Evaluation of a structured clinical program and formal coursework in breast surgeon training in Australia and New Zealand

Abstract

IntroductionBreast surgeon training has been restructured since the inception of Breast Surgeons of Australia and New Zealand Inc. (BreastSurgANZ) in 2010. In 2016 a voluntary online course with a contemporary curriculum for breast surgery was initiated and taken up by the majority of post-fellowship trainees (PFTs). This article reports on PFT's perceptions of these major changes. MethodsA 46-item online survey was sent to the 56 PFTs enrolled in 2015–2017. The survey canvassed PFT's views on aspects of the two-year training program, the Graduate Certificate in Breast Surgery (GCBS) and the role of BreastSurgANZ in training. Results33/56 participants responded. The training program was rated positively with variation in satisfaction levels depending on operating experience and quality of training between clinical placements. The majority of respondents endorsed restricting numbers of training positions. GCBS students valued the clinical knowledge and structured format of the course. A range of diverse, often opposing, opinions were expressed on the appropriate role of BreastSurgANZ in training and accreditation. DiscussionThe dissonance caused by variability in training exposure and perceived mentor quality in different sites was the most important finding. The GCBS was well regarded by all students but time constraints and costs prevented some PFTs from undertaking the course. Standardisation of mandatory requirements for full BreastSurgANZ membership was identified as an issue for further consideration. ConclusionThis evaluation illuminates the challenges of providing consistently high quality breast surgical training. Many of the issues raised are being addressed by BreastSurgANZ.