South Thames Training Programme, London and Kent, Surrey & Sussex Deanery, London, UK.
BMJ Open. 2013 May 6;3(5):e002578. doi: 10.1136/bmjopen-2013-002578.
To evaluate surgical experience among current doctors appointed into ophthalmology training posts since the introduction of the Modernising Medical Careers programme. Additionally, to identify regional variations in surgical experience and training programme delivery.
A cross-sectional survey.
The UK's four largest deaneries (Schools of Ophthalmology).
Trainee ophthalmologists, all having completed three or more years of training, who were appointed to the new ophthalmic specialty training programme.
The mean annual surgical rate for each deanery in phacoemulsification cataract extractions and experience in other common elective and emergency surgical operations. Second, to calculate the mean timetabled clinical activity.
The responses of 40 doctors were analysed, with a response rate of 83%. Overall, the phacoemulsification rate was 73.52±29.24 operations/year. This was significantly higher in the South Thames Deanery (99.69±26.16, p=0.0005) and significantly lower in the North Western Deanery (48.08±19.72, p=0.0008). The annual mean complex cataract rate was 5.21±4.38. Only 40% were confident in dealing with the most common complication of cataract surgery (vitreous loss). The mean trabeculectomy (surgery for glaucoma) rate was 0.47±1.16 and for squint surgery it was 3.54±2.82 operations/year. Regarding the common ocular trauma surgery, 42.5% had not sutured a corneal laceration and 60% a globe rupture. 50% thought the training programme would adequately prepare them surgically. The timetabled clinical activity was highest in the South Thames Deanery (48.17 h/week) and lowest in the North Western Deanery (40.82 h/week) due to variations in the European Working Time Directive implementation and on-call commitments.
Significant regional variations in surgical training experience exist between UK deaneries, particularly with respect to cataract surgery, and they appear to be correlated to timetabled activity. Experience and confidence levels in managing complex cataract surgery and complications were low and experience with previously commonly performed elective and emergency operations was minimal. Although doctors from all the regions surveyed were very likely to achieve the minimum cataract extractions required for specialist training completion, we have identified shortcomings of the current training programme that need attention.
评估自现代医学职业计划实施以来，在眼科培训岗位上任职的现任医生的手术经验。此外，确定手术经验和培训计划实施方面的区域差异。
横断面调查。
英国四个最大的教务区（眼科学校）。
已完成三年或以上培训的受训眼科医生，他们被任命为新的眼科专业培训计划。
每个教务区白内障超声乳化术的年平均手术率以及其他常见选择性和急诊手术的经验。其次，计算平均时间表临床活动。
对 40 名医生的回复进行了分析，回复率为 83%。总体而言，超声乳化白内障吸除术的年手术率为 73.52±29.24 例。在南泰晤士教务区（99.69±26.16，p=0.0005）明显更高，而在西北教务区（48.08±19.72，p=0.0008）明显更低。每年平均复杂白内障手术率为 5.21±4.38。只有 40%的医生对白内障手术最常见的并发症（玻璃体丢失）有信心处理。平均小梁切除术（青光眼手术）率为 0.47±1.16，斜视手术为 3.54±2.82 例/年。对于常见的眼部创伤手术，42.5%的人没有缝合角膜裂伤，60%的人没有缝合眼球破裂。50%的人认为培训计划在手术方面能充分准备他们。南泰晤士教务区的时间表临床活动最高（每周 48.17 小时），而西北教务区最低（每周 40.82 小时），这是由于欧洲工作时间指令的实施和值班承诺存在差异。
英国教务区之间的手术培训经验存在显著的区域差异，特别是白内障手术方面，并且似乎与时间表活动相关。处理复杂白内障手术和并发症的经验和信心水平较低，以前常见的选择性和急诊手术经验很少。尽管调查的所有地区的医生都非常有可能完成完成专家培训所需的最低白内障摘除量，但我们已经发现了当前培训计划的不足之处，需要加以关注。
