Abstract Background The COVID-19 pandemic and 2023 junior doctors’ strikes have disrupted the consistent practical training required for General Surgery Specialty Registrars (GS StRs) to develop competencies for safe independent practice. This study quantifies the cumulative impact of these events on operative exposure. Methods Demographic data from the Intercollegiate Surgical Curriculum Programme (ISCP) were linked to operative records from eLogbook, covering all procedures logged by GS StRs between 2018 and 2023. A multivariate Poisson regression model was used to analyse monthly procedure counts and supervision levels adjusting for demographics, working patterns, and ARCP outcomes. Results are reported as Incident Rate Ratios (IRR, above 1 indicating an increase and below a decrease), using 2018 activity as the baseline. Results A total of 1,255,606 operations logged by 1,671 GS StRs were analysed. The lowest IRR was observed in April 2020 (IRR 0.32, 95% CI:0.31–0.33). In 2023 monthly adjusted IRRs ranged from 0.82 (95% CI:0.81–0.84) to 0.93 (95% CI:0.91–0.95) during months unaffected by strikes, and 0.73 (95% CI:0.77–0.81) to 0.92 (95% CI:0.90–0.94) during strike-affected months. Index procedures like inguinal hernia repair and appendicectomy were 32.8% and 33.5% lower, respectively than in 2018. Significant declines were seen in: “Performed” (IRR 0.81, 95% CI:0.81–0.82) and “Supervised, Trainer Scrubbed” (IRR 0.84, 95% CI:0.84–0.85) supervision levels. Conclusions The COVID-19 pandemic and 2023 strikes have led to substantial, sustained reductions in operative exposure for GS StRs. This decline threatens trainees’ preparedness for independent practice and highlights urgent challenges for UK surgery.
Barter et al. (Fri,) studied this question.
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