Who actually does orthopaedic operating?

Recent correspondence in the British Medical Journal suggested that up to 80% of orthopaedic trauma surgery is carried out by unsupervised trainees. We examined our own experience by gathering theatre computer system data over a six month period and case note verification. Unsupervised trainees carried out 48% of the trauma surgery, but only 13% of the elective surgery. Case sheet review demonstrated that the computer system over-attributed operating to the senior surgeon, and under-recorded the presence of unscrubbed consultants. Supervision of trainees is important for both training and service provision, and needs to be tailored to the needs of individual trainees, but we were disappointed with our results. Theatre computer records may not be accurate enough to allow assessment of the level of supervision.