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PubMed · 8554141

General surgery in evolution: technology and competence.

L W Way
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Abstract

This paper addresses the current status of General Surgery, the direction in which it is moving, and how to prepare for future changes. The paper points out that, since the predicted effects of new technology on the practice of General Surgery are more technical complexity, decreasing invasiveness, and fewer traditional operations, the consequences for the training of surgeons, the division of responsibilities among specialists, and the organization of surgical care will be substantial. In light of the current difficulty in dealing with the stresses within General Surgery, the paper discusses how changes in residency training and an increased use of Fellowships will enable the specialty to handle such disruptive changes in the future.

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Clinical CompetenceEthics, MedicalFellowships and ScholarshipsForecastingGeneral SurgeryInternship and ResidencyMedical Laboratory ScienceOrganizationsTechnology, High-CostJournal Article

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L W Way. 1996. General surgery in evolution: technology and competence.. https://doi.org/10.1016/s0002-9610(99)80064-6

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Undergraduate procedural skills training in Victoria: is it adequate?

OBJECTIVES: To assess the experience in basic and advanced clinical procedures of recently graduated medical students and to identify deficiencies in procedural skills training. DESIGN: An anonymous, voluntary, questionnaire-based survey. SETTING: The 13 hospitals in the State of Victoria that employ their own interns. SUBJECTS: New interns, immediately before starting their intern year in 1996. RESULTS: One hundred and seventy-four interns participated. They reported that they had had few opportunities to practise some procedures during their medical courses. By their own report, 3% had never sutured a patient, 10% had never drawn blood gases, 16% had never applied a limb plaster, 18% had never inserted a catheter and 37% had never intubated a patient. Twenty-nine per cent perceived their proficiency in basic procedural skills to be inadequate and 43% perceived their training in basic skills to have been inadequate. Except for intravenous cannulation, there was a significant association (P < 0.01) between the number of procedures performed and perceived proficiency in that procedure. The new interns reported that they had been taught mainly by residents and registrars in the emergency department. "Doctors performing most procedures" and "limited access to patients" were considered the main obstacles to procedural training. Fewer than 50% of interns had spent extra time improving their procedural skills. CONCLUSION: Undergraduate training in procedural skills in Victoria is inadequate. Comprehensive training programs appear to be lacking and clinical schools have few techniques for quality assurance. RECOMMENDATION: Victorian clinical schools need to review their procedural skills training programs.

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