Current attitude of British trainees (BOTA Members)
towards trauma surgery in UK.
Bone Joint Surg Br 1997; 79-B (Supplement II): 221
HG; Sakka SA
Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex, England.
We are embarking on major changes in training
with the introduction of the continuum training, reduction of
on call hours and increase in the number of consultant posts.
The delivery of trauma services in the UK is changing to consultant delivered care with an increasing number
of consultants being appointed as either full time trauma surgeons
or expected to devote the main part of their clinical practice
to trauma surgery.
Similar changes were implemented in the
10 years ago. However recent reports from the USA highlight
the fact that these changes have altered the attitude of the residents
in a negative way towards trauma surgery as a career. The purpose
of this study is to establish the current trends in the UK and establish
a baseline for future comparison.
members of the British Orthopaedic Trainees’ association (BOTA)
were contacted by a postal Questionnaire. A total of 480 questionnaires
were posted and 253 (52%) replies received. The respondents comprised
consultants 37%, senior registrars 34%, career registrars 22%
and others 7%. 53% were working at teaching hospitals, 43% in
non-teaching hospitals and 3% in research. 77% are Advanced and
Trauma Life Support (ATLS) providers and 14% instructors.
Although over 90% of the respondents
found trauma surgery enjoyable and exciting, only 55% considered
it attractive and rewarding as a career. Even fewer 39% foresee
good future prospects for trauma surgery being a major part of
their clinical practice. 64% did not think trauma surgery will
bring financial rewards in the future. Only 19% expressed trauma
surgery as one of their subspecialties of interest.
Some of the main reasons for the disaffection
shown towards trauma surgery by the respondents are: lack of provision
for out of hours work (77%), demanding
on call commitments (65%), lack of private patients (58%), HIV
risk (58%), poor career structure (49%), excessive work load (42%)
and inadequate training (36%). Furthermore only 20% consider trauma
surgery is given sufficient accreditation or acknowledgement in
Other details including the differences
between the three main grades i.e. consultants,
senior registrars and registrars will be presented.