Health Education and Improvement Wales' School of Surgery, Tŷ Dysgu, Cefn Coed, Nantgarw.
School of Medicine, Cardiff University, Heath Park Campus, Cardiff.
Int J Surg. 2023 Aug 1;109(8):2359-2364. doi: 10.1097/JS9.0000000000000488.
This study aimed to evaluate core surgical training (CST) differential attainment related to coronavirus disease 2019 (COVID-19), gender and ethnicity. The hypothesis was that COVID-19 adversely influenced CST outcomes.
A retrospective cohort study of 271 anonymised CST records was undertaken at a UK Statutory Education Body. Primary effect measures were Annual Review of Competency Progression Outcome (ARCPO), Membership of the Royal College of Surgeons (MRCS) examination pass and Higher Surgical Training National Training Number (NTN) appointment. Data were collected prospectively at ARCP and analysed with non-parametric statistical methods in SPSS.
CSTs numbering 138 completed training pre-COVID and 133 peri-COVID. ARCPO 1, 2 and 6 were 71.9% pre-COVID versus 74.4% peri-COVID ( P =0.844). MRCS pass rates were 69.6% pre-COVID versus 71.1% peri-COVID ( P =0.968), but NTN appointment rates diminished (pre-COVID 47.4% vs. peri-COVID 36.9%, P =0.324); none of the above varied by gender or ethnicity. Multivariable analyses by three models revealed: ARCPO was associated with gender [m:f 1:0.87, odds ratio (OR) 0.53, P =0.043] and CST theme (Plastics vs. General OR 16.82, P =0.007); MRCS pass with theme (Plastics vs. General OR 8.97, P =0.004); NTN with the Improving Surgical Training run-through programme (OR 5.00, P <0.001). Programme retention improved peri-COVID (OR 0.20, P =0.014) with pan University Hospital rotations performing better than Mixed or District General-only rotations (OR 6.63, P =0.018).
Differential attainment profiles varied 17-fold, yet COVID-19 did not influence ARCPO or MRCS pass rates. NTN appointment fell by one-fifth peri-COVID, but overall training outcome metrics remained robust despite the existential threat.
本研究旨在评估与 2019 年冠状病毒病（COVID-19）、性别和种族相关的核心外科培训（CST）的差异。假设是 COVID-19 对 CST 结果产生了不利影响。
在英国法定教育机构进行了一项 271 名匿名 CST 记录的回顾性队列研究。主要效果测量指标是年度审查能力进展结果（ARCPO）、皇家外科医学院会员（MRCS）考试及格率和高级外科培训国家培训号码（NTN）任命。数据在 ARCP 前瞻性收集并使用 SPSS 中的非参数统计方法进行分析。
138 名 CST 在 COVID-19 前完成培训，133 名 CST 在 COVID-19 期间完成培训。ARCPO1、2 和 6 的 COVID-19 前比例为 71.9%，COVID-19 期间为 74.4%（P=0.844）。MRCS 及格率在 COVID-19 前为 69.6%，COVID-19 期间为 71.1%（P=0.968），但 NTN 任命率下降（COVID-19 前为 47.4%，COVID-19 期间为 36.9%，P=0.324）；以上结果不受性别或种族影响。三个模型的多变量分析显示：ARCPO 与性别相关（男：女 1:0.87，比值比（OR）0.53，P=0.043）和 CST 主题（整形术与普通外科 OR 16.82，P=0.007）；MRCS 及格与主题（整形术与普通外科 OR 8.97，P=0.004）；NTN 与改进外科培训方案（OR 5.00，P<0.001）相关。COVID-19 期间方案保留率提高（OR 0.20，P=0.014），大学医院的泛轮转表现优于混合或地区综合医院的轮转（OR 6.63，P=0.018）。
差异获得情况的差异高达 17 倍，但 COVID-19 并未影响 ARCPO 或 MRCS 及格率。COVID-19 期间，NTN 任命下降了五分之一，但尽管存在生存威胁，整体培训结果指标仍然稳健。
