Despite this two-year programme being a good introduction to duties as a doctor there have been some concerns that the trainees do not gain significant experience in surgical procedures leading to reduced confidence.⁵ Which can make transition from a second year postgraduate (Foundation) doctor (PGY2) to a surgical resident particular difficult. To gain more experience a large number of doctors undertaking additional posts, which are not part of the recognised training scheme, in the UK and abroad, or roles such as anatomy demonstrators, in order to broaden their skills and relevant knowledge prior to progressing to surgical training.⁶

We propose a multi-specialty surgical, simulation embedded course, designed for and addressed strictly to PGY2 doctors due to commence their surgical training in the UK. The course comprised of procedures and skills in general surgery, urology, trauma and orthopaedics and plastic surgery. The curriculum was developed by teams of experts, based on their clinical experience of what a junior surgical resident will be asked to do during the first year of their core surgical training and the national surgical training curriculum (ISCP).⁷

We used pretest-posttest design to assess improvement in (a) knowledge through multiple choice question test and (b) confidence level in procedures. The participants were twenty-three PGY2 doctors, fourteen males, nine females, who were scheduled to commence surgical residency within 3 months from the course. Participants were divided in to 4 groups and the course director assigned 6 participants to each group (urology, general surgery, plastic surgery and orthopaedics). Skills included urology (suprapubic catheterisation, flexible cystoscopy, circumcision [synthetic models] and scrotal exploration on animal models), plastic surgery (burns management, skin closure and hand fracture fixation [synthetic model], Orthopaedics (Thomas splint application, knee injection and aspiration [synthetic model], plastering, plating long bone fractures[synthetic models] and reducing shoulder dislocation) and general surgery (hand sewn bowel anastomosis, ileostomy, serosal tear repair and laparoscopic appendicectomy [animal model]). Each session was 4 hours long and included an introduction, followed by essential procedures in the specialty with debriefing. All participants rotated through each specialty in 2 days.  Four months after the completion of the course the confidence levels  for the same procedures were assessed in the same way.

Nineteen residents of similar training level, who did not participate in the course, were randomly selected and asked to score their confidence, using a similar questionnaire. The results from participants and non-participants were compared with each other in order to assess for medium term retainement of the immediate impact of the course.

Confidence in performing all the taught surgical skills was significantly improved after the completion of the course between participants and non-participants of the same training level four months after the completion of the course. Multiple Choice Question scores were also significantly improved after the completion of the course.

The authors declare that they have no conflict of interest.