title: Surgical and procedural skills training at medical school - a national review.
abstract: This national study quantifies procedural and surgical skills training at medical schools in the United Kingdom (UK), a stipulated requirement of all graduates by the General Medical Council (GMC). A questionnaire recorded basic procedural and surgical skills training provided by medical schools and surgical societies in the UK. Skills were extracted from (1) GMC Tomorrows Doctors and (2) The Royal College of Surgeons Intercollegiate Basic Surgical Skills (BSS) course. Data from medical school curricula and extra-curricular student surgical societies were compared against the national GMC guidelines and BSS course content. Data were analysed using Mann-Whitney U tests. Representatives from 23 medical schools completed the survey (71.9% response). Thirty one skills extracted from the BSS course were split into 5 categories, with skills content cross referenced against GMC documentation. Training of surgical skills by medical schools was as follows: Gowning and gloving (72.8%), handling instruments (29.4%), knot tying (17.4%), suturing (24.7%), other surgical techniques (4.3%). Surgical societies provided significantly more training of knot tying (64.4%, P = 0.0013) and suturing (64.5%, P = 0.0325) than medical schools. Medical schools provide minimal basic surgical skills training, partially supplemented by extracurricular student surgical societies. Our findings suggest senior medical students do not possess simple surgical and procedural skills. Newly qualified doctors are at risk of being unable to safely perform practical procedures, contradicting GMC Guidelines. We propose a National Undergraduate Curriculum in Surgery and Surgical Skills to equip newly qualified doctors with basic procedural skills to maximise patient safety.
authors.affiliation: Department of Plastic and Reconstructive Surgery, The Royal Free Hospital, London, UK. Electronic address: chrisdavis959@hotmail.com.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Davis
authors.affiliation: Division of Surgery & Interventional Science, University College London, London, UK.
authors.forename: Edward C
authors.initials: EC
authors.lastname: Toll
authors.affiliation: Faculty of Medicine, University of Bristol, Bristol, UK.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Bates
authors.affiliation: Faculty of Medicine, University of Bristol, Bristol, UK.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Cole
authors.affiliation: University Hospitals Bristol NHS Trust, Bristol, UK; Confidential Reporting System for Surgery (CORESS), UK.
authors.forename: Frank C T
authors.initials: FC
authors.lastname: Smith
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D006801:Humans; D012577:Schools, Medical; D013337:Students, Medical; D013514:Surgical Procedures, Operative / Q000193:education*; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Education; Procedures; Surgical skills; Training; Undergraduate