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Unsupervised surgical training

BMJ 1997; 315 doi: (Published 15 November 1997) Cite this as: BMJ 1997;315:1306

Logbooks are essential for assessing progress

  1. Charles Galasko, Chairman, training boarda,
  2. Colin MacKay, Chairman, Joint Committee on Higher Surgical Traininga
  1. a Royal College of Surgeons of England, London WC2A 3PN
  2. b Spindlewood, 59 Pewley Hill, Guildford GU1 3SW
  3. c Association of Surgeons in Training at Royal College of Surgeons of England, London WC2A 3PN

    Editor—Wilson's conclusion from her questionnaire study about unsupervised surgical training must be taken seriously but must also be considered in context.1 We would agree that “unsupervised first time surgery is not ideal training.”

    Surgical trainees vary in experience, from recently qualified doctors to those about to become consultants. During this period they will assist in operations, perform operations under supervision, and then perform operations without direct supervision, progressing to more complex procedures. It is essential that all trainees can carry out major and complex operations without supervision by the time their training is complete.

    Logbooks are an essential requirement for both senior house officer and specialist registrar levels. At senior house officer level these books are inspected regularly and must be satisfactory before the trainee is allowed to take the final part of the MRCS/AFRCS examination, a requirement for entry to higher surgical training. At specialist registrar level logbooks are inspected yearly as part of the annual appraisal. Every operation in which the trainee is involved must be entered in the logbooks, each entry indicating whether the trainee assisted at the operation, performed it under supervision, …

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