We were interested in the article from Williams et al, concerning the potential to improve training on weekend Trauma lists.
Whilst, we accept the point that increasing Consultant presence at weekend Trauma lists allows the completion of Work Based Assessments, the data shown in this article do not appear to show improved operative training. In fact, the number of operations carried out by Specialist Registrars ( SpRs) (alone or under Consultant supervision) fell from 94% to 50%. Correspondingly, operations carried out by Consultants (presumably with SpRs assisting) rose from 6% to 50%.
We assume that the SpRs felt capable of performing the 93% of operations that they undertook alone before the system change. Unless there was a dramatic increase in case complexity in the second period assessed, then an improvement in training would surely have been indicated by a similar proportion of cases being carried out by SpRs, with Consultants either available or directly supervising.
If the surgical profession wishes to address the concerns surrounding diminishing surgical training opportunities , then a commitment to the fundamental importance of training juniors on operative lists is essential.
Imperial NHS Trust