title: Mismatch between trainees' subspecialist interest and advertised jobs; worrying implications for upper gastrointestinal trainees
abstract: AIMS: The aim of this study was first to assess the primary subspecialist interests of general surgical specialist registrars who were accredited and still looking for a consultant position, or who were within 3 years of their CCST (certificate of completion of surgical training). These interests were then compared with subspecialist interests declared in consultant vacancies advertised in the British Medical Journal over the preceding 16 months. METHODS: All trainees in general surgery holding a national training number in six regions (Mersey, North West, Trent, Yorkshire, Northern, West Midlands) were identified, and those accredited or within 3 years of their CCST (n = 136) were telephoned to ascertain their primary subspecialist interest, whether they had a higher degree and what their desired consultant job would be. The consultant vacancies advertised in the British Medical Journal between 3 January 1998 and 8 May 1999 were assessed according to the required subspecialist interest. RESULTS: Upper gastrointestinal surgery is the second most popular subspecialty (n = 37; 27 per cent of trainees) after colorectal surgery (n = 40; 29 per cent of trainees). However, there were fewer consultant vacancies in upper gastrointestinal surgery (31 of 226; 14 per cent of jobs) than in any of the other three main subspecialist areas of general surgery (colorectal, vascular and breast/endocrine). The ratio of percentage of jobs to percentage of trainees was lowest in upper gastrointestinal surgery (0.50), compared with colorectal (0.77), vascular (0.89) and breast/endocrine (2.23) surgery. CONCLUSIONS: Upper gastrointestinal surgery appears to be the most competitive of the general surgical subspecialties at present, having by far the lowest ratio of jobs to trainees. In addition, 87 per cent of upper gastrointestinal trainees have or are completing a higher degree, and 43 per cent expressed a desire to work in a teaching hospital.
authors.affiliation: Department of Surgery, Royal Hallamshire Hospital, Sheffield, UK.
authors.initials: IC
authors.lastname: Cameron
authors.initials: AG
authors.lastname: Johnson