Attitudes of surgical trainees towards transplantation surgery as a career

At present there are a number of unfilled consultant posts in transplantati on surgery in the United Kingdom, particularly within the field of kidney t ransplantation. Unless the current shortfall is addressed, it seems highly probable that the number of unfilled consultant posts will continue to incr ease. This survey aimed to highlight the reasons underlying trainees' reluc tance to enter the field of transplantation surgery and to assess how the s pecialty might be changed to attract new trainees. Questionnaires were sent to 102 surgical trainees requesting details on age, sex, training grade, r esearch interests and chosen specialty. They were asked to consider nine sp ecified reasons commonly thought to influence a trainee's decision on wheth er or not he/she would enter their chosen specialty and to grade each of th ese according to their relative importance in the context of considering a career in transplantation. The survey then suggested five changes in traini ng/structure, and the trainees were again asked to grade the relative impor tance of each with regard to whether it would attract them towards transpla ntation surgery. Replies were received from 61 trainees (60 %). Trainees we re deterred from transplantation surgery because of the on-call commitment, unpredictable workload, lack of exposure and a lack of information on the specialty. A reduced on-call commitment, increased income, increased exposu re, improved training structure and increased information would all serve t o attract new trainees to the specialty. To attract new trainees to transpl antation surgery, there must be exposure to the specialty at an earlier sta ge in training, and a proactive stance must be adopted in providing informa tion for the trainees. In addition, there needs to be ongoing commitment to improvements in training structure. The issues of increased income and an acceptable on-call commitment must be addressed.