Abstract
BackgroundThere is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. We aimed to quantify the operative exposure of all trainees on the National Basic Surgical Training (BST) programme in Ireland and compare the results with arbitrary training targets.MethodsRetrospective analysis of data obtained from a web-based logbook (http://www.elogbook.org) for all general surgery and orthopaedic training posts between July 2007 and June 2009.Results104 trainees recorded 23,918 operations between two 6-month general surgery posts. The most common general surgery operation performed was simple skin excision with trainees performing an average of 19.7 (± 9.9) over the 2-year training programme. Trainees most frequently assisted with cholecystectomy with an average of 16.0 (± 11.0) per trainee. Comparison of trainee operative experience to arbitrary training targets found that 2-38% of trainees achieved the targets for 9 emergency index operations and 24-90% of trainees achieved the targets for 8 index elective operations. 72 trainees also completed a 6-month post in orthopaedics and recorded 7,551 operations. The most common orthopaedic operation that trainees performed was removal of metal, with an average of 2.90 (± 3.27) per trainee. The most common orthopaedic operation that trainees assisted with was total hip replacement, with an average of 10.46 (± 6.21) per trainee.ConclusionsA centralised web-based logbook provides valuable data to analyse training programme performance. Analysis of logbooks raises concerns about operative experience at junior trainee level. The provision of adequate operative exposure for trainees should be a key performance indicator for training programmes.
Highlights
There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices
Data has been published on the operative experience of senior trainees in general surgery [6,7] and orthopaedics [8,9,10,11] in the United Kingdom and Ireland
This study was exempt from review by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee as the data was collected for the purpose of auditing operative exposure by basic surgical trainees
Summary
There is concern about the adequacy of operative exposure in surgical training programmes, in the context of changing work practices. Recent data from the United States, suggests that the operative exposure of junior surgical trainees may be affected by these changes to an even greater extent [4,5]. Since July 2007, all new entrants to the BST programme have been required to keep a record of their operative experience using a web-based logbook. This has allowed us a unique opportunity to comprehensively analyse the operative experience of a large cohort of junior surgical trainees and their role in these operations
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