Transplant surgeons in training: is anybody out there?

There is a long-standing recognition that there is an organ donor shortage in the United Kingdom and Ireland (UK&E) that limits transplant activity. H owever, the fact that, at present, there are several unfilled consultant va cancies would suggest that a shortage of trained surgeons may soon be an eq ually important limiting factor. The aim of this current study was to ident ify all transplant trainees in the UK&E and to determine their career aspir ations. A list of all trainees intending to practice as transplant surgeons was com piled. A combination of postal questionnaire and telephone interview was us ed to construct a database on past and present training in transplantation, and preferred type of consultancy was assessed both by direct questioning and by using a visual analogue scale to grade desirability of various posts . Of 110 potential trainees identified, 50 (45%) replied and indicated a desi re to pursue a career in transplant surgery. Thirty-one intended practising in the UK&E (19 UK&E graduates and 12 overseas). The preferred consultancy (27/31) was transplantation (Tx) together with a second specialty while on ly four wanted a multivisceral practice. The mean score (0-10) for desirabi lity of a multivisceral transplant post was 4.7, for renal transplant and v ascular access it was 3.6 and for transplantation and a second specialty it was 8.4. We conclude that the majority of trainees do not wish to apply for pure tra nsplant posts, either single organ or multivisceral, and that the majority wish to practice transplantation with a second specialty. In addition, ther e is still a major shortage of trainees and further studies are required to identify reasons why trainees fail to pursue a career in transplantation.