Competency Assessment in General Surgical Training

Abstract

Beyond its scientific and technical prowess, surgery holds a unique fulfilling allure as a profession. It has upheld the highest standards and dedicated itself unwaveringly to the well- being of humanity. In return, it has earned the respect of society, other professions, and policymakers. Its steadfast nature has been a source of stability and reliability.

Yet, the introduction of work time restrictions and safe working hours, as well as becoming an increasingly litigious environment are some variables that are presenting the surgical profession with various challenges. These have been reflected in clinical practice as depicted in the literature revealing progressive deterioration in perceived competencies with less autonomy as the future generation of surgeons approach the end of their training. The expectation is, however, that the same product and standard of surgeon is produced despite these progressive challenges.

The aim of this study was to assess factors that contribute to perceived competencies at the different stages of surgical training by means of review articles and surveys.

The survey studies in this thesis suggests that in the competition for entry into Surgical Education and Training (SET), both at the undergraduate and postgraduate medical school

iilevels, has led to a diverse pool of doctors with varying ages and skill levels applying for surgical training. This diversity in age and life experiences naturally results in differences in how individuals perceive their competence and confidence.

Overall, these studies revealed that a heterogenous group of doctors prepare and apply for general surgical training in Australia. The results also show that following graduation, the newly minted Australian General Surgeons are quite homogenous as a group, especially in their self-perception of their surgical skill competencies. Finally, this study highlights areas of preparation and support required for doctors applying for general surgical training.