Impact of Trainee Age and Sex on Operative Training Experience

Area of Science:

• Medical Education
• Surgical Training
• Health Disparities

Background:

• Differential attainment (DA) is evident in UK medical training, including surgical postgraduate education.
• DA in surgery impacts Annual Review of Competence Progression (ARCP) outcomes and postgraduate examinations.
• Systemic inequalities from DA hinder the development of a safe, competent, and representative surgical workforce.

Purpose of the Study:

• To investigate gender-based differences in operative recording and independence among General Surgery Specialty Registrars (STRs).
• To analyze trainee characteristics associated with variations in operative experience and supervision roles.

Main Methods:

• Analysis of operative data from the intercollegiate surgical curriculum program (ISCP) and eLogbook (2018-2023).
• Multivariate negative binomial regression modeled monthly operation and supervision counts.
• Adjusted for trainee demographics, deanery, and working patterns; results presented as incident risk ratios (IRR).

Main Results:

• Female trainees recorded 7% fewer index procedures and 2% fewer total procedures than male peers.
• Older trainees (over 30) recorded more index and total procedures than younger trainees.
• Female trainees documented 19% fewer procedures as 'performed' and 24% fewer as 'Training a Trainee.'

Conclusions:

• Female general surgery trainees log fewer monthly operations and are less likely to document independent performance or supervision.
• Findings suggest gender-based disparities in operative experience and documentation.
• These disparities may affect the development of procedural independence and surgical competencies.