Varley Iain, Keir James, Fagg Phillip
Doncaster & Bassetlaw Foundation Hospitals NHS Trust, Doncaster Royal Infirmary, Doncaster, DN2 5LT.
BMC Med Educ. 2006 Jan 18;6:6. doi: 10.1186/1472-6920-6-6.
Recent reforms to the training grades have provoked debate about both quality and quantity of training. The bulk of previous research into this area has been qualitative, and little is known about the quantity of training opportunities. This study aimed to determine if the number of elective operations available to trainees was stable.
The number of elective procedures carried out in each surgical specialty (General & Vascular Surgery, Urology, Orthopaedics, ENT) in a large district general hospital was analysed in 6 month periods and adjusted for the number of basic surgical trainees in each specialty. In order to allow comparison between specialties, results for each 6 month period were calculated as a percentage of those for the first period.
The number of elective operations available per trainee fell in 3 of the 4 specialties, with a rise in Orthopaedics. Overall, the number of operations available to each trainee was 56% of that less than a decade ago.
The number of operations available in a conventional hospital setting is decreasing. Introduction of the Modernizing Medical Careers reforms must take account of this if they are to succeed in improving the quality of surgical training.
近期培训等级的改革引发了关于培训质量和数量的争论。此前该领域的大量研究都是定性的，而对于培训机会的数量了解甚少。本研究旨在确定可供实习医生选择的手术数量是否稳定。
对一家大型地区综合医院各外科专业（普通外科与血管外科、泌尿外科、骨科、耳鼻喉科）每6个月进行的择期手术数量进行分析，并根据各专业基础外科实习医生的数量进行调整。为了便于各专业之间进行比较，将每个6个月期间的结果计算为第一个期间结果的百分比。
4个专业中有3个专业可供每位实习医生选择的择期手术数量下降，骨科则有所上升。总体而言，每位实习医生可进行的手术数量仅为不到十年前的56%。
传统医院环境中可进行的手术数量正在减少。如果要成功提高外科培训质量，现代化医疗职业改革的引入必须考虑到这一点。
