A PERSONAL AUDIT OF PEDIATRIC SURGICAL TRAINING BEFORE IMPLEMENTATIONOF THE CALMAN GUIDELINES

Purpose: The purpose of this study was to audit the surgical training experience of a Higher Surgical Trainee in the United Kingdom during t he tenure of the posts of Career Registrar, Research Fellow and Senior Registrar from August 1992 to July 1997. Although the Report of the W orking Party on the UK Specialist Medical Training (the Calman report) was published during this study, the training remained the same becau se the author elected not to transfer to the new grade. Methods: A 39- field database was designed, and the surgical experience was entered p rospectively. The data were analyzed chronologically according to age of patient, condition, level of supervision, and nature of admission ( emergency, elective). Results: Two thousand two hundred ninety patient s or operations are presented. Only a small number of patients underwe nt surgery during the research year (1994). The pattern of operating c hanged from one of large numbers of supervised to one of more major pr ocedures. The numbers of neonates and younger infants who underwent su rgery increased significantly, and the level of supervision changed al lowing more autonomy toward the end of the training period. This trend was reversed partially during the period of overseas secondment. The results are compared with those in a recently published USA/Canadian s tudy. Conclusion: The volume of work undertaken by the trainee ensures adequate exposure to a wide range of procedures to achieve a satisfac tory level of competence. Changes that may affect this are discussed. Copyright (C) 1998 by W.B. Saunders Company.