National trends in general surgical trainees' operative numbers (2013-2022)

Area of Science:

• Surgical Education
• Healthcare Workforce Development
• Operative Procedure Analysis

Background:

• UK surgical training has undergone significant evolution due to technological advancements, healthcare reforms, and the pandemic.
• Anecdotal evidence suggests a decline in trainee operative volume and independence over the past two decades.

Purpose of the Study:

• To examine operative numbers and supervision trends for UK General Surgery trainees.
• Analysis covers the period from 2013 to 2022 for index surgical procedures.

Main Methods:

• Utilized anonymous logbook data from the JCST for general surgery trainees (CT1-ST8).
• Data spanned from 2013 to 2022.
• Statistical analysis included Spearman's and Pearson's rank correlation to compare trends over time.

Main Results:

• A significant decrease in total recorded procedures from 209,661 (2013) to 147,026 (2022).
• Increased consultant presence observed, with reduced levels of supervised-trainer unscrubbed (STU) procedures.
• Senior trainees (ST6, ST8) experienced substantial reductions in STU procedures for common operations like inguinal hernia repair and cholecystectomy.

Conclusions:

• A marked decline in operative procedures across all general surgery training levels was confirmed.
• Senior trainees are disproportionately affected by reduced operating opportunities.
• Urgent adaptation of surgical training programs is required to ensure future consultant competency.