Rural Rotations at Core: Rarefied Exposure or Real Experience?

Area of Science:

• Surgical Education
• Medical Training Outcomes
• Rural Health Professions

Background:

• Rural General Hospitals (rGH) face recruitment challenges due to perceived disadvantages in social support and training opportunities.
• Understanding the comparative effectiveness of core surgical training in rGH versus urban settings is crucial for addressing recruitment issues.

Purpose of the Study:

• To compare the outcomes of core surgical training rotations in rural General Hospitals (rGH) with those in urban hospitals within a UK Deanery.
• To evaluate if training experiences in rGHs impact key performance indicators for surgical trainees.

Main Methods:

• Analysis of online Intercollegiate Surgical Curriculum Programme portfolios for 163 core surgical trainees (CST).
• Comparison of trainees with significant rGH exposure (≥50% of 2-year posts) against a control group in urban general and teaching hospitals (uGH).
• Primary outcome measures included MRCS examination pass rates and success in national ST3 selection.

Main Results:

• Similar MRCS pass rates (70.4% vs 72.8%) and ST3 selection success (22.2% vs 27.0%) were observed between rGH and uGH rotations.
• While operative case load and assessments varied, other academic achievements like publications were comparable.
• Learned society communications showed a statistically significant difference (1 vs 2, p=0.020).

Conclusions:

• Core surgical training rotations in rGHs provide comparable primary outcomes to those in urban settings.
• Despite differences in the training experience spectrum, rGH rotations do not negatively impact crucial career progression milestones for surgical trainees.
• These findings challenge negative perceptions and may inform strategies to improve rural surgical training recruitment.