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Changing autonomy in operative experience through UK general surgery training: a national cohort study

Elsey, Elizabeth J.; Griffiths, Gareth; West, Joe; Humes, David J.


Elizabeth J. Elsey

Gareth Griffiths

Professor of Epidemiology

Clinical Associate Professor


Objectives:To determine the operative experience of UK general surgery trainees and assess the changing procedural supervision and acquisition of competency assessments through the course of training.

Background Summary Data: Competency assessment is changing with concepts of trainee autonomy decisions (termed entrustment decisions) being introduced to surgical training.

Methods: Data from the Intercollegiate Surgical Curriculum Programme (ISCP) and the eLogbook databases for all UK General Surgery trainees registered from 1st August 2007 who had completed training were used. Total and index procedures (IP) were counted and variation by year of training assessed. Recorded supervision codes and competency assessment outcomes for IPs were assessed by year of training.

Results: We identified 311 trainees with complete data. Appendicectomy was the most frequently undertaken IP during first year of training (mean procedures (mp) = 26) and emergency laparotomy during final year of training (mp = 27). The proportion of all IPs recorded as unsupervised increased through training (p

Journal Article Type Article
Publication Date Mar 1, 2019
Journal Annals of Surgery
Print ISSN 0003-4932
Electronic ISSN 1528-1140
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 269
Issue 3
Pages 399-406
APA6 Citation Elsey, E. J., Griffiths, G., West, J., & Humes, D. J. (2019). Changing autonomy in operative experience through UK general surgery training: a national cohort study. Annals of Surgery, 269(3), 399-406. doi:10.1097/sla.0000000000003032
Keywords Surgery
Publisher URL


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