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Emergency General Surgery: evolution of a subspecialty by stealth
L Pearce1, S R Smith1, E Parkin1
1Clinical Research Fellow, Department of General Surgery, Central Manchester University Hospitals Foundation Trust, Oxford Road, Manchester, M13 9WL UK.
World Journal of Emergency Surgery : WJES
|January 7, 2016
Summary
The number of advertised Emergency General Surgery (EGS) consultant posts is increasing, highlighting its emergence as a subspecialty. Training and examination systems require revision to meet the growing demand for EGS services.
Area of Science:
- Surgical training and workforce planning
- Subspecialty development in surgery
- Healthcare policy and service delivery
Background:
- Emergency surgical patients constitute a significant portion of National Health Service (NHS) surgical workload and mortality.
- There is a lack of specialized training programs and formal assessment for Emergency General Surgery (EGS).
- An increasing number of EGS positions are being advertised despite training deficits.
Purpose of the Study:
- To analyze employment opportunities for surgical trainees in Emergency General Surgery (EGS).
- To assess the trend in advertised consultant surgeon posts in EGS.
- To understand current perceptions of EGS among consultants and trainees.
Main Methods:
- A review of all consultant surgeon posts advertised in the British Medical Journal from 2009 to 2014.
- Data categorization by specialty, region, and institute, with analysis divided into 2009-2011 and 2012-2014 periods.
- Statistical analysis using Chi-squared tests and an online survey of consultants and trainees regarding EGS experience and attitudes.
Main Results:
- 1240 general surgery consultant posts were advertised; 55 were in EGS (20 with another subspecialty, 35 standalone).
- A statistically significant increase in EGS adverts was observed between 2012-2014 compared to 2009-2011 (p=0.008).
- Only 8.2% of trainees plan a career in EGS, and less than half of consultants view it as a subspecialty.
Conclusions:
- The study indicates a growing societal need for EGS consultants and the emergence of EGS as a distinct subspecialty.
- Current general surgical training and examination frameworks are inadequate to address the evolving needs of EGS.
- Revisions to surgical training and assessment are necessary to meet the NHS's demand for Emergency General Surgery services.
