DS03 Survey of dermatological surgical training in the UK

Abstract Skin cancer incidence is rising annually in the UK, creating a substantial surgical burden. The dermatology training curriculum stipulates the need for regular supervised surgical lists with increasing independence throughout training to help address this growing demand. We distributed an electronic survey to dermatology trainees via the British Association of Dermatologists and British Society for Dermatological Surgery to evaluate current dermatological surgery training in the UK. The survey focused on training experience, satisfaction, and procedural competence to identify areas for improvement. Overall, 79 out of approximately 280 trainees responded (28.2%), of whom 64 (82%) were based in England, 8 in Wales (10%), 5 in Scotland (6%) and 1 in Northern Ireland (1%). Twelve deaneries within England were represented. The majority worked full time (56 trainees; 71%), and 76% of respondents were female. Twelve respondents were CESR trainees (15%) and three were clinical fellows (4%), with the remainder distributed from ST3 to ST6. In total, 59 respondents (76%) had surgical exposure within dermatology or allied surgical specialties before entering the training programme. Fifteen respondents (19%) reported having a supervised surgical list prior to starting training, defined as a consultant, senior dermatologist or equivalent observing their list. Around one-half of trainees (45, 53%) first received surgical supervision during their ST3 year, and 20.3% (16 trainees) had never received direct surgical supervision. Of these respondents, more than one-third (38%, six trainees) were at ST5/ST6 level. Overall, 65% (50 trainees) received intermittent direct supervision during their training, influenced by factors such as departmental staffing and prioritization of service provision; 68% of respondents (54 trainees) reported seeking additional hands-on surgical opportunities to fill gaps in their training. In total, 20% (16 trainees) felt that the procedural curriculum was unachievable within their training programme, and 29% of ST6 trainees (6 of 21) reported an inability to perform excision biopsies on the head and neck unsupervised. Dissatisfaction with surgical training was expressed by 35% (27 trainees). While our response rate limits the ability to draw definitive conclusions, our survey highlights significant intra- and interdeanery disparities in dermatological surgical training. A striking 86% of trainees (68) expressed the need for more consistent supervision to maintain and develop their surgical skills. Trainees call for clearer curricular guidance on surgical exposure and supervision, and national standardization of training to enhance surgical proficiency among the future consultant workforce.