Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK.
Division of Surgery & Interventional Science, University College London, London, UK.
Int J Surg. 2014;12(8):877-82. doi: 10.1016/j.ijsu.2014.05.069. Epub 2014 Jun 5.
This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety.
这项全国性研究量化了英国（UK）医学院的程序和手术技能培训，这是英国总医学委员会（GMC）对所有毕业生的规定要求。一份问卷记录了英国医学院和外科协会提供的基本程序和手术技能培训。技能是从（1）GMC Tomorrows Doctors 和（2）皇家外科学院联合基础外科技能（BSS）课程中提取出来的。从医学院课程和课外学生外科协会的数据与国家 GMC 指南和 BSS 课程内容进行了比较。使用 Mann-Whitney U 检验分析数据。23 所医学院的代表完成了调查（71.9%的回应率）。从 BSS 课程中提取的 31 项技能分为 5 类，与 GMC 文件交叉参考技能内容。医学院的外科技能培训如下：穿手术服和戴手套（72.8%）、处理器械（29.4%）、打结（17.4%）、缝合（24.7%）、其他手术技术（4.3%）。外科协会提供了更多的结打（64.4%，P=0.0013）和缝合（64.5%，P=0.0325）培训，比医学院多。医学院提供的基本外科技能培训很少，部分由课外学生外科协会补充。我们的发现表明，高年级医学生没有掌握简单的手术和程序技能。新获得资格的医生可能无法安全地进行实际操作，这与 GMC 指南相矛盾。我们建议制定国家本科生外科学和手术技能课程，使新获得资格的医生具备基本的程序技能，以最大限度地提高患者安全。
