals Impact of the COVID-19 pandemic on core surgical training

2020 ◽  
Vol 65 (4) ◽  
pp. 133-137 ◽  
Author(s):  
Khurram Shahzad Khan ◽  
Rona Keay ◽  
Morag McLellan ◽  
Sajid Mahmud
Keyword(s):  
Surgical Training ◽  
Teaching Hospital ◽  
General Surgery ◽  
Negative Impact ◽  
Outpatient Clinics ◽  
Box Trainer ◽  
Surgical Trainees ◽  
Long Term Impact ◽  
The Impact

Background and aims COVID-19 pandemic has caused significant disruption in training which is even more pronounced in the surgical specialties. We aim to assess the impact of COVID-19 pandemic on core surgical training. Methods All core surgical and improving surgical trainees in West of Scotland region were invited to participate in an online voluntary anonymous survey via SurveyMonkey. Results 28 of 44 (63.6%) trainees responded, 15 (53.6%) were CT1/ST1. 14 (50.0%) working in teaching hospital and 15 (53.6%) working in general surgery. 20 (71.4%) felt that due to the pandemic they have less opportunity to operate as the primary surgeon. 21 (75.0%) have not attended any outpatient clinics. 8 (28.6%) did not have any form of access to the laparoscopic box-trainer. 20 (71.4%) felt their level of confidence in preforming surgical skills has been negatively impacted. 18 (64.3%) found it difficult to demonstrate progress in portfolio. 21 (75.0%) trainees have not attended any teaching. 10 (35.7%) trainees have been off-sick. 8 (28.6%) trainees have felt slightly or significantly more stressed. Conclusion COVID-19 pandemic has an unprecedented negative impact on all aspects of core surgical training. The long term impact on the current cohort of trainees is yet to be seen.

scholarly journals EVALUATION OF ETHICAL IN INSTRUCTIONS TO AUTHORS OF BRAZILIAN SURGICAL JOURNALS

2015 ◽  
Vol 28 (4) ◽  
pp. 247-249
Author(s):  
Renan Kleber Costa TEIXEIRA ◽  
Vitor Nagai YAMAKI ◽  
Ruy Victor Simões PONTES ◽  
Marcus Vinicius Henriques BRITO ◽  
José Antonio Cordero da SILVA
Keyword(s):  
General Surgery ◽  
Scientific Journal ◽  
Average Score ◽  
Research Protocol ◽  
Surgical Specialty ◽  
Specific Research ◽  
Significant Difference ◽  
New Research ◽  
Surgical Journals ◽  
Ethical Requirement

Background: The instructions to authors are the only means of communication between researchers and the editorial standards of a scientific journal. One of the mandatory items to be contained therein is about the ethical part, to prevent new research to carry out abuses with the enrolled on the research are published and stimulated. Aim: To verify the ethical questions on the guidelines of Brazilian surgical journals Method: Thirteen selected journals were divided into two groups: general surgery (n=3), and surgical specialty (n=10). The instructions to authors were analyzed by the quote of ethical requirements based on a specific research protocol, ranging from zero to six points. Results: The average score of the general surgery group was similar than that of the surgical specialty group (3.66±0.57 vs 3.30±1.15, p=0.6154). When each ethical requirement was compared between the groups, there was no significant difference between the ethical requirements (p<0.05). Conclusion: There was respect for most ethical questions evaluated, with no difference between the journals of general or specialty surgery.

National Selection into General Surgery: A Pilot Study

2011 ◽  
Vol 93 (9) ◽  
pp. 1-10 ◽  
Author(s):  
PM Lamont ◽  
G Griffiths ◽  
L Cochrane
Keyword(s):  
General Surgery ◽  
Selection Process ◽  
Personal Communication ◽  
Medical Specialty ◽  
Specialty Training ◽  
Surgery Training ◽  
Medical Careers ◽  
Surgical Trainees ◽  
National Selection ◽  
General Surgery Training

General surgery training in England ceased to run through to completion of training from specialty training level one (ST1) as of August 2010. Instead, a second competitive interview to enter ST3 has been introduced. As a result, up to 180 ST3 vacancies in general surgery should become available for recruitment each year in England, according to figures obtained from Medical Specialty Training (England), the successor to Modernising Medical Careers (MMC) (personal communication). The general surgery specialist advisory committee (SAC) was asked in 2008 by MMC to consider how best to appoint to these ST3 posts. Experience from other surgical specialties has shown that a national selection process offers the potential to recruit the best core surgical trainees.

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