Surgical training and clinical trial involvement—the trainees’ view
BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h2773 (Published 26 May 2015) Cite this as: BMJ 2015;350:h2773
- Aneel Bhangu, academic clinical lecturer in surgery1
- On behalf of Paul Marriott, Dmitri Nepogodiev (West Midlands Research Collaborative); Angelos G Kolias, Aimun Jamjoom (British Neurosurgical Trainee Research Collaborative); Matthew D Gardiner (Reconstructive Surgery Trials Network); Frank D McDermott (Irish Surgical Research Collaborative); Clare Skerritt (Paediatric Surgical Trainee Research Network); Rhiannon L Harries, Julie Cornish, Amy L Stimpson, James C Glasbey, Dave C Bosanquet (Welsh Barbers Research Group); Stephen Chapman, Shafaque Shaikh, Greg Taylor (Yorkshire Surgical Research Collaborative); Matthew Lee, Jonathan Wild (South Yorkshire Surgical Research Group); Matt Mawdsley, Will Manning (Collaborative Orthopaedic Research Network); Shameen Jaunoo, Hannah L. Adams (Warwickshire Surgical Research Group); Natalie S Blencowe (Severn and Peninsula Audit and Research Collaborative for Surgeons); Jennifer A Smith (North West Research Collaborative); Clare Burdett (Cardiothoracic Trainees Research Collaborative); Vimal J Gokani, Philip W Stather (Vascular and Endovascular Research Network); James B Haddow, Nicholas R A Symons (London Surgical Research Group); Nicholas Ventham, Gary Nicholson (Scottish Surgical Research Group)
- 1West Midlands Research Collaborative, Academic Department of Surgery, Room 29, 4th Floor, Queen Elizabeth Hospital, Edgbaston, Birmingham, B15 2TH, UK
- aneelbhangu{at}doctors.org.uk
As surgical trainees across multiple disciplines, it is our collective aim for all surgical patients to have the opportunity to participate in at least one clinical trial during their hospital episode.1 We recognise that most patients wish to have this option,2 and we want our training to facilitate this. Because patients have the right to be involved in improving surgical practice, we must challenge the dogma that surgical clinical trials are an optional extra provided only in elite centres.
Training programmes need to support us in achieving this goal. We ask that training in all aspects of clinical trials and high quality research (design, conduct, analysis, critical appraisal) is embedded in surgical training programmes and is accessible to all trainees. This should include good clinical practice training and practical opportunities to enter patients into clinical trials during rotations. This could complement currently accepted assessments based on first author peer reviewed publications, which, although a marker of research output, give almost no credit for multicentre collaborative research.3 The UK’s world leading surgical trainee research collaboratives provide the framework to facilitate this.4
Not every trainee needs to become an expert in trial methodology, although trial recruitment can become part of everyday clinical practice. Strong leadership by the surgical royal colleges, the Joint Committee on Surgical Training, surgical specialty advisory committees, and surgical trainee associations is needed to ensure that the NHS has a sizeable cohort of trainees and consultants who will be actively engaged with collaborative multicentre clinical trials. Patients who wish to be offered the opportunity to discuss entry into trials should have the option to be treated by surgeons who can provide this; participation in clinical trials cannot remain a postcode lottery.
Notes
Cite this as: BMJ 2015;350:h2773
Footnotes
Competing interests: The authors are active trainee members of subspecialty research groups within the UK National Research Collaborative (www.nationalresearch.org.uk/).