MTP7.12 Progression of academic surgical residents to higher academic training and associations with protected characteristics: a UK cohort study

Aim The Integrated Academic Training (IAT) pathway was introduced to support surgical academic careers encouraging research integration alongside clinical training. Success of the IAT pathway remains unclear. This study investigates the progression of IAT surgical residents from Academic Clinical Fellowship (ACF) to Clinical Lectureship (CL) while exploring the impact of gender, age and COVID-19. Methods A retrospective cohort study of 686 academic trainees across 10 surgical specialties was conducted using data from the Joint Committee on Surgical Training (JCST) and ISCP. Statistical analysis was performed using Cox proportional hazards and logistic regression models to assess factors influencing progression from ACF to CL. Protected characteristics were analysed along with the impact of COVID-19. Results Progression from ACF to CL was low (7.3%) with no significant gender differences observed in progression rates (7.62% for men vs 6.32% for women). COVID-19 had a significantly negative impact on progression (p < 0.001), whereas specialty had no effect (p = 0.94). Trainees under the age of 30 had slightly improved rates, but age was not a significant predictor (p = 0.316). Trainees in Paediatric Surgery and Neurosurgery had the longest academic placements. Conclusion The surgical IAT pathway has an attrition of over 90%, exacerbated by COVID-19. Selection into and experiences in IAT should be urgently reviewed to develop a future surgical academic workforce. As only 7% progress to CL, we suggest IAT trainees should not be appointed to run through training in uncoupled specialties, as this disadvantages those who do not choose an IAT pathway.