scholarly journals Exposure to and training in the control of major intraoperative haemorrhage: a survey of surgical trainees

2021 ◽  
Vol 103 (1) ◽  
pp. 28-31
Author(s):  
RJ Brown ◽  
SA Hosgood ◽  
R Praseedom ◽  
ML Nicholson
Keyword(s):  
Surgical Training ◽  
Emergency Surgery ◽  
Large Animal ◽  
Surgical Trainees ◽  
The Uk ◽  
And Training

Recent changes in surgical training coupled with increased specialisation of surgeons have led to reduced exposure for trainees to general and emergency surgery. We conducted a survey of all current general surgical trainees in the East of England to ascertain levels of experience and extent of training in dealing with major intra-operative haemorrhage during surgery. The findings confirmed that trainees lack exposure to and training in this area. Respondents were keen to see improvements in the existing training pathway and the majority were supportive of the establishment of a live large animal course in the UK as part of the solution.

scholarly journals A Critical Appraisal of the Evidence of Current Methods of Assessment for Surgical Trainees

2013 ◽  
Vol 95 (6) ◽  
pp. 7-11
Author(s):  
AJ Batchelder ◽  
MJ McCarthy
Keyword(s):  
Surgical Training ◽  
Critical Appraisal ◽  
Junior Doctors ◽  
The Past ◽  
Medical Careers ◽  
Surgical Trainees ◽  
The Uk ◽  
Supervision And Training ◽  
And Training

Over the past decade training pathways in the UK have been subject to extensive changes. Concerns regarding the supervision and training of junior doctors led to a number of reforms that were implemented through the Modernising Medical Careers programme and these mandated formalisation of curricula for all specialties. Consequently, the surgical royal colleges of the UK and Ireland designed the Intercollegiate Surgical Curriculum Programme (ISCP), which delineates the framework for surgical training from core trainee level through to the award of a Certificate of Completion of training.

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 > 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 > 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, > 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.

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.

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 O9 The Effects of Coronavirus (COVID-19) on operative and work-based assessment (WBA) activity on surgical training

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
◽  
Joshua Clements
Keyword(s):  
Surgical Training ◽  
Negative Impact ◽  
Training Programme ◽  
Continuous Variables ◽  
Data Governance ◽  
Training Activity ◽  
Surgical Trainees ◽  
Percentage Difference ◽  
The Impact ◽  
And Training

Abstract Background COVID-19 has had a global impact on all aspects of healthcare including surgical teaching and training. The COVID-STAR qualitative study demonstrated a perceived negative impact of COVID-19 on numerous aspects of surgical training across all specialties and training grades. The aim of this study is to investigate how COVID-19 has affected operative case exposure and work-based assessments for surgeons in training. Methods Anonymized data has been sought from the Intercollegiate Surgical Curriculum Programme (ISCP) database for operations and work-based assessments in each specialty, involving surgical trainees on an approved training programme at defined Pre-COVID (16/03/19 – 11/05/19) and COVID (16/03/2020 – 11/05/20) timepoints. Primary outcome measures are the percentage (%) difference in WBA and operative activity between time points respectively. Differences in training activity between time periods will be tested using Pearson χ2 and Kruskal–Wallis tests for categorical and continuous variables respectively. Results This study has been approved by the ISCP Data Analysis, Audit and Research Group, and data will be managed in accordance with ISCP data governance. The hypothesis of this study is that COVID-19 has caused a reduction in the operative and WBA activity of trainees across all specialties. Conclusion This study seeks to quantify the impact of COVID-19 on operative training activity and completion of WBAs in clinical practice. This information will inform major stakeholders involved in optimising surgical training in the COVID-19 recovery phase.

scholarly journals 1358 Does A COVID Protected Hospital Within A COVID Hospital Enable Elective Care and Training Opportunities?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Rashid ◽  
T Gala ◽  
Q Ain ◽  
H Ashraf ◽  
S Vesamia ◽  
...  
Keyword(s):  
Critical Care ◽  
Training Environment ◽  
Informatics System ◽  
Surgical Trainees ◽  
Business Informatics ◽  
The Uk ◽  
The Impact ◽  
Second Wave ◽  
Training Opportunities ◽  
And Training

Abstract Introduction Elective care in the UK came to a standstill with the advent of the COVID-19 pandemic. A restart could only be enabled with ‘green site’ separation and a ‘covid protected’ zone. A ‘hospital within the hospital’ concept was developed including 9 elective theatres, 28 ring fenced elective beds, a surgical enhanced care unit, a canteen, and a separated entrance. This model was underpinned with PPE, enhanced infection control and guidance for staff. The study documented the ability to recover elective activity and therefore provide a training environment for surgical trainees. Method Data was collected weekly (7/20 to 1/21) through the business informatics system with regard to theatres cases completed compared to the activity achieved in the 11-theatre elective estate pre COVID-19. Results Pre COVID-19, an average of 263 cases were completed per week. In the first week of operation, 31% of theatre capacity was achieved. By week 7, 106% of pre COVID was recorded and 130% by week 11. This was maintained until the impact of the second wave where activity has reduced to 50% but is not anticipated to reduce further as local anaesthetic and blocks maybe utilised. Conclusions This ‘hospital within the hospital’ has enabled elective care to return to above normal levels, with increased efficiencies. This has enabled a rapid return to a training environment for trainees disheartened with deployment to critical care in the first wave.

scholarly journals Study leave funding: a national survey of postgraduate centres

2007 ◽  
Vol 89 (5) ◽  
pp. 164-166
Author(s):  
R Moorthy ◽  
V Veer ◽  
L Abbas
Keyword(s):  
Surgical Training ◽  
National Survey ◽  
Surgical Trainees ◽  
The Uk

All surgical trainees attend courses. Their training is enhanced as a result, indeed, some courses are even mandatory. But these courses are not cheap. This paper examines the study leave budgets for surgical trainees across the UK and reveals inconsistencies between deaneries and also within deaneries. It raises some important questions and is a pointer toward a debate that I am sure will occur sometime soon: who should pay for surgical training? In order to benefit from the most consistently well-trained workforce best able to care for patients, should it be the taxpayer, or in an increasingly cashstrapped NHS should trainees fund themselves?

scholarly journals Curtailment of Higher Surgical Training in the UK: Likely Effects in Otology

2005 ◽  
Vol 98 (6) ◽  
pp. 259-261 ◽  
Author(s):  
J Ray ◽  
E Hadjihannas ◽  
R M Irving
Keyword(s):  
Skull Base ◽  
Surgical Training ◽  
Questionnaire Survey ◽  
Training Programme ◽  
Surgical Trainees ◽  
Operative Experience ◽  
Higher Surgical Training ◽  
One Year ◽  
The Uk

Higher surgical training in the UK faces a cut of two years. We conducted a questionnaire survey to assess the operative experience of current higher surgical trainees in otological surgery and the likely effect of the proposed reduction from six to four years. 91 (65%) of the 142 higher surgical trainees responded with details of major otological procedures performed (independently or assisting) over one year. In the present six-year scheme a typical trainee performs 72 myringoplasties, 79 mastoidectomies, 7 skull base procedures and 28 other procedures. In the first four years, however, his or her experience is only 39 myringoplasties, 44 mastoidectomies, 4 skull base procedures and 7 others. The large shortfall in experience that might result from shortening of the training programme would need to be met by intensification of the training or institution of accredited otology fellowships. Very similar dilemmas are faced by other surgical specialties.

scholarly journals Surgical training in China

2008 ◽  
Vol 90 (3) ◽  
pp. 84-86 ◽  
Author(s):  
Yong-Ming Lu
Keyword(s):  
Communication Skills ◽  
Surgical Training ◽  
Medical Practice ◽  
Training Time ◽  
Surgical Trainees ◽  
Unmet Demand ◽  
The Uk ◽  
Training Opportunities

Many of the problems in the structure of surgical training in our society seem to occur in China as well. Drs Lu and Fau have shown that there is diversity of training opportunities and facilities among Chinese hospitals. Communication skills are becoming as necessary in the East as they are in Western medical practice. It is interesting to note the perceived unmet demand for GPs within China. Our own trainees may feel that they are now contributing to the costs of their training with falling (stolen) study leave budgets but trainee surgeons' salaries in China are a mere fraction of those in the UK. Thankfully, in the UK we don't reduce the training time for those with postgraduate degrees. Perhaps worthwhile exchanges between Chinese and UK surgical trainees may be more feasible following last year's council visit to China?

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