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J R Soc Med. 2005 August; 98(8): 387–388.
PMCID: PMC1181856

Higher surgical training in the UK

Ray and co-workers demonstrate the large effect that shortening of higher specialist training might have on operative experience (June 2005 JRSM1). Looking for solutions, they mention a proposal that trainees not wishing to undertake a certain procedure should 'turn over those cases to fellow trainees keen to take up that procedure.' This approach, however, would substantially reduce overall surgical experience, with adverse effects on surgical judgment. They also suggest intensification of training to make up for the shortfall. It is difficult to envisage how this could be achieved with a shift working pattern and the limitation of working hours. Quality of life for junior doctors and continuity of care would also be adversely affected. One proposal is that surgical nurse practitioners could do tasks traditionally performed by junior doctors, leaving the juniors to spend more time in the operating theatre.2 An important consideration is that, when surgical trainees are providing service work at night, they lose training opportunities during the day when operating lists are done. This might be remedied by having specific operating lists run by committed teachers. Surgical training needs to be restructured with an emphasis on quality rather than quantity.


1. Ray J, Hadjihannas E, Irving RM Curtailment of higher surgical training in the UK: likely effects in otology. JR Soc Med 2005;98: 259-61 [PMC free article] [PubMed]
2. Scallan S. Education and the working patterns of junior doctors in the UK: a review of the literature. Med Educ 2003;37: 907-12 [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press