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英国眼科手术培训的变化:2009 - 2015年累积手术经验分析

Changes in UK ophthalmology surgical training: analysis of cumulative surgical experience 2009-2015.

作者信息

Hoffman Jeremy, Spencer Fiona, Ezra Daniel, Day Alexander C

机构信息

NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK.

UCL Institute of Ophthalmology, London, UK.

出版信息

BMJ Open. 2017 Oct 6;7(10):e018526. doi: 10.1136/bmjopen-2017-018526.

Abstract

OBJECTIVE

To investigate changes in the patterns of cumulative surgical experience for ophthalmologists in the UK following the introduction of a new national training scheme.

DESIGN

Retrospective review of all surgical training records submitted to the UK Royal College of Ophthalmologists by trainees for the award of Certificate of Completion of Training (CCT) for the period 2009-2015.

SETTING

Secondary level care, UK.

PARTICIPANTS

539 trainees achieving CCT over the 7-year study period.

INTERVENTIONS

Higher specialist training or ophthalmology specialist training.

OUTCOME MEASURES

Number of CCT awards by years and procedures performed for cataract surgery, strabismus, corneal grafts, vitreoretinal (VR) procedures, oculoplastics and glaucoma.

RESULTS

Cataract surgical experience showed little change with median number performed/performed supervised (P/PS) 592, IQR: 472-738; mean: 631. Similarly, the median number of strabismus (P/PS 34), corneal grafts (assisted, 9) and VR procedures (assisted, 34) appeared constant. There was a trend towards increasing surgical numbers for oculoplastics (median 116) and glaucoma (57). Overall case numbers for ophthalmic specialist training (OST) trainees (7-year training programme) were higher than higher surgical training (HST) trainees (4.5-year programme) with the exception of squint (P/PS), corneal grafts (P/PS) and VR cases (P/PS).

CONCLUSIONS

Overall case numbers reported at time of CCT application appear stable or with a marginal trend towards increasing case numbers. HST (4.5-year programme) case numbers do not include those performed before entry to HST, and although case numbers tended to be higher for OST trainees (7-year programme) compared with HST trainees, they were not proportionately so.

摘要

目的

调查英国引入新的国家培训计划后眼科医生累积手术经验模式的变化。

设计

对2009年至2015年期间学员提交给英国皇家眼科医学院以获得培训结业证书(CCT)的所有手术培训记录进行回顾性审查。

背景

英国二级医疗保健机构。

参与者

在7年研究期间获得CCT的539名学员。

干预措施

更高专科培训或眼科专科培训。

观察指标

按年份统计的CCT授予数量以及白内障手术、斜视、角膜移植、玻璃体视网膜(VR)手术、眼整形手术和青光眼手术的实施数量。

结果

白内障手术经验变化不大,实施/监督实施的中位数(P/PS)为592,四分位间距:472 - 738;均值:631。同样,斜视(P/PS 34)、角膜移植(辅助,9)和VR手术(辅助,34)的中位数似乎保持不变。眼整形手术(中位数116)和青光眼手术(57)的手术数量有增加趋势。眼科专科培训(OST)学员(7年制培训计划)的总体病例数高于更高外科培训(HST)学员(4.5年制培训计划),斜视(P/PS)、角膜移植(P/PS)和VR病例(P/PS)除外。

结论

CCT申请时报告的总体病例数似乎稳定,或略有增加趋势。HST(4.5年制培训计划)的病例数不包括进入HST之前实施的病例,尽管OST学员(7年制培训计划)的病例数往往高于HST学员,但并非成比例地高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/313b/5640272/1fa119b02a14/bmjopen-2017-018526f01.jpg

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