A five-year review of operative experience and indicative numbers in urological training in the UK and Ireland

Abstract

Objective: The Joint Committee of Surgical Training guidelines for the award of a Certificate of Completion of Training in urology were updated in 2015. In 2015, we published operative logbook data from Certificate of Completion of Training in urology applications in 2010–2012 in line with the original 2011 guidelines. This study reviewed a contemporary cohort against the 2015 guidelines and this previous cohort to evaluate whether the number of trainees achieving these requirements had changed. Materials and methods: All Certificate of Completion of Training in Urology application logbooks from March 2014–October 2015 (77 in total, 2015 cohort) were reviewed and compared to 154 logbooks in 2010–2012 (2012 cohort). Results: There was a significant increase ( p<0.05) in the percentage of trainees achieving indicative exposure in 10 domains in the 2015 cohort according to the updated guidelines. Percentage increases included male lower urinary tract symptoms procedures from 68.2% to 88.3%, transurethral resection of bladder tumour from 64.3% to 89.6%, paediatric urology from 1.9% to 23.4%, female incontinence from 9.7% to 33.8% and andrology from 9.1% to 42.9%. There were significant reductions ( p<0.01) in mean operative numbers for transurethral resection of bladder tumour and male lower urinary tract symptoms procedures from 184 to 162 and 187 to 161, respectively. One trainee in the 2015 cohort achieved requirements in all 17 domains and 55% failed to meet the requirement in ⩾5 domains. Conclusions: While an increasing number of trainees currently meet Joint Committee of Surgical Training expectations, some domains remain at low levels. Despite this, no trainee to date has not been awarded a Certificate of Completion of Training as a direct consequence of this, but this could become a possibility in the near future, and it is the responsibility of Local Education Training Boards and trainees to ensure that indicative numbers are both achievable and achieved.