Related Experiment Video
Updated: Mar 12, 2026
Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
Published on: August 15, 2025
Flexible and Out-of-Programme Training: Differential Attainment in ARCP Outcomes for LTFT and OOP Surgical Trainees
Jaspreet Kaur Seehra1, Ricky Ellis2, Brett Doleman1
1School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom.
Objective:
To assess whether Less-Than-Full-Time (LTFT) training or return from Out of Programme (OOP) is associated with developmental Annual Review of Competence Progression (ARCP) outcomes among UK surgical trainees, and to describe demographic and specialty-level variation in these associations.
Design:
Retrospective cross-sectional analysis SETTING: National ARCP outcome data across all UK surgical specialties PARTICIPANTS: A total of 5911 surgical trainees (54,016 ARCP outcomes) for the LTFT analysis and 761 returners from OOP (761 ARCP outcomes on return to training) OUTCOME MEASURE: receipt of a developmental ARCP outcome, defined as outcome 2 (targeted additional training required without extra time) or outcome 3 (inadequate progress requiring extension of training). These outcomes indicate development of competencies are occurring at a slower rate than expected.
Results:
LTFT status was not associated with increased odds of developmental outcomes in the overall cohort (adjusted OR: 0.98; 95% CI: 0.87-1.10, p = 0.697), although higher odds were seen in trauma and orthopaedics (OR: 1.28; 95% CI: 1.04-1.58) and vascular surgery (OR: 1.97; 95% CI: 1.13-3.44). OOP returners had higher odds of a developmental outcome at their first ARCP after returning to training (adjusted OR: 1.88; 95% CI: 1.32-2.69, p = 0.001). Among OOP returners with at least 2 postreturn ARCPs, repeating the analysis using the second postreturn ARCP as the outcome showed that they continued to have higher odds of a developmental outcome compared with trainees who had not taken OOP (aOR: 1.80, 95% CI: 1.29-2.52, p = 0.001). All models were adjusted for age, gender, ethnicity, and sexual orientation.
Conclusion:
Flexible and out-of-programme pathways are not associated with higher odds of developmental ARCP outcomes overall, but targeted support may be needed in specific specialties to ensure equitable progression.
