Six of the Best, General 20

Aims: To compare the operative activity of two first-year basic surgical trainees working in comparable district general hospitals in 1992 and 2000. Methods: Prospectively collected operating log-book data was compared for the first 15 months of general surgical training of a BST in 1992 to that of a similar trainee in 2000. Both elective and emergency cases were analysed. The surgical speciality and the trainees' role in the case were recorded. Several index operations were also compared. Results: Emergency case numbers were similar (145 in 1992 and 133 in 2000), however, the elective workload was almost halved (435 in 1992 and 225 in 2000). The trainee in 1992 assisted, was supervised and performed more operations, in all grades of procedure, than the trainee in 2000 (Table 1), as a result the trainee in 2000 spent the majority of his time assisting cases but the trainee in 1992 had moved on to be the principal operator. The trainee in 1992 had a greater exposure to most surgical subspecialties than the trainee in 2000 (Table 2). In all index procedures (appendicectomy, varicose veins, hernia and upper GI endoscopy), the 1992 trainee did appreciably more. Conclusions: The emergency workload was similar, however, the elective workload was reduced by 48 per cent, resulting in a reduction in the training available to the 2000 trainee. Training in 1992 was more ‘general’ compared to 2000.