Operative experience of urological trainees in the UK

• Published in: BJU international Vol. 109; no. 9; pp. 1296 - 1301
• Main Authors: Gill, Jonathan D., Stewart, Lianne F., George, Nicholas J.R., Eardley, Ian
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.05.2012; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Biological and medical sciences; Education, Medical, Graduate - statistics & numerical data; Education, Medical, Graduate - trends; European Working Time Regulations (EWTR); Humans; Laparoscopy; Medical sciences; nephrectomy; Nephrology. Urinary tract diseases; operative logbook; Physician's Role; Prostate; TURP; United Kingdom; Urologic Surgical Procedures - education; Urologic Surgical Procedures - statistics & numerical data; Urologic Surgical Procedures - trends; urological training; Urology - education; United Kingdom; Europe; Nephrology; operative logbook; Surgical resection; Time; Urinary tract; Transurethral route; Urology; European Working Time Regulations (EWTR); Regulation(control); Treatment; Urinary system; Nephrectomy; urological training; Surgery; TURP; Formation
• ISSN: 1464-4096; 1464-410X
• DOI: 10.1111/j.1464-410X.2011.10579.x

What's known on the subject? and What does the study add? One of the main components of surgical training is the development of operative skills which, in part, is related to the extent of the practical operative experience. The operative experience of urological trainees in the UK has not being previously published. We examine trainees' current operative experience and analyse the changes over recent years. With a notable decrease in experience of certain procedures, we highlight the possible reasons and discuss the implications for future training. We have examined the operative experience of urological trainees in the UK over a 6‐year period. Between 2004 and 2009, urological trainees submitting their operative logbooks to the Specialist Advisory Committee for the award of Certificate of Completion of Training were analysed. We recorded trainees' experience in eight operative procedures; transurethral resection of the prostate (TURP, including bipolar TURP), transurethral resection of bladder tumour (TURBT), radical nephrectomy (RN, open and laparoscopic), radical cystectomy (RC), radical prostatectomy (RP), percutaneous nephrolithotomy (PCNL) and ureteroscopy (flexible and rigid). In all, 251 logbooks were identified over the 6‐year period. In 2008/2009, the mean (range) number of cases ‘performed’ and ‘supervised’ were as follows; TURP 189 (41–516), TURBT 190 (50–432), open RN 21 (2–78), RC 10 (0–70), RP 13 (0–80), PCNL 19 (0–125), ureteroscopy 131 (14–465), laparoscopic RN 11 (0–97). Latterly there has been a significant reduction in the numbers of TURP, open RNs and RCs. There has been an increase in the use of trainees as assistants for RC, RP and open RN. There was a large variation in numbers of procedures performed between trainees. In summary there has been a recent decline in the numbers of TURP, open RNs and RCs performed. For all procedures, significant variability exists between trainees.