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Ann R Coll Surg Engl. 2009 May; 91(4): 353.
PMCID: PMC2749422

Authors' Response 2

We thank Ahmad and colleagues for their positive comments regarding our article and share in their concern about the quality and quantity of training to which basic surgical trainees are exposed. Although their suggestion that basic trainees should be exposed to more laparoscopic cases is laudable, we are concerned as to how this would work in practice.

Increasing amounts of the SHOs' time are now given over to acute day- and night-time service provision, which includes cross-cover for a number of specialities. This environment offers little in the way of training opportunities and we are finding that SHOs are increasingly unavailable to involve themselves in simple out-of-hours operations like abscess drainage or appendicectomy. Moreover, this schedule of acute commitments, along with enforced leave to maintain compliant weekly hours, is compressing the day-time elective exposure of trainees. This includes access to CEPOD lists along with the opportunity to pick up operative experience (laparoscopic or otherwise).

As a result, we are now finding that some newly appointed higher surgical trainees are lacking experience in basic surgical procedures. This perpetuates the problem as the higher trainees then utilise training opportunities of interest to the basic trainees, in order to acquire proficiency in these procedures. We believe that any solution must ultimately lie in freeing up training opportunities for basic trainees and providing them with their own dedicated training lists.


Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England