Providing Adequate Consultant Supervised Surgical Training Episodes

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Providing adequate consultant supervised surgical training episodes for Trauma and Orthopaedic Specialist trainees (ST) in a busy DGH in the context of limitations posed by service delivery and the restrictions of the EWTD –European Working Time Directive hours.

Specialist Registrars in Trauma and Orthopaedics must receive a prescribed number of consultant supervised surgical training episodes set out in their learning agreement.

Every 6 months at their ARCP (annual review of competence progression),they are required to meet the minimum curriculum standards and numbers. They risk failure or poor performance in their ARCP with the consequent adverse effect on the trainee, trainer, parent hospital, the programme director and deanery. (Frostick S. 2013)

Surgical training and competency in operative procedures is not the only facet in the training of a surgical registrar, but, for the purposes of this article, I am highlighting this particular issue, as there are specific problems in achieving the necessary surgical training to fulfil the requirements.

The particular issues:

The EWTD has its effect on the ST rota causing reduced supervised clinical hours. (Morrow et .al .2012). Shift work leads to fragmented clinical supervision and decreased interaction with the consultant. There is a lack of continuity of care.

The Consultant rota is loaded for service commitment with very little time for education and training. Employer indifference to
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