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Abstract
INTRODUCTION Working conditions are changing rapidly in medicine. We analyzed the actual work situation and future plans in the next 5 years and in the long term. MATERIALS AND METHODS A survey among the members of the German Society of Pediatric Surgery was performed asking how and where physicians work now and how and where they want to work in the future. RESULTS Five hundred twelve questionnaires were sent out, and 195 colleagues answered the questionnaire (99 women, 94 men, and 2 of unknown gender). Among them, 27% were trainees, 16% were fully trained pediatric surgeons, 6% were senior physicians, and 50% were consultants, while 66% worked full time, 25% worked part time, and 8% did not work in pediatric surgery. In the future, 49% of consultants and 24% of the trainees wanted to work part time. Among the 73 participants who wanted to become a department head, 33% of them also wanted to work part time. CONCLUSION Pediatric surgery is changing toward a discipline with many female doctors and people working part time. Leaders in pediatric surgery should be aware of this development to adapt their working conditions to reality.
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Affiliation(s)
- Andrea Schmedding
- Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Goethe-University, Frankfurt/Main, Germany
| | - Mechthild Sinnig
- Department of Pediatric Surgery and Center for Pediatric Burns, Children's Hospital AUF DER BULT, Hannover, Germany
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Hippolyte-Blake D, Dreschler A, Rose A, Rae P, Archer J, Garrod TJ. A qualitative study of the incentives and barriers that influence preferences for rural placements during surgical training in Australia. ANZ J Surg 2022; 92:341-345. [PMID: 35112443 DOI: 10.1111/ans.17523] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Rural exposure of long durations during clinical training is positively associated with rural career uptake and is a central strategy to addressing the geographical maldistribution of Australia's surgical workforce. However, the incentives and barriers to trainees undergoing surgical training preferencing repeated rural placements in Australia are not well understood. This qualitative study explores the incentives and barriers that influence preference for rural placements during surgical training in Australia. METHODS This qualitative study employed online semi-structured in-depth interviews. Participants were recruited using an online survey, and interviews were conducted between October 2020 and November 2020. Transcripts were transcribed and de-identified, and thematically analysed. RESULTS Twenty-nine semi-structured interviews were conducted with trainees and 12 Fellows. Twenty-five participants identified as male, and four identified as female. Four main incentives identified were: (1) broad scope of learning opportunities, (2) quality of supervision, (3) positive work environment and (4) lifestyle. Seven barriers identified were: (1) inadequate preparation for placement, (2) limited case mix to support learning outcomes, (3) lack of formally structured learning opportunities, (4) workload and safe hours concerns, (5) lack of peer support, (6) childcare and educational needs and (7) partner career development. CONCLUSION The strategy of encouraging trainees to undertake rural placements to address the maldistribution of the surgical workforce should include initiatives that support learning outcomes across their training levels. In addition, improving trainees' ability to prepare adequately for placements may also improve the number and duration of rural placements trainees undertake during their training.
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Affiliation(s)
- Dinah Hippolyte-Blake
- Education Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
| | - Alison Dreschler
- Fellowships Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
| | - Andrew Rose
- Training Services Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
| | - Peter Rae
- Education Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
| | - Julian Archer
- Education Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Tamsin J Garrod
- Education Portfolio, Royal Australasian College of Surgeons, Melbourne, Victoria, Australia
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Lockhart KR, Blatt A. We have cracked the ceiling, but how long must we walk on broken glass? Addressing the pitfalls confronting women in surgery. ANZ J Surg 2021; 91:1647-1649. [PMID: 34506060 DOI: 10.1111/ans.17072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/21/2021] [Accepted: 07/04/2021] [Indexed: 11/29/2022]
Affiliation(s)
| | - Alison Blatt
- Department of Urology, John Hunter Hospital, Newcastle, New South Wales, Australia
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Papachristos AJ, Loveday BPT, Nestel D. Learning in the Operating Theatre: A Thematic Analysis of Opportunities Lost and Found. JOURNAL OF SURGICAL EDUCATION 2021; 78:1227-1235. [PMID: 33243675 DOI: 10.1016/j.jsurg.2020.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 11/11/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The operating theatre (OT) is an important learning environment. Trainees face barriers to learning in the OT that may reduce meaningful educational interactions. The impact of these barriers on the intraoperative learning experience of trainees and the strategies that they employ to overcome them are not known. This qualitative study aimed to describe the intraoperative learning experiences of senior general surgery trainees in Australia and their strategies to optimize learning in the OT. DESIGN, SETTING, PARTICIPANTS The authors developed a semi-structured interview guide based on published literature. Purposive sampling was used to identify a representative group of general surgery trainees in Australia, who were interviewed in a private setting with audio recordings deidentified for verbatim transcription and analysis. Thematic analysis was conducted using an interpretivist approach to produce a coding framework. RESULTS Ten trainees participated in the study. Themes were divided into external and internal barriers to learning, promoters of effective learning and actions to facilitate learning. External barriers included cultural neglect of an important issue, with inadequate prioritization of teaching and a lack of structure for intraoperative learning. From this, we identified the theme of missed opportunities. Internal barriers included difficulties in developing assertiveness required to address these issues and a failure to adequately plan for learning, with reliance on the mentor to initiate. Actions to facilitate learning were rarely employed by trainees, as most were unaware of strategies to maximize intraoperative learning. CONCLUSIONS Trainees find the barriers to learning in the OT difficult to address and are not well acquainted with strategies that may allow them to maximize their learning.
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Affiliation(s)
- Alexander J Papachristos
- Department of Surgery, University of Melbourne, Victoria, Australia; Department of General Surgical Specialties, Royal Melbourne Hospital, Victoria, Australia.
| | - Benjamin P T Loveday
- Department of General Surgical Specialties, Royal Melbourne Hospital, Victoria, Australia; Department of Surgical Oncology, Peter MacCallum Cancer Centre, Victoria, Australia; Department of Surgery, University of Auckland, New Zealand
| | - Debra Nestel
- Department of Surgery, University of Melbourne, Victoria, Australia
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Harries RL, Gokani VJ, Smitham P, Fitzgerald JEF. Less than full-time training in surgery: a cross-sectional study evaluating the accessibility and experiences of flexible training in the surgical trainee workforce. BMJ Open 2016; 6:e010136. [PMID: 27091819 PMCID: PMC4838701 DOI: 10.1136/bmjopen-2015-010136] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Generational changes in lifestyle expectations, working environments and the feminisation of the medical workforce have seen an increased demand in postgraduate less than full-time training (LTFT). Despite this, concerns remain regarding access to, and information about, flexible training for surgeons. This study aimed to assess the opinions and experiences of LTFT for surgical trainees. DESIGN Prospective, questionnaire-based cross-sectional study. SETTING/PARTICIPANTS An electronic, self-administered questionnaire was distributed in the UK and Republic of Ireland through mailing lists via the Association of Surgeons in Training and British Orthopedic Trainee Association. RESULTS Overall, 876 completed responses were received, representing all grades of trainee across all 10 surgical specialties. Median age was 33 years and 63.4% were female. Of those who had undertaken LTFT, 92.5% (148/160) were female. Most worked 60% of a full-time post (86/160, 53.8%). The reasons for either choosing or considering LTFT were childrearing (82.7%), caring for a dependent (12.6%) and sporting commitments (6.8%). Males were less likely to list childrearing than females (64.9% vs 87.6%; p<0.0001). Only 38% (60/160) found the application process easy and 53.8% (86/160) experienced undermining behaviour from workplace staff as a result of undertaking LTFT. Of all respondents, an additional 53.7% (385/716) would consider LTFT in future; 27.5% of which were male (106/385). Overall, only 9.9% of all respondents rated current LTFT information as adequate. Common sources of information were other trainees (47.3%), educational supervisors (20.6%) and local postgraduate school website (19.5%). CONCLUSIONS Over half of surgical trainees working LTFT have experienced undermining behaviour as a result of their LTFT. Despite a reported need for LTFT in both genders, this remains difficult to organise, access to useful information is poor and negative attitudes among staff remain. Recommendations are made to provide improved support and information for those wishing to pursue LTFT.
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Affiliation(s)
- Rhiannon L Harries
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Vimal J Gokani
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
| | - Peter Smitham
- The British Orthopaedic Trainees Association, British Orthopaedic Association Offices, London, UK
| | - J Edward F Fitzgerald
- Association of Surgeons in Training Council, Association of Surgeons in Training, London, UK
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Vasey CE, Mitchell RA. Gender perceptions in surgery: is it really a level playing field? ANZ J Surg 2015; 85:898-901. [DOI: 10.1111/ans.13311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Carolyn E. Vasey
- Department of Surgery; North Shore Hospital; Auckland New Zealand
- Immediate Past Chair, Royal Australasian College of Surgeons Trainee Association; Royal Australasian College of Surgeons; Melbourne Victoria Australia
| | - Ruth A. Mitchell
- Department of Neurosurgery; Royal Melbourne Hospital; Melbourne Victoria Australia
- Department of Surgery (The Royal Melbourne Hospital); The University of Melbourne; Melbourne Victoria Australia
- Support and Advocacy Portfolio; Royal Australasian College of Surgeons Trainee Association; Royal Australasian College of Surgeons; Melbourne Victoria Australia
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Harries RL, McGoldrick C, Mohan H, Fitzgerald JEF, Gokani VJ. Less Than Full-time Training in surgical specialities: Consensus recommendations for flexible training by the Association of Surgeons in Training. Int J Surg 2015; 23 Suppl 1:S10-4. [DOI: 10.1016/j.ijsu.2015.09.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Eyre HA, Mitchell RD, Milford W, Vaswani N, Moylan S. Portfolio careers for medical graduates: implications for postgraduate training and workforce planning. AUST HEALTH REV 2014; 38:246-51. [PMID: 24718035 DOI: 10.1071/ah13203] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 01/23/2014] [Indexed: 11/23/2022]
Abstract
Portfolio careers in medicine can be defined as significant involvement in one or more portfolios of activity beyond a practitioner's primary clinical role, either concurrently or in sequence. Portfolio occupations may include medical education, research, administration, legal medicine, the arts, engineering, business and consulting, leadership, politics and entrepreneurship. Despite significant interest among junior doctors, portfolios are poorly integrated with prevocational and speciality training programs in Australia. The present paper seeks to explore this issue. More formal systems for portfolio careers in Australia have the potential to increase job satisfaction, flexibility and retention, as well as diversify trainee skill sets. Although there are numerous benefits from involvement in portfolio careers, there are also risks to the trainee, employing health service and workforce modelling. Formalising pathways to portfolio careers relies on assessing stakeholder interest, enhancing flexibility in training programs, developing support programs, mentorship and coaching schemes and improving support structures in health services.
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Affiliation(s)
- Harris A Eyre
- School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - Rob D Mitchell
- The Townsville Hospital, Queensland Health, Townsville, Qld 4814, Australia.
| | - Will Milford
- Australian Medical Association Council of Doctors in Training, 42 Macquarie Street, Barton, ACT 2600, Australia.
| | - Nitin Vaswani
- Joondalup Health Campus, Western Australia Health, Perth, WA 6027, Australia.
| | - Steven Moylan
- School of Medicine, Deakin University, Geelong, Vic. 3216, Australia.
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Williams SA. Flexible surgical training in Australasia. Med J Aust 2013; 198:426. [PMID: 23641992 DOI: 10.5694/mja13.10341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 03/28/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Simon A Williams
- Royal Australasian College of Surgeons, Melbourne, VIC, Australia.
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