Survey on trainees' perception on creation of special interests within the domain of general surgery in Sri Lanka: is it the way forward?

Abstract

Introduction Sri Lankan surgical training curriculum underwent a major revision in 2012 with the introduction of special interests within the domain of general surgery. The main employers are yet to recognize this transformation into the employment structure. In such a setting, evaluation of the trainees' perspective is important as their careers may be negatively affected. Methods A pre-tested questionnaire was sent electronically to all fiftyone general surgery senior registrars (SR) who started their post-MD general surgery training after February 2012. Gathered data were reviewed during an observational study. Results Among twenty-four (47%) respondents, eight (33%), seven (29%) and nine (38%) were second years SRs, SRs in overseas training and acting consultant surgeons (aCS) respectively. Four, nine, five, four and two trainees have declared upper-gastrointestinal surgery, coloproctology, hepato-pancreaticobiliary surgery, breast surgery and endocrine surgery. Eight (33.3%), thirteen (54.2%) and three (12.5%) had their speciality training at a university unit, a ministry unit and an overseas unit respectively. Eleven (46%) believed they had adequate special interest training during local or overseas training. Six out of nine (66.7%) colorectal trainees believed they had adequate special interest training during local training compared to other categories. Trainees who had speciality training in university units (7/8) were more satisfied compared to those in the ministry units (3/13). Three (12.5%) said their employer recognizes this system and two (8.3%) believed that they can practice the special interest in future. Seven (29%) each believed that there are career benefits and patient care improvement with the new system but only three (12.5%) believed it is better than the previous one. Five of nine aCSs who have completed training thought they would opt for general surgery without a special interest if the option was available compared to SRs on training (1/15). Discussion and conclusions Colorectal speciality and trainees selected to university units were more satisfied with the local special interest training circumstances. Non-recognition of the new system by the employer was a major concern for them. A limited minority of trainees believed to have the opportunity to function with a trained speciality. Trainees doubted personal career benefits or patient care improvement from this change and this as a better system overall.