O'Callaghan John, Mohan Helen M, Sharrock Anna, Gokani Vimal, Fitzgerald J Edward, Williams Adam P, Harries Rhiannon L
Association of Surgeons in Training, London, UK.
BMJ Open. 2017 Nov 15;7(11):e018086. doi: 10.1136/bmjopen-2017-018086.
Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training.
Prospective, cross-sectional, questionnaire-based study.
SETTING/PARTICIPANTS: A non-mandatory online questionnaire for UK-based trainees was distributed nationally. A similar national questionnaire was distributed for Ireland, taking into account differences between the healthcare systems. Only fully completed responses were included.
There were 848 and 58 fully completed responses from doctors based in the UK and Ireland, respectively. Medical students in the UK reported a significant increase in debt on graduation by 55% from £17 892 (2000-2004) to £27 655 (2010-2014) (p<0.01). 41% of specialty trainees in the UK indicated that some or all of their study budget was used to fund mandatory regional teaching. By the end of training, a surgical trainee in the UK spends on average £9105 on courses, £5411 on conferences and £4185 on exams, not covered by training budget. Irish trainees report similarly high costs. Most trainees undertake a higher degree during their postgraduate training. The cost of achieving the mandatory requirements for completion of training ranges between £20 000 and £26 000 (dependent on specialty), except oral and maxillofacial surgery, which is considerably higher (£71 431).
Medical students are graduating with significantly larger debt than before. Surgical trainees achieve their educational requirements at substantial personal expenditure. To encourage graduates to pursue and remain in surgical training, urgent action is required to fund the mandatory requirements and annual training costs for completion of training and provide greater transparency to inform doctors of what their postgraduate training costs will be. This is necessary to increase diversity in surgery, reduce debt load and ensure surgery remains a popular career choice.
在过去十年中，外科培训的申请人数有所下降，而且据传闻，以外科实习医生为代价的培训成本正在上升。我们旨在量化外科实习医生预计为研究生培训支付的费用。
前瞻性、横断面、基于问卷的研究。
地点/参与者：向英国的实习医生发放了一份非强制性的在线问卷，并在全国范围内进行了分发。考虑到医疗系统的差异，为爱尔兰发放了一份类似的全国性问卷。仅纳入了完整填写的回复。
分别有来自英国和爱尔兰的848名和58名医生完整填写了问卷。英国的医学生报告称，毕业时的债务大幅增加，从2000 - 2004年的17892英镑增加了55%，达到2010 - 2014年的27655英镑（p<0.01）。英国41%的专科实习医生表示，他们的部分或全部学习预算被用于支付强制性的区域教学费用。到培训结束时，英国的一名外科实习医生平均在课程上花费9105英镑，在会议上花费5411英镑，在考试上花费4185英镑，这些费用不在培训预算范围内。爱尔兰的实习医生也报告了类似的高额费用。大多数实习医生在研究生培训期间攻读更高学位。完成培训的强制性要求的成本在20000英镑至26000英镑之间（取决于专业），除口腔颌面外科外，该专业的成本要高得多（71431英镑）。
医学生毕业时的债务比以前大幅增加。外科实习医生要实现教育要求需承担大量个人支出。为鼓励毕业生从事并继续接受外科培训，需要采取紧急行动，为完成培训的强制性要求和年度培训成本提供资金，并提高透明度，让医生了解他们的研究生培训成本将会有多高。这对于增加外科领域的多样性、减轻债务负担以及确保外科仍然是一个受欢迎的职业选择是必要的。
