A cross-sectional study examining MRCS performance by core surgical training location.

Area of Science:

• Medical Education
• Surgical Training
• Professional Examinations

Background:

• Core Surgical Training (CST) in the UK provides foundational experience for early-career surgeons.
• Significant variations exist in CST programs across different deaneries.
• The impact of these training differences on trainee performance requires investigation.

Purpose of the Study:

• To assess the association between Core Surgical Training (CST) deanery and trainee success in Membership of the Royal College of Surgeons (MRCS) examinations.
• To determine if variations in CST programs influence MRCS examination outcomes.

Main Methods:

• A retrospective cohort study analyzed 1104 UK trainees attempting MRCS between 2014 and 2020.
• Chi-squared tests were used to examine the relationship between training locality and first-attempt MRCS pass rates.
• Multivariate logistic regression identified the likelihood of MRCS success based on CST deanery.

Main Results:

• MRCS Part A and Part B pass rates demonstrated a significant association with CST deanery (p < 0.001 and p = 0.013).
• Trainees from specific London deaneries and Thames Valley showed over twice the likelihood of passing MRCS Part A.
• North Central and East London trainees had over ten times the likelihood of passing MRCS Part B at first attempt.

Conclusions:

• MRCS examination performance is linked to the CST deanery where trainees complete their core surgical training.
• A substantial proportion of candidates attempt MRCS exams before or early in CST, with many passing.
• MRCS performance is not a reliable indicator of CST training quality due to early exam attempts and potential selection bias.