Abstract
Background
In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery.
Methods
A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 (n = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery.
Results
MRCS Part A and Part B pass rates were associated with CST deanery (p < 0.001 and p = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00–6.42), North Central and East London (OR 2.37 [95% CI 1.04–5.40]) or South London (OR 2.36 [95% CI 1.09–5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23–51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST.
Conclusion
MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality.
In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery.
Methods
A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 (n = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery.
Results
MRCS Part A and Part B pass rates were associated with CST deanery (p < 0.001 and p = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00–6.42), North Central and East London (OR 2.37 [95% CI 1.04–5.40]) or South London (OR 2.36 [95% CI 1.09–5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23–51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST.
Conclusion
MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality.
| Original language | English |
|---|---|
| Pages (from-to) | 388-393 |
| Number of pages | 7 |
| Journal | Medical Teacher |
| Volume | 44 |
| Issue number | 4 |
| Early online date | 2 Nov 2021 |
| DOIs | |
| Publication status | Published - 2022 |
Bibliographical note
AcknowledgementsThe authors would like to thank Professor Peter Johnston for his valuable insights and expertise in reviewing an earlier draft of this paper. The authors would also like to acknowledge Iain Targett at the Royal College of Surgeons of England and John Hines and Gregory Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project.
Funding:
This work was supported by Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, and Royal College of Physicians and Surgeons of Glasgow.
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Keywords
- post graduate
- training
- education
- assessment
- surgery