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Trainee Surgeons in the COVID-19 Era: Supporting the Next Generation

In November’s blog, the Confederation of British Surgery once again focus a spotlight on trainee surgeons’ experiences in the era of COVID-19, and we feel certain that this series offers valuable discussion points for surgeons at all stages, in all specialties.

Following September’s blog, In Their Own Words; and October’s, Combatting Suboptimal Conditions, this month, we’d like to highlight the necessity of establishing a clear and sustainable framework that supports surgical trainees and those in the surgical training pathway – which CBS believes can not only ameliorate existing issues; but also help to identify and ideally to remedy problems earlier on, and to advance the profession as a whole.

Naturally, we recognise that specialist surgical training requires unique approaches; however, since CBS is a trade union designed to represent the voices of surgeons across the specialties, we also recognise the significant benefits of uniting to innovate, share ideas, and work together to further elevate British surgery.  

At the beginning of the year, (Surgeons Meet the New Decade with 20/20 Vision) we noted the relatively recent trend of those within the surgical community speaking out more frequently and passionately on the issues that mattered to them – notably, environmental, technological, and societal – and although COVID-19 has inarguably thrown up not just clinical challenges, but challenges within our social and family lives, we continue to see our community teeming with discussion on a wide variety of topics.

Recently, heated discussion and great consternation was levelled over several controversial and unwarranted criticisms directed at surgical trainees. CBS stands in solidarity with trainees, who continue to deliver above and beyond the call of duty during the most challenging circumstances the NHS has ever faced; and who are additionally encountering unique and daunting uncertainties, challenges and disruptions to their training.

While we recognise that the damage done by criticisms such as these cannot be undone, we hope that at minimum, trainees can be reassured of their baselessness - both by the individuals that work with them, and by relevant surgical associations. Second to this, we hope that these unfounded criticisms, and the wide response they have generated within the profession serves to shine a light on the prevalence of toxic sentiments to facilitate active listening and participation in this discussion, as well as the subsequent taking of actions that are long overdue.  

As we touched upon in last month’s blog: assessing the hefty financial cost in addition to the psychological, social and physical costs of surgical training, then factoring in a culture that can frequently leave trainees demoralised, and we see a perfect storm on the horizon. This storm not only risks the wellbeing of our next generation of surgeons; but, if talented, enthusiastic individuals are deterred from pursuing a surgical career due to a proliferation of toxic culture, it presents risk to the profession itself. To weather this proverbial storm, the status quo must be urgently addressed.

We’d like to close our series with an excerpt from a piece on the so-called ‘good old days,’ authored by CBS President and consultant colorectal surgeon, Professor John Macfie, which was previously published in the Royal College of Surgeons of Edinburgh’s Journal (September 2018):

 “The role of the consultant surgeon has changed dramatically over the past 40 years from an omnipotent authoritarian revered by all to a subservient technician beholden to non-clinical managers – at least this is how many perceive the changes. The reality is different. The old role was a chimera, created to reassure the public and the individual patient of the infallibility of the consultant. Now we have a team player committed to involving many different disciplines in the care of individual patients. The modern surgeon understands technology, embraces change and defers to multidisciplinary team decisions. This model is far better for patient care than the illusions of a golden age in the past.

If the role of the consultant surgeon of the future is to be defined by his/her place as a team leader, then surely what we should all be striving for is recognition of this fundamental change in clinical practice by the GMC. We need to evolve away from obsession with the old- fashioned practice of having a single name over the bed. The consultant of the future is a team player not a prima donna strutting their stuff on the surgical stage.

I wish the future generations of surgeons well. Whatever the constraints on day-to-day practice, patients will continue to value the efforts of the surgeon, and the practice of surgery is likely to remain both a privilege and a pleasure for the foreseeable future.”

As always, we invite you to share your views and comments to our social media platforms @UKsurgeons; and encourage you to spread the word about CBS to encourage awareness and membership to your colleagues. For more information on becoming a CBS member, click here.

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