Selection matters-a regional survey of UK consultant opinion on selection into postgraduate surgical and medical training.

BACKGROUND AND AIMS: Recent changes to postgraduate training in the United Kingdom have led to considerable debate regarding selection processes for specialist training (ST) positions. A survey of the opinion of a group of consultants on the relative importance of selection criteria for entry into the first year of specialist training (ST 1) was conducted. METHODS: An electronic questionnaire was sent to the e-mail addresses of all consultants at 4 hospitals in London with a request to rank order the importance of specific selection criteria when assessing (1) a candidate's suitability for entry into ST 1, (2) the fairest shortlisting mechanism, and (3) whether an interview should be a necessity for appointment. RESULTS: Of 657 consultants successfully contacted, 212 (32%) replied. Previous specialty-specific experience gained during foundation (intern-level) training was considered the most important criteria in assessing suitability for entry into ST 1 with additional research degrees second most important. A conventional curriculum vitae (CV) was considered the fairest way of shortlisting candidates, whereas a nationalized final undergraduate examination (Final MB) was least favored. Ninety-five percent of respondents felt that an interview was essential for appointment to ST 1. CONCLUSIONS: Consultants place the most emphasis on previous specialty-specific experience and additional research degrees when considering selection for ST 1, bringing into question the generic nature of foundation training. Consultants preferred to maintain some subjective controls over purely objective markers in the selection process. Thus, there is little support for a nationalized ranked examination as a shortlisting tool, and an interview is recognized as essential for appointment to ST 1. There is a need to build on these preliminary findings by conducting further investigations before changes to selection methodology are implemented.

Quality of reporting in randomized trials published in high-quality surgical journals.

BACKGROUND: Randomized controlled trials (RCTs) in surgery can provide valuable evidence of the efficacy of interventions if they are well-designed, appropriately executed, and adequately reported. Adequate reporting of methodology in surgical RCTs is known to be poor, and adverse-event reporting in surgical research is inconsistent. The Consolidated Standards of Reporting Trials (CONSORT) statement is a framework to help authors report their findings in a transparent manner. Extensions to the CONSORT statement have been published recently to address deficiencies in adverse-event reporting and in reporting of specific criteria related to nonpharmacologic treatments. The aim of this study was to assess the quality of reporting of trial methodology and adverse events in a sample of general surgical RCTs published in high-quality surgical journals using the criteria specified in the CONSORT statements. STUDY DESIGN: We used impact factor to identify the top three ranked surgical journals in 2004. We then obtained information on all RCTs published in these journals in the 2005 calendar year. We assessed quality of reporting using Jadad score, compared the quality of RCTs from CONSORT-endorsing journals with nonendorsers, and assessed the number of RCTs adequately reporting key generic methodologic, adverse-event-related, and specific nonpharmacologic criteria. RESULTS: Of 42 RCTs analyzed, only 40% (17 of 42) had a Jadad score > or = 3. There was no significant difference in the number of high-quality RCTs published in CONSORT-endorsing journals compared with nonendorsers (p = 0.3). The median percentage of RCTs adequately reporting generic methodologic, adverse-event-related, and specific nonpharmacologic criteria was 32.5%, 17%, and 36.5%, respectively. CONCLUSIONS: Quality of reporting of generic methodologic, adverse-event-related, and specific nonpharmacologic criteria in surgical RCTs is poor. Increased attention to quality of reporting of surgical RCTs is required if studies are to meet published criteria.