All basic surgical trainees should rotate through an accident and emergency post.
A 6-month post in accident and emergency is no longer compulsory for basic surgical training. Meanwhile, trauma teams have emerged in many UK hospitals to receive seriously injured patients, often with no involvement of basic surgical trainees (BSTs). This may lead to the appointment of surgical specialist registrars (SpRs) who have had little exposure to the initial management of seriously injured patients. This study documents the experience of a senior house officer undertaking a 6-month post in the accident and emergency department of a district general hospital.


METHODS
Data concerning the nature of cases seen were collected retrospectively from all patient record cards signed by the author during the placement.


RESULTS
During the period studied, the author was present in the resuscitation room on 41 occasions, of which 10 episodes involved the management of a multiply injured patient. A total of 159 fractures and significant soft tissue injuries in the upper limb and 122 such cases in the lower limb were seen. There were 25 head injuries, 17 spinal injuries, 5 significant cases of chest trauma, 4 of abdominal trauma and 5 significant urinary tract injuries. Some 86 practical procedures were carried out during the placement.


CONCLUSIONS
The 6-month post in accident and emergency provided the BST with significant exposure to the care of seriously injured patients. Such a post should be compulsory to ensure that SpRs on appointment have already received exposure to managing the seriously injured. The post provided additional benefit in terms of performing practical procedures and exposure to other acute surgical conditions.
Britten
S
S
Department of Orthopaedics, Frenchay Hospital, Bristol, UK.
D004503:Education, Medical, Graduate / Q000458:organization & administration*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D004739:England; D013502:General Surgery / Q000193:education*; D006801:Humans; D012189:Retrospective Studies; D014194:Traumatology / Q000193:education*; D000078329:Workforce; D014947:Wounds and Injuries / Q000628:therapy