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Adequate vascular training opportunities can be provided without compromising patient care
1Nuffield Dept of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK. m.pai@ucl.ac.uk
Objectives:
to review the results of index operations in vascular surgery and to evaluate the impact of a specialist vascular training programme on patient outcome.
Methods:
we undertook a 5-year (January 1995-December 1999) review of the weekly-collected mortality and morbidity data. The total number, 30-day mortality and stroke rate of all index operations i.e. AAA repairs (ruptured and elective), carotid operations and infra-inguinal bypasses (above and below knee, elective and emergency) was recorded. The number of operations performed by trainees under supervision was recorded.
Results:
in the 5-year period 991 index operation were done of which 738 (74%) were done by trainees. Operations done by trainees were supervised by a consultant in 82% of cases with no significant effect on death or stroke rates. Overall vascular trainees performed 75% of the index operations of which 82% were supervised.
Conclusions:
trainees under supervision performed three out of four index operations. The mortality and morbidity of index operations in our unit compared well with accepted best mortality and morbidity figures. Our unit provides good training opportunities for vascular trainees whilst maintaining satisfactory standards of patient care.