Comparison of SHO surgical logbooks a generation apart

There is current concern regarding operative experience obtained by senior house officers (SHOs) during basic surgical training prior to beginning registrar level. Anecdotally, working hours are greatly reduced compared to 20 years ago. The reduction in experience is attributed to the New Deal, which was introduced by the Department of Health in 1991 to improve working conditions for doctors, primarily through reduction of working hours to 76 per week maximum by 1996. In addition, Calmanisation, ie the introduction of the specialist trainee registrar grade of training, and the recent introduction of the European Working Time Directive (EWTD) have both had an effect on juniors' working hours.

Experience gained by basic surgical trainees in varicose vein surgery over a 15 year period - has it changed?

OBJECTIVE

The aim of this study was to see if the training provided for Basic Surgical Trainees (BST's) by one consultant vascular surgeon has changed over a 15-year period.

METHOD

From a computerized database we have a 15-year record of varicose vein operations identifying the first and second surgeon. We have analysed cases involving the BST and those in which the consultant operated alone. In such instances training opportunities were lost.

RESULTS

No change was found in the total number of cases performed, the number of operations carried by the BST as the first surgeon, or the cases performed by the consultant operating alone. The number of operations performed by a BST annually correlated positively with the total number of cases. A BST was named as first surgeon in 39% of cases (632/1622).

CONCLUSION

This study has shown no definite evidence to support the view that training in varicose vein surgery has deteriorated.