Vascular surgery trainee retention in the UK: how many leave and why? A survey of trainee and Training Programme Directors' perceptions.

BACKGROUND: It is currently not known how many trainees leave vascular surgery, and their reasons for doing so are unclear. This paper is the first to publish the number of UK trainees leaving the training programme and interrogates their reasons for doing so. METHODS: An email survey was distributed to current and recent Training Programme Directors (TPDs) to quantify the number of trainees resigning between 2013 and 2019. Trainees resigning a National Training Number (NTN) were surveyed regarding their reasons for doing so. RESULTS: Since 2013, 23 UK vascular surgery trainees have resigned NTNs, representing 15.4% of the 149 NTNs awarded between 2013 and our analysis. Reasons for leaving, as relayed by TPDs, included availability of an academic career, geography, health and many other reasons classified as "work-life balance" factors. Data from the trainees surveyed also highlighted work-life balance but also identified pressures within the training system and NHS. CONCLUSIONS: UK data of this sort has not previously been available. The authors' primary recommendation is that prospective data collection on trainee retention is carried out, with structured exit interviews with trainees who decide to leave. Our secondary recommendations include improvements to the inter-deanery transfer process and early realistic exposure to vascular surgery for junior doctors to improve trainee retention rates in vascular surgery.

Faculty development review: Improving learning in the operating theatre.

BACKGROUND: Undergraduate medical students' time is precious, and with increasingly limited exposure to surgery, learning at every opportunity needs to be facilitated. The operating theatre is a unique classroom and factors related to this environment could impact on learning opportunities. We aim to help surgical faculty overcome these barriers and develop the operating theatre's potential as a learning environment. RESULTS: Reports in the literature frequently mention the emotional aspects of attending theatre and trying to fit in with the surgical team, and often report negative feelings such as feeling unwelcome. Students also report feeling confused about what they should be hoping to learn from their theatre experience, and what their role is in theatre. CONCLUSION: We suggest ways in which surgical faculty can help the student fit into the theatre environment and hope that this will improve undergraduate surgical education and enthusiasm for surgery.