A prospective analysis on current trends in upper gastrointestinal surgical training.

Aim: To determine any possible trends in the exposure of major upper gastrointestinal (GI) trainees from years 4 to 6 nationally. Methods: A postal questionnaire was sent to 120 Association of Upper Gl Surgeons trainee members detailing their year of training (4-6) and the number of major gastrointestinal surgical operations they had performed under supervision in each of the following operations; cardiooesophagectomy, thoracic oesophagectomy, gastrectomy, hepatectomy, splenectomy, Whipple's operation and open or laparoscopic fundoplication. Results: 41 trainees completed the questionnaire (year 4 = 12, year 5 = 9 and year 6 = 20). Encouragingly, there appeared to be an increase in the number of cases performed by trainees from years 4 to 6 for all procedures indicating an expected cumulative effect. However, by year 6, only 30% and 45% of trainees had performed greater than 10 cardio-oesophagectomies or gastrectomies respectively. Furthermore only 45% of trainees had performed more than 5 Whipple procedures. Open Nissen fundoplication did not show an increase in the percentage of trainees performing greater than 10 procedures from years 4 to 6 (0% to 5%), but did exhibit an increase in the percentage of laparoscopic fundoplications (0% to 55%) respectively. Conclusions: Upper GI trainees are depicting an increasing trend in the number of cases they are being exposed to from years 4 to 6. However, the overall low number of cases performed by trainees by year 6 needs to be addressed and may explain the low compliance of the survey. [ABSTRACT FROM AUTHOR]