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Differences in progression by surgical specialty: a national cohort study
Carla Hope1, Jonathan Lund2, Gareth Griffiths3
1Division of Graduate Entry Medicine and Health Sciences, University of Nottingham, Nottingham, UK carlahope@nhs.net.
BMJ Open
|February 10, 2022
Summary
Surgical training outcomes vary significantly by specialty in the UK. General surgery trainees face higher rates of non-standard Annual Review of Competency Progression (ARCP) outcomes, with female and older trainees also more likely to receive them.
Area of Science:
- Medical Education
- Surgical Training
- Competency Assessment
Background:
- Surgical training aims to produce competent day 1 consultants.
- The Annual Review of Competency Progression (ARCP) assesses trainee progress in the UK.
Purpose of the Study:
- To examine variations in ARCP outcomes within surgical training.
- To identify differences in ARCP outcomes between surgical specialties.
Main Methods:
- National cohort study utilizing the UK Medical Education Database.
- Multilevel ordinal regression analyses were performed on ARCP outcomes nested within trainees.
- Included higher surgical trainees (ST3-ST8) from nine UK specialties (2010-2017).
Main Results:
- Substantial variation in non-standard ARCP outcomes across specialties observed.
- General surgery trainees had the highest proportion of non-standard outcomes (22.5%), while urology had the fewest (12.4%).
- General surgery trainees were 1.3x more likely, and urology trainees 36% less likely, to receive non-standard outcomes compared to trauma and orthopaedics.
- Female sex and older age were associated with non-standard outcomes.
Conclusions:
- Significant variation exists in surgical training outcome assessments across specialties.
- General surgery exhibits higher rates of non-standard ARCP outcomes compared to other specialties.
- Female and older trainees across all specialties are more likely to receive non-standard outcomes.
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