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

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.

Training to be a cleft surgeon in the UK

UK cleft services are centralised and involve working in a multidisciplinary team, offering patients a high quality of care and surgeons a potentially enormously rewarding career. Trainees wishing to specialise in cleft surgery should endeavour to gain targetted experience in cleft lip and palate from early in their surgical career as this will stand them in good stead for the cleft training fellowship applications towards the end of higher surgical training.

930 Impact of the COVID-19 Pandemic on Higher General Surgical Training – A West of Scotland Experience

Introduction COVID-19 pandemic has caused significant disruption in all aspects of training. Our aim was to explore the degree of impact caused by the pandemic on higher general surgical trainees. Method All higher general surgical trainees in a single UK deanery were invited to participate in an online, voluntary, anonymous survey via SurveyMonkey. Results 64 (72.7%) of the trainees responded. 39.1% were ST3/4, 29.7% were ST5/6, 20.3% were ST7/8 and 10.9% were out of training (maternity & research). Thirty-five (55.6%) worked in district general hospitals. Forty (68.9%) trainees felt that they had fewer opportunities to be primary surgeon. Forty-two (67.7%) trainees did not have access to laparoscopic simulation trainers. Fifty-two (88.1%) trainees had their courses and 2 (3.4%) had their FRCS part 2 exam postponed. 16 (27.1%) trainees reported they had been off-sick, with a median of 7 days off (range 3-35 days). Thirty-three (55.9%) trainees felt more stressed due to the pandemic and 35 (59.4%) had symptoms of burnout. Conclusions The COVID-19 pandemic has had an unprecedented impact on all aspects of higher surgical training. The most noticeable impact has been on the reduction in the confidence in laparoscopic and endoscopic skills.

550 “No One Told Me About This Side of The Job!” A Novel Method for Teaching Senior Surgical Trainees

Introduction Higher surgical training is specifically geared towards preparation for working as a Consultant, but trainees typically get limited exposure to Consultant level administration tasks. Whilst Consultants are familiar with these tasks, registrars are often naïve to this side of clinical practice and new Consultants find it takes up a significant proportion of their time. We developed an “office admin” simulation session as a method for gaining further non-technical skills in surgery. Method A simulation based on a real Consultant General Surgeon’s workload was created, which included actioning pathology reports, vetting referrals, and planning a theatre list. Trainees were given 40 minutes to work through the tasks before debriefing with an experienced simulation facilitator. Results Six general surgical trainees took part in the pilot. All found it ‘useful’ or ‘very useful’ and stated that it will help prepare them for the role of Consultant. All felt it would make a useful regular addition to the regional teaching programme. Conclusions This novel simulation was well received and demonstrated a useful method to practise these skills in preparing for the role of Consultant. We aim to develop the simulation package further so it can augment the regional speciality training.

962 COVID-19 And ST3 National Selection in Surgery: What Happens to Core Surgical Trainees When We Remove the Face-to-Face Interview?

Introduction The 2020 ST3 recruitment year for Higher Surgical Training (HST) did not have a face-to-face interview due to COVID-19. Candidates were solely scored on portfolio self-assessment alone. We have assessed the impact on Core Surgical Trainee progression into ST3 by comparing the 2020 recruitment year with 2019. Method Total numbers of applicants to ST3 for all 7 surgical sub-specialties that recruit at ST3 level were obtained via Freedom of Information requests from Health Education England (HEE). These were sorted by those who were in CST, had completed CST or had an alternative equivalence certificate. Results Overall applicant numbers were up in 2020, mainly from an increase in applicants with a Certificate of Readiness to Enter Higher Surgical Training. Overall ST3 positions appointed to were down. CST progression rate was down slightly, with an increase in appointees >10 years since graduation. Conclusions The 2020 recruitment year for ST3 HST had a higher number of applicants and lower places available than 2019. The majority of the extra applicants were trainees who have not completed CST in the UK. CST progression rate to HST was down slightly. The lack of face-to-face interview may benefit some candidates graduating >10 years ago.

Experiences in academic publication among ENT trainees in the UK: results from a national survey

Objective This study aimed to provide an objective means of identifying patterns in academic publication among ENT trainees during their higher surgical training. Method A cross-sectional survey was distributed to ENT higher surgical trainees. Results A total of 153 ENT specialty trainees participated, giving a response rate of 46.5 per cent. Across all years of training, the mean number of first author publications was three and the mean number of non-first author publications was two. For trainees at specialty trainee year 8 level, these figures were nine and five, respectively. Participants with doctoral degrees and those in academic programmes published more papers but the mean difference was only significant for the doctoral subgroup (p < 0.0001). Those with additional undergraduate degrees and those in less than full-time training had an overall lower number of publications. Conclusion Participants in the current survey achieved a higher average number of academic publications than is presently required to successfully complete higher surgical training in ENT. It is hoped that these results act as a guide for trainees planning the research component of their training to ensure that they remain competitive at consultant interview.

The effect of surgical complications on ENT trainees

Background The ‘second victim phenomenon’ is a term attributed to the traumatic effect a medical error can have on healthcare professionals. Patient safety incidents have been shown to occur in as many as one in seven patients in hospital. These incidents cause significant, potentially devastating, trauma to patients and their relatives, and can have deep and long-lasting effects on the health professionals involved. These incidents can have a negative impact on doctors’ emotional wellbeing; their professional practice in relation to this impact has not been extensively investigated in surgical trainees. Method A survey of UK otolaryngology trainees was conducted to investigate the effects of complications and medical errors on trainees, and examine how these are discussed within departments. Results and conclusion The findings suggest that further training is required and would be warmly received by otolaryngology trainees as part of higher surgical training.