FY1 Doctors Research Articles

EP488 - Improving understanding on the care of post-op Whipple’s patients amongst FY1 doctors

Abstract Aims Improve understanding of Whipple’s procedure and post-op care for these patients amongst FY1 doctors. Promote teamwork and increase awareness amongst FY1 doctors regarding the roles and responsibilities of different members of the multidisciplinary team. Methods A teaching session was delivered to the ward FY1 doctors using PowerPoint presentation. The session was livered by a surgical core trainee, a HPB nurse specialist and a dietician. A pre- and post-teaching questionnaire was used to evaluate the session. Two cycles of this project were completed. Results During the first cycle, 86% of FY1’s surveyed reports they can manage basics when it comes to looking after post-op Whipple’s patients but unsure, 14% said they’re somewhat confident but can be improved. All of those surveyed agrees that regular HPB/general surgery teaching for FY1’s would be beneficial. During the second cycle which took place earlier during the FY1’s rotation, similar results were obtained. 83% of those responded felt not confident at all regarding the management of post-op Whipple’s patients. All those attended the session in both cohorts found the session very useful. There was also a marked increase in confidence level after the session with more than 80% feeling confident with most aspects of management. FY1’s also found it helpful to speak to other members of the MDT. Conclusions This QIP achieved the intended objectives. Positive feedback was received from all those involved. Future session should be delivered regularly to include more detailed knowledge on the topic and other members of the MDT.

WP6.17 - Assessing the value of a general surgical handbook to improve confidence levels in foundation year one doctors

Abstract Aims Evaluate the surgical handbook with former foundation year one (FY1) doctors in general surgery. Identify areas where further support could be given to improve confidence levels. Methods FY1 doctors from August 2022 – July 2023 who rotated through general surgery were invited to evaluate the guide in January 2024. Twenty questions used Likert scales (1 to 5: not at all confident to very confident; not useful to very useful) to assess the management of the general surgical patient having read the guide. Four questions assessed the overall value of the guide and a further four questions focused on how to improve the guide; including, individual sections needing further development. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 32% (10/31) completed the survey. 100% (10/10) found the guide helpful and felt it would enhance their general surgical experience. 90% (9/10) felt the guide would have a positive effect on their morale through their rotation. Modal scores ranged from four to five for how confident FY1 doctors are in managing different aspects of general surgery having read the guide. Overall, the guide was seen as very useful. Areas where the guide could be improved include; post bariatric surgery, post-surgery nutrition and pancreatitis. Conclusions Evaluation of the surgical guide was very positive. This guide could be used to help enhance the general surgical rotation of FY1 doctors.

WP6.16 - A comparison of post-rotation confidence levels over a year of surgical foundation year one doctors in a busy district general hospital

Abstract Aims Assess the confidence levels of foundation year one (FY1) doctors in managing surgical patients post-rotation. Identify areas where further support could be given to improve confidence levels. Methods August 2022, December 2022 and April 2023 cohorts were surveyed following the end of their four-month rotation. Ten questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. One question focused on education methods and one was an open question. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 100% (10/10) August 2022 cohort, 38% (3/8) December 2022 and 80% (8/10) April 2023 cohort completed the survey. Modal post-rotation confidence levels were mostly four and five across all cohorts. August 2022 and December 2022 cohorts had a modal value of three for confidence in speaking with a patient’s family when a patient was dying. August 2022 cohort had a modal value of three for confidence in speaking to a patient when their condition was unknown. Common concerns of FY1 doctors were managing a deteriorating patient and being unable to contact a senior. Most FY1 doctors felt that case-based discussion would be the preferred method to increase understanding of general surgery. Conclusions Confidence levels were high post-rotation and increased throughout the year. This could suggest that FY1 doctors are receiving a good understanding of general surgery by the end of their rotation. Further work needs to be done to target improvement in areas of lower confidence.

EP160 - A comparison of pre-rotation confidence levels over a year of surgical foundation year one doctors in a busy district general hospital

Abstract Aims Assess the confidence levels of foundation year one (FY1) doctors in managing surgical patients pre-rotation. Identify areas where further support could be given to improve confidence levels. Methods Ten questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. One question focused on education methods and one open question. Cohort One (August 2022) were asked to reflect in December 2022. Cohort Two (December 2022) and Cohort 3 (April 2023) were surveyed at the start of their general surgical rotation. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 100% (10/10) cohort one, 75% (6/8) cohort two and 100% (10/10) cohort three completed the survey. Pre-rotation confidence levels mostly improved between the first cohort and last cohort. Areas where modal scores were below three in the last cohort were in managing the acutely unwell general surgical patient, managing biliary disease and managing non-specific abdominal pain. Common concerns of FY1 doctors were not being able to contact a senior in theatre and the busyness of the specialty. Most FY1 doctors felt that group teaching would be the preferred method to increase understanding of general surgery. Conclusions Confidence levels were higher in the final cohort. This suggests core skills are picked up in different specialties which are transferrable to aspects of general surgery. Further work needs to be done to target improvement in areas of lower confidence.

WP6.15 - A dedicated teaching programme in Colorectal Surgery: continuing education beyond medical school

Abstract Background The UK Foundation Programme (UKFP) Curriculum illustrates the need for educational progression for doctors in their first two years of work. Although UKFP recommends use of departmental teaching for this, there is limited guidance on structured and learning-objective focussed training. We designed a colorectal surgery lecture series to create a reproducible teaching programme with defined learning outcomes. Methods We developed a 6-part lecture series aimed at FY1 doctors working in General Surgery at our Teaching Hospital. Teaching was in the form of 30-minute powerpoint presentations, with 15 minutes for questions, at weekly departmental teaching meetings. Lectures were delivered by FY2 doctors and members of colorectal multidisciplinary team (Enhanced Recovery CNS, Stoma Care CNS). Each session was supervised by a Colorectal Consultant. Feedback was obtained using a 10-point Likert scale questionnaire, assessing various domains. Results FY1 trainees indicated an increase in their knowledge with each lecture. Furthermore, the domains of relevance (mean score 9.53±0.80); teaching style (mean score 9.66±0.94); and audiovisual aid (mean score 9.68±0.70) were all rated highly. Lecture duration was rated as perfect length (mean score 5.86±1.80). Conclusion We have demonstrated that weekly departmental teaching can be utilised to enhance training for FY1 doctors within a challenging surgical subspecialty. Feedback revealed high satisfaction, facilitating improvement in knowledge and thus empowerment in undertaking clinical duties. Strengthened by this positive outcome work is in progress to introduce this format of structured teaching into departmental teaching meetings in all disciplines of medicine and surgery across our Trust.

WP8.6 - Improved confidence levels with the introduction of a junior doctor led surgical handbook for first rotation foundation year one doctors

Abstract Aims Assess the confidence levels of general surgical foundation year one (FY1) doctors in managing patients at the start of their rotation in August 2022 and August 2023. Assess the impact of a surgical handbook on confidence levels at the start of the rotation. Methods Cohort one (August 2022) were asked to reflect on their confidence before their surgical placements. Cohort two (August 2023) were surveyed at the start of their rotation. A surgical handbook was given to cohort two pre-rotation. Ten questions used Likert scales (1 to 5: not at all confident to very confident). One question on education methods and one was an open question. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 100% (10/10) cohort one and 100% (12/12) cohort two completed the survey. 83% (10/12) of cohort two had read the surgical handbook pre-rotation. 100% (10/10) who read the guide found it useful. Modal confidence scores were higher across all 10 questions in cohort two in comparison to cohort one. The lowest confidence levels in both cohorts were in speaking to a dying patient’s family. The majority of FY1 doctors would prefer case-based discussions as their preferred method of learning. A common concern of FY1 doctors was a lack of senior support. Conclusions Confidence levels were higher pre-rotation with the cohort that received the surgical handbook. Targeted case-based discussions may support increasing confidence through the rotation

Exploring the challenges faced by foundation doctors when prescribing high risk medicines safely during the on-call period: A qualitative study.

Errors with prescribing high-risk medicines (HRMs) have a greater propensity to cause harm than with non-HRMs. Prescribing errors arise due to multiple factors and it can be particularly challenging for junior doctors to prescribe safely during the on-call period. Knowledge regarding the challenges of prescribing HRM during the on-call period would be useful to target preventative interventions. The aim of this study was to explore the challenges encountered by foundation doctors (doctors who have graduated medical school within the last 2 years) when prescribing specific HRMs (anticoagulants, insulin and opioids) safely during the on-call period. Six focus groups exploring the challenges of prescribing HRMs safely during the on-call period were conducted, 3 with foundation year 1 and 3 with foundation year 2 doctors from across 3 different hospitals. A thematic framework analysis based on the London Protocol was conducted. Doctors described multiple challenges to prescribing HRMs safely during the on-call period including a lack of prescribing support, nursing pressure, complex prescribing tasks, unknown patients as well as individual factors such as lack of knowledge and tiredness. Many of these factors exist to some extent during the day, yet the nature of the on-call period as a fast-paced environment heightened the challenges that prescribers faced. There are multiple challenges experienced by foundation doctors when prescribing HRMs during the on-call period. The potentially devastating consequences of errors with HRMs means that closer attention and more concern from healthcare professionals, researchers and policymakers is required to improve safe prescribing of HRMs in hospitals.

A83Assessment of the Use of Assorted Methods of Scenario Presentation in Communication Skills Simulation

FY2 doctors in Greater Glasgow and Clyde (GGC) participate in simulation-based learning [1] to improve communication skills in difficult consultations. COVID-19 pandemic restrictions from 2020 – 2022 meant actors could not be present in person for this. Scenarios were therefore adapted to run as remote consultations - two were conducted using Zoom video calls and one by telephone with professional actors, and one ward-based manikin scenario with faculty as actors. We compared the effectiveness of the session, and of each scenario, in improving confidence in communication. Questionnaires were completed before and after simulation. Confidence levels were assessed using a Likert Scale (1 – 5) for each scenario. Participants were also asked to rank each scenario (1 – 4) for engagement, realism and relevance to practice at the end of the session, and for which of the three Intended Learning Objectives (ILOs) for each scenario they had gained most information. Over 10 days, 126 FY2s (6 - 8 per group) and 23 Faculty members participated. 92 completed questionnaires were obtained. ‘Take Forward Messages’ (TFM) from scenario debriefs from 12 groups were correlated with the ILOs. Overall, there was a significant improvement in confidence in dealing with difficult communication scenarios after the session; (mean ± SEM) score pre 2.87 ± 0.11, post 3.69 ± 0.08, p < 0.01. These values did not differ significantly from 2019 when actors were present in person. When asked to rank which scenario was most effective in different aspects, the case on how to deal with an angry patient (Zoom video call) performed best overall ( Scenario Quality Assessment and Improvement in Participant Confidence Levels Zoom and telephone consultations, and manikin-based scenarios can be used to provide effective simulation sessions to improve communication skills. Perception of scenario quality does not always correlate with success in achieving the learning objectives. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

1005 Core Surgical Training Applications: Moving Goalposts and the Introduction of the MSRA

Abstract Aim The core surgical training (CST) application has changed year-on-year for the past 3-years. The 2023 application cycle saw the inclusion of the Multi-Specialty Recruitment Assessment (MSRA) for long-listing. Our aim was to assess the impact of the new CST application requirements on applicants. Method A questionnaire was distributed to attendees of a CST preparation course. Demographic data were collected. A Likert scale was used to determine agreement with a series of statements regarding the CST application and inclusion of the MSRA. Respondents were also given free text to express opinions regarding CST applications. Results One hundred fifty-eight (158) responses were collected, 67 [42.4%] were FY2 doctors, 66 [41.8%] were FY3/out of training in the UK, 8 [5.1%] outside of the UK, 14 [8.9%] FY1s and 3 [1.8%] were in another non-training post. Eighty-nine (89) [56.3%] respondents applied to CST only, with 60 [38.0%] stating that inclusion of the MSRA made them more likely to apply to other specialties requiring the exam. 16 [10.1%] applicants felt that the MSRA was a fair addition to the application progress. The common themes of qualitative data included: frustration at the short notice given to criteria changes, as applicants felt they spent years preparing their applications. Concern was expressed that candidates with no interest in surgery may consider applying due to inclusion of the MRSA. Conclusions Changing the CST application criteria had an overall negative effect on applicants. Most respondents reported the need for changes to applications to be communicated earlier in advance.

361 A comparison of confidence at the start of a general surgical rotation between first and second rotations of foundation year one doctors in a busy district general hospital

Abstract Aims Methods FY1 doctors were surveyed in December 2022. Ten questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. One question focused on education methods and one open question. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 10 FY1 doctors (10/10) completed the pre-questionnaire in their first rotation. 6 FY1 doctors (6/9) completed the pre-questionnaire in their second rotation. All second-rotation respondents had a previous medical rotation. Confidence levels were higher for FY1 doctors at the start of their second rotation in surgery than those in their first rotation. Areas, where FY1 doctors in their first rotation had higher confidence levels, were: maintenance fluid therapy, managing biliary disease, managing non-specific abdominal pain and speaking to a patient about their management when their condition is unknown. Most FY1 doctors in the first rotation felt that case-based discussions would be the preferred method to increase understanding in general surgery whereas most second rotation FY1 doctors preferred method was group teaching would be. Conclusions Confidence levels were higher in the doctors on their second rotation than in their first. Further targeted teaching may support increasing confidence before the rotation.

364 Surgical confidence over a rotation in foundation year one doctors in a busy district general hospital

Abstract Aims Methods FY1 doctors were surveyed in December 2022. Ten questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. One question focused on education methods and one open question. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 10 FY1 doctors (10/10) completed the pre-questionnaire and post-questionnaire. Confidence levels were greater across all Likert scale questions at the end of the rotation. Confidence levels at the start of the rotation had a modal score of 1 in managing the deteriorating surgical patient, end-of-life care and prescribing pre-emptive medications. The lowest confidence levels at the end of the rotation were for speaking to a dying patient’s family and speaking to a patient about their management when their condition is unknown. Common concerns of FY1 doctors were not being able to contact a senior in theatre and the busyness of the specialty. Most FY1 doctors felt that case-based discussions would be the preferred method to increase understanding of general surgery. Conclusions Confidence levels improved by the end of the rotation. Targeted case-based discussions may support increasing confidence before and through the rotation.

359 Confidence levels in junior doctors managing paediatric surgical patients in a busy district general hospital

Abstract Aims Methods Doctors were surveyed in December 2022. Eight questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. Five closed questions were asked, and one question focused on education methods. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 7 FY1 doctors (7/10) and 4 SHO doctors (4/11) completed the questionnaire. 2/11 have had to clerk or create a management plan for a paediatric patient. 8/11 would use guidance to prescribe for a paediatric patient. 2/11 have had teaching or e-learning to support prescribing. 3/11 have had to prescribe for a paediatric patient. Confidence levels were low for prescribing at the start of the rotation but increased by the end of the rotation. The highest confidence modal values were 3. Confidence levels of diagnosing and managing appendicitis were higher than mesenteric adenitis. Most doctors felt that group teaching would be the preferred educational method to increase understanding. Conclusions Most doctors did not receive teaching in managing paediatric patients. The highest modal value for confidence was 3. Further targeted group teaching may support increasing confidence levels.

A different state of mind: developing a mental health simulation programme for foundation doctors in Scotland

The new Foundation Curriculum 2021 for Doctors in Training (DiT) in the United Kingdom calls for an increased focus on developing mental health-related skills [1], bringing them into parity with physical health. The importance of developing the core clinical skills needed to work with patients who have mental illness is now well-recognised within medical education [2,3]. In collaboration with NHS Education Scotland (NES), we piloted a half-day programme of immersive high-fidelity simulation in Psychiatry for foundation year one (FY1) doctors working in NHS Lothian. Scenario design was by a core group consisting of simulation faculty and Foundation programme directors who were consultant psychiatrists and acted as content experts. The intended learning outcomes (ILOs) for these sessions were constructively aligned with key presentations set out in the revised Foundation Curriculum. The scenarios considered the limitations of practice for an FY1, particularly in regard to mental health law. The three immersive scenarios developed included management of an aggressive patient with delirium, challenging communication with relatives, and management of a depressed patient. Scenarios were based in general wards to maximise fidelity with FY1 experience. 18 sessions were run for FY1 doctors at the three main acute hospital sites in NHS Lothian to ensure equitable access. Participants completed a pre-session evaluation to determine their perceived ability to perform key skills, including assessment of a patient who has self-harmed, a patient with depressive symptoms, assessment of capacity and use of mental health legislation, use of verbal de-escalation, safe sedation, and how to take a collateral history. Assessments were made on a Likert scale and were repeated immediately following the session. We plan to repeat this questionnaire three months following the session. A total of 68 FY1 doctors attended the pilot sessions. When considering the percentage of participants who felt prepared or very prepared, substantial improvements were seen in all assessed domains following the session ( Percentage of candidates who reported feeling either prepared or very prepared to carry out they key skills included in the pilot sessions We have demonstrated that immersive simulation-based education can be used to improve knowledge and confidence in core aspects of psychiatry. With support from NES, we aim to offer this session to all FY1s in Scotland. 1. UK Foundation Programme (2021) UK Foundation Programme. 2. Piot MA, Dechartres A, Attoe C, Jollant F, Lemogne C, Layat Burn C, Rethans JJ, Michelet D, Cross S, Billon G, Guerrier G. Simulation in psychiatry for medical doctors: a systematic review and meta‐analysis. Medical Education. 2020;54(8):696–708. 3. Piot MA, Attoe C, Billon G, Cross S, Rethans JJ, Falissard B. Simulation training in psychiatry for medical education: a review. Frontiers in Psychiatry. 2021;12:658967.

Clinical Skills Day: A Novel Approach to Enhancing Procedural Skills Teaching for Foundation Year One Doctors.

Background Completion of the Foundation Year One (FY1) doctor training is a requirement for full General Medical Council registration in the United Kingdom. Training during this year is mapped to a curriculum with one of the key elements being safe procedural skills. The objective of this project was to improve the teaching of procedural skills through the means of a Clinical Skills Day (CSD) and to quantify any improvement. Materials and methods A one-group pretest-posttest design was conducted on 32 doctors who completed a confidence inventory before and after four core procedural stations: suturing, urethral catheterisation (both male and female), lumbar puncture, and bimanual and speculum examinations. The intervention of simulated procedural skills occurred under the supervision of senior clinicians, with FY1 doctors receiving teaching and practising the four skills. The primary outcome was the impact of a CSD on trainees' confidence in performing certain skills. Pre- and post-CSD trainees' confidence levels were collected via an online-focused questionnaire and descriptive statistics, paired t-test, and one-way analysis of variance (ANOVA) with post-hoc Bonferroni comparisons were undertaken for statistical analysis. Results The difference in the mean scores of confidence post-intervention was significant in all four procedural stations with or without supervision (p <0.0001). Conclusions The use of CSDs impacted positively on the FY1 doctors' confidence in performing certain skills. Wider implementation of this promising approach for Foundation Doctors is recommended.

Postgraduate oncological training: Developing an adaptive oncology-focused teaching programme for central doctors rotating to the Christie NHS Foundation Trust

Background: Junior doctors (FY2 and internal medicine doctors) will be involved in the care of patients with cancer in whichever specialty they choose and yet less than half receive dedicated oncology training. Improving exposure to oncology patient management can develop confidence and engagement and encourage a career in oncology. We aimed to identify stimulating ways to encourage doctors to enjoy and pursue an interest in oncology during their rotation at a tertiary cancer centre.

Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study

BackgroundThe demography of the medical profession is changing as more women join the workforce. Traditional assumptions about the personal qualities required to be a successful surgeon may change as more women join the specialty. While exploring the attitudes and beliefs of doctors in their second ‘Foundation’ year of post-graduate training (FY2) about their choice of specialty, evidence emerged about how the stereotype of the surgeon influences professional identification and beliefs about person-specialty fit.MethodsQualitative telephone interviews with 24 FY2 doctors, 17 women and 7 men, in South-West England.ResultsMany participants reported exposure to stereotypes about the personal qualities desirable in a surgeon. Senior doctors and other trainees were the primary source of these stereotypical views. Experience on surgical placements could either reinforce stereotypes or challenge them, the latter particularly where senior surgeons provided positive role models. As more women enter the surgical specialties, they are increasingly challenging the traditional stereotype and sub-culture.ConclusionGendered stereotypes about surgical roles persist, and for some this can hinder professional identification with the role. Positive role models and mentoring can encourage and support women who are interested a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.

Regional survey of foundation trainee doctors’ views on a career in gastroenterology: implications for diversity and inclusion

ObjectiveWe aimed to establish the perception of foundation doctors (FDs) towards gastroenterology, focusing on identifying determinants which make the career desirable or undesirable between genders, and to recognise factors to...

888 Utility of a Virtual Mock Interview Course to Prepare Trainees on UK Core Surgical Training Interviews – a Cross-Sectional Study

Abstract Aim To assess the usefulness of a virtual mock interview course to prepare trainees for UK Core Surgical Training (CST) interviews. Method Junior doctors interested in applying for CST attended a one-day interview course delivered by highly ranked surgical trainees. All attendees were invited to complete pre- and post-interview course questionnaires to assess usefulness in improving the confidence and preparedness for interviews. Results A total of 60 trainees attended the course with an 87% (52/60) response rate to both pre- and post-course surveys. Most trainees were FY2 doctors (50%) applying to CST for the first time (78%). Before the course, 60% of attendees reported feeling “not so confident” for their upcoming interview; 38% of participants felt “somewhat confident” whilst 2% reported feeling “very confident.” 100% of doctors found the pre-mock interview presentations “very useful” or “extremely useful”. Matched data revealed an improvement in attendees’ overall confidence (p&amp;lt;0.0001), with 98% reporting they felt “somewhat” or “very confident” and 2% reporting feeling “extremely confident” about upcoming interviews. Conclusions We demonstrate evidence of a successful CST virtual mock interview course that significantly aids preparation and improves confidence for junior doctors.

EP-196 The effect of medical and surgical rotations in confidence in managing surgical patients

Abstract Aims Methods FY1 doctors were surveyed throughout July – August 2021 and December 2021 across two sites. Seven questions used Likert scales (1 to 5: not at all confident to very confident) to assess general surgical patient management. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 44 FY1 doctors (27 Surgery, 17 Medicine) completed the initial questionnaire. 19 FY1 doctors (13 Surgery, 6 Medicine) completed the questionnaire post rotation. Confidence levels were greater for FY1 doctors in surgery when managing the unwell general surgical patient and prescribing antiemetics. Confidence levels in managing analgesia, diverticulitis, gallstone disease and appendicitis were similar for FY1 doctors in either group. Conclusions Confidence levels are similar post first rotation in managing surgical conditions between medical and surgical specialties. Confidence levels are higher for surgical FY1 doctors. Further research is required in this area to improve FY1 doctor education in managing surgical patients.

EP-195 The effect of medical and surgical rotations on confidence in managing acute kidney injury

Abstract Aims Methods FY1 doctors were surveyed throughout July – August 2021 and December 2021 across two sites. Six questions used Likert scales (1 to 5: not at all confident to very confident) to assess AKI management. Data was initially inputted using Google Docs and analysed in Microsoft Excel. Results 44 FY1 doctors (27 Surgery, 17 Medicine) completed the initial questionnaire. 19 FY1 doctors (13 Surgery, 6 Medicine) completed the questionnaire post rotation. Confidence levels were greater for FY1 doctors in surgery than those in medicine at recalling the five most common drugs that cause AKI and understanding the significance of lactate and bicarbonate. Confidence levels were greater for FY1 doctors in medicine than in surgery at assessing a patient's fluid status. Confidence levels in identifying causes and management of AKI in both surgical and medical patients were similar for FY1 doctors in either group. Conclusions Confidence levels are similar post first rotation management of AKI between medical and surgical specialties. Confidence levels are slightly higher for surgical FY1 doctors overall. Further research is required in this area to improve FY1 doctor education.