Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Urology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Med Teach. 2022 Apr;44(4):388-393. doi: 10.1080/0142159X.2021.1995599. Epub 2021 Nov 2.
In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery.
A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 ( = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery.
MRCS Part A and Part B pass rates were associated with CST deanery ( < 0.001 and = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00-6.42), North Central and East London (OR 2.37 [95% CI 1.04-5.40]) or South London (OR 2.36 [95% CI 1.09-5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23-51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST.
MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality.
在英国，核心外科培训（CST）是初级外科医生接受的第一个专业经验，但培训在不同的 CST 学系之间差异很大。为了确定这些差异对学员表现的影响，我们评估了是否成功通过皇家外科医师学会会员（MRCS）考试与 CST 学系有关。
对 2014 年至 2020 年期间参加 CST 的英国学员进行了一项回顾性队列研究（n=1104）。卡方检验检查了地理位置与首次 MRCS 表现之间的关联。多变量逻辑回归模型确定了根据 CST 学系，MRCS 成功的可能性。
MRCS 第 A 部分和第 B 部分的通过率与 CST 学系有关（ < 0.001 和 = 0.013，分别）。在泰晤士河谷（优势比 [OR] 2.52（95%置信区间 [CI] 1.00-6.42）、中北部和东伦敦（OR 2.37（95% CI 1.04-5.40））或南伦敦（OR 2.36（95% CI 1.09-5.10））接受培训的候选人首次尝试时通过 MRCS 第 A 部分的可能性是其他候选人的两倍以上。来自中北部和东伦敦的学员首次尝试时通过 MRCS 第 B 部分的可能性是其他候选人的 10 倍以上（OR 10.59（95% CI 1.23-51.00））。然而，68%的候选人在 CST 之前参加了第 A 部分考试，48%的候选人在 CST 之前或第一年期间参加了第 B 部分考试。
MRCS 表现与 CST 学系有关；然而，许多候选人在几乎没有或没有 CST 经验的情况下通过了考试，这表明一些学系吸引了高学术表现者。因此，MRCS 表现不是 CST 培训质量的合适标志物。
