Association of Surgeons in Training Conference: Cardiff 2012

AbstractThe Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. With a membership of over 2000 surgical trainees from all ten surgical specialities, the association provides support at both regional and national levels throughout the United Kingdom and Republic of Ireland. Originally founded in 1976, ASiT is independent of the National Health Service (NHS), Surgical Royal Colleges, and speciality associations. The 2012 Annual Conference in Cardiff City Hall brought together nearly 700 delegates for an educational weekend programme with expert guest speakers. Clinical updates were complimented by debates on current training in surgery, and the weekend included 6 pre-conference courses covering a diverse range of topics including laparoscopic skills, surgical drawing and a masterclass in journal club. A record number of 1168 abstract submissions were received and those successful competed for 18 awards representing £3500 in trainee prizes and bursaries. As the only national surgical trainee meeting for all specialities, ASiT continues to grow and we look forward to an even larger and more successful conference next year

Emergency cross-cover of surgical specialties: Consensus recommendations by the Association of Surgeons in Training

AbstractIn recent years, working time restrictions and a restructuring of postgraduate surgical training have resulted in increased reliance on emergency cross-cover (ECC) – the provision of emergency care by a doctor trained or training in a different specialty to that which they are requested to assess or manage. There are increasing concerns surrounding the provision of ECC, particularly regarding appropriate supervision of trainees and in turn their competence, experience and confidence in dealing with surgical problems of outside their own specialty. Surgical training has failed to keep pace with workforce changes and in this document we outline the key principles of providing safe ECC. In particular this includes the medico-legal implications of providing such cover outside a surgical trainee's normal area of practice, particularly without previous experience or means for regular skills practice and up-dating. We report the findings of an ASiT snapshot survey that demonstrates concerns surrounding existing cross-cover arrangements. Variable access to senior support, together with varied willingness to provide this, and a paucity of specific training opportunities for trainees required to provide cross-cover were highlighted. These have the potential to promote variability in patient care and resource use by those providing care outside of their usual specialty. This document provides consensus recommendations to address these issues, including clarification of curricula and improved provision of training for, and supervision of, trainees who are expected to deliver cross-cover

Mentoring during surgical training: Consensus recommendations for mentoring programmes from the Association of Surgeons in Training

AbstractMentoring has been present within surgical training for many years, albeit in different forms. There is evidence that formal mentoring can improve patient outcomes and facilitate learning and personal growth in the mentee. The Association of Surgeons in Training (ASiT) is an independent educational charity working to promote excellence in surgical training. This document recommends the introduction of a structured mentoring programme, which is readily accessible to all surgical trainees.A review of the available evidence – including an ASiT-led survey of its membership – highlights the desire of surgical trainees to have a mentor, whilst the majority do not have access to one. There is also limited training for those in mentoring roles. In response, ASiT have implemented a pilot mentoring scheme, with surgical trainees acting both as mentors and mentees. Based on the existing literature, survey data and pilot experience, ASiT formalises in this document consensus recommendations for mentoring in surgical training

Outpatient management of biliary colic: A prospective observational study of prescribing habits and analgesia effectiveness

AbstractBackgroundUncomplicated biliary colic presents a significant health and financial burden to hospitals and primary care services alike. There is little guidance on the correct analgesia to use on an outpatient basis. This study aimed to evaluate the effectiveness of oral analgesics on biliary colic pain and to explore the prescribing habits of community doctors.MethodsConsecutive patients with ultrasound proven symptomatic gallstones completed a questionnaire recording demographics and symptomatology. Pain was assessed using a visual analogue scale (VAS) based on the Biliary Symptom Score (BSS) to evaluate the effectiveness of various analgesic agents. Local General Practitioners were also surveyed to establish prescribing practices.ResultsCo-Codamol had the highest mean effectiveness VAS score (6.5/10). Patients with increased BMI, short symptom duration and a BSS >70 were most likely to suffer from severe pain. Patients in a subgroup with severe pain were most likely to have their pain reduced by NSAID analgesia compared to no NSAID (OR 2.20, p = 0.027). This effect remained significant upon multivariable regression (OR 2.52, p = 0.018) in a model containing age and NSAIDs. There was wide variation in the prescribing practice of GPs and hospital doctors.ConclusionsThe range of drugs prescribed for biliary colic is extensive with little evidence base. In this study NSAIDs were the most effective analgesia for patients with severe pain. In the absence of contraindications to their use, physician education or guidance emphasizing the benefits of NSAIDs may potentially reduce symptomatic hospital presentation and admissions for biliary colic