Commentary to “Undergraduate Suture and Local Anaesthetic Training in the United Kingdom”

Abstract

The correspondence by Jones et al. provides further proportion of UK undergraduates that would pass their support for improved suture and local anaesthetic training in the United Kingdom. The authors state that our national survey adds to a growing body of evidence highlighting potential insufficiencies in basic surgical skills (BSS) training in the UK. Jones et al. highlight that surgical societies are known to provide more BSS training than medical schools. The authors describe their suturing and wound management courses in which they provide students with “take-home” suturing packs following completion of the course, including disposable instruments, a wound care pack, 2 sutures and a small sharps bin. They state their goal was to promote reinforcement of their new skills at home through repeated practice, which results in long-term retention of BSS skills as demonstrated by Routt et al. This offers a practical solution to the problems highlighted in our national survey. It would therefore be valuable for the authors to perform a comparative study of the competence of students post-BSS course completion with take-home suture packs vs those without suture packs, after a significant time lag. If the differences in their skills are found to be significant, a recommendation could be made to the UK’s General Medical Council to advise the incorporation of take-home suture packs into the undergraduate curriculum to help maintain “Tomorrow’s Doctors” standards. Jones et al. suggest that because our questionnaire made specific reference to only performing skills “without supervision,” this may have underestimated students’ true confidence by excluding students who may be reluctant to close wounds without supervision. Though this may have been the case, we did so intentionally to evaluate the proportions of students competent in performing unsupervised skills prequalification in line with the General Medical Council “Tomorrow’s Doctors” standards. These competencies are then observed during foundation year 1, where newly qualified doctors nationally are assessed performing core competencies by a qualified supervisor as core procedures and directly observed procedures, after which they are expected to perform such procedures unsupervised. Therefore our national survey provides a snapshot of the