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A retrospective cohort study of differential attainment, COVID and chaos: taking the difference out of a terrible

Osian P James1,2, Katie Mellor1, Oliver Luton1

  • 1Health Education and Improvement Wales' School of Surgery, Tŷ Dysgu, Cefn Coed, Nantgarw.

International Journal of Surgery (London, England)
|May 24, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) did not significantly impact core surgical training (CST) outcomes like Annual Review of Competency Progression Outcome (ARCPO) or Membership of the Royal College of Surgeons (MRCS) exam pass rates. However, National Training Number (NTN) appointments decreased during the pandemic.

Area of Science:

  • Medical Education
  • Surgical Training
  • Public Health

Background:

  • Core Surgical Training (CST) faced unprecedented challenges due to the COVID-19 pandemic.
  • Differential attainment in medical education requires ongoing evaluation, particularly concerning the pandemic's impact.
  • Previous hypotheses suggested COVID-19 negatively affected CST outcomes.

Purpose of the Study:

  • To evaluate the impact of COVID-19 on CST differential attainment.
  • To assess the influence of gender and ethnicity on training outcomes during the pandemic.
  • To analyze changes in Annual Review of Competency Progression Outcome (ARCPO), MRCS examination pass rates, and National Training Number (NTN) appointments.

Main Methods:

  • Retrospective cohort study of 271 anonymised CST records from a UK Statutory Education Body.
  • Analysis of primary outcome measures: ARCPO, MRCS pass rates, and NTN appointment.
  • Non-parametric statistical methods were employed using SPSS for data analysis.

Main Results:

  • No significant difference in ARCPO or MRCS pass rates between pre-COVID and peri-COVID training cohorts.
  • A notable decrease in NTN appointment rates was observed during the peri-COVID period (36.9% vs. 47.4%).
  • Multivariable analyses indicated associations between ARCPO and gender, MRCS pass and surgical theme, and NTN with specific training programmes.

Conclusions:

  • COVID-19 did not adversely affect ARCPO or MRCS pass rates in CST.
  • While NTN appointments declined, overall training outcome metrics remained resilient.
  • Differential attainment profiles showed significant variation, independent of the pandemic's direct impact on key metrics.
Abstract

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