Surgical training in the UK versus Canada/US

[Knightmd]

So how does the quality of the surgical training in the UK compare to its North American counterpart? I know that all the Canadian programs are v.strong, high flow, academic, excellent all in all. I also know that in the US the programs drastically vary in quality between really bad programs, and excellent programs.

But how does the UK training (BST+HST) compare to them? I read this on another thread, which wasn't exactly what I was expecting:

....you will more than likely receive better surgical training in the US. You will probably spend more time starting IV lines and charting medications in your first few years of surgical training than you will operating, in Ireland. And by operating, I don't mean just holding retractors and adjusting the lights. By the way, are interns even allowed to go in the OR in Ireland??? The approach to surgical training is much different in the US, more 'hands on'.

Source thread: http://forums.studentdoctor.net/showthread.php?t=250973

So, how would you relatively rate the UK's surgical training?

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[bambi]

So how does the quality of the surgical training in the UK compare to its North American counterpart? I know that all the Canadian programs are v.strong, high flow, academic, excellent all in all. I also know that in the US the programs drastically vary in quality between really bad programs, and excellent programs.

But how does the UK training (BST+HST) compare to them? I read this on another thread, which wasn't exactly what I was expecting:


Source thread: http://forums.studentdoctor.net/showthread.php?t=250973

So, how would you relatively rate the UK's surgical training?

My experience is that UK surgical trainees are vastly superior to their US counterparts in terms of knowledge and clinical skill. I'm not saying that because I am English either. I went to a very good US hospital and expected them to be the best in the world and was stunned and actually pretty disappointed at what I saw.

This sort of thing will obviously vary at least slightly depending on where you go and honestly a few random examples isn't going to help you too much. The atmosphere is very different in the 2 countries and in the UK training is a lot longer which is something you should think seriously about.

If you were trained in the US you might have difficulty with certain aspects of the job in the UK. We are much, much better generalists because of how our training works and you will be expected to be able to deal with a lot of minor things that aren't related to your specialty that you would just refer in the US. We do a lot more of the minor clinical duties too in the very junior years that you may not be trained for. The main issue the other way round, as in a UK educated Dr going to the US is learning to deal with the atmosphere and attitudes of people there, it really is very different.

 

[Knightmd]

Well I was recently shocked to learn that UK residents only work 40-something hours a week (which most of them surpass by around 10-20 hrs), while in the US they work 80 hrs a week (and unofficially reaches up to 100 hrs and beyond)...

Sure 80-100 hrs might be a bit too much, and could negatively impact the training, but 40 hrs is way too little IMO...

 

[bambi]

Well I was recently shocked to learn that UK residents only work 40-something hours a week (which most of them surpass by around 10-20 hrs), while in the US they work 80 hrs a week (and unofficially reaches up to 100 hrs and beyond)...

Sure 80-100 hrs might be a bit too much, and could negatively impact the training, but 40 hrs is way too little IMO...

It's nothing like 40 hours. The rule is 48 but it is NEVER stuck to like it isn't in the US. Lots of us are very against it. Even breaking this rule our hours are not the same as yours, however our hours are far, far busier, you achieve nothing extra in a day.

 

[Knightmd]

It's nothing like 40 hours. The rule is 48 but it is NEVER stuck to like it isn't in the US. Lots of us are very against it. Even breaking this rule our hours are not the same as yours, however our hours are far, far busier, you achieve nothing extra in a day.

Well even if it's broken by 50% more (so, instead 48 hrs, it approaches 70 hrs), in the US/Canada is reaches 100 hrs....

But then again my question wasn't exactly about the hours of work. I personally think 60 hrs of intense work beats 100 hrs where you're worn out and "unteachable" for a good part of it.

It was more about the educational experience. The rounds. The amount of OR time they get. The diversity of cases they'll get to work during their shorter working hours. The responsibilities assigned to registrars... etc.

Do surgical residents in Canada end up with overall superior training compared to that of the UK?

 

[bambi]

Well even if it's broken by 50% more (so, instead 48 hrs, it approaches 70 hrs), in the US/Canada is reaches 100 hrs....

But then again my question wasn't exactly about the hours of work. I personally think 60 hrs of intense work beats 100 hrs where you're worn out and "unteachable" for a good part of it.

It was more about the educational experience. The rounds. The amount of OR time they get. The diversity of cases they'll get to work during their shorter working hours. The responsibilities assigned to registrars... etc.

Do surgical residents in Canada end up with overall superior training compared to that of the UK?

Exactly how many hours will vary by sub-specialty.

Registrar is from ST3-7/8 so 5-6 years so responsibility will vary on which year you are but generally there is quite a lot. Each consultant will have just one registrar or a registrar may be the registrar for several consultants so when the consultant isn't there the reg runs everything. In theatre our registrars are allowed to operate alone also, obviously what they are allowed to operate on varies by stage but it means they get a lot of experience.

I have no idea about Canada, sorry.

 

[Chest Cutter]

Training in the UK will produce a good / safe surgeon. The duration of training is longer than north american residency but offers a better work/life balance... I still have time to go out and chase girls 😀. There are a few bottle necks along the way to get through and you may have to spend some time in a non training post or in research if you're unlucky. I spent some time in Canada as a student and our senior registrars are just as good (and more confident in taking cases alone to theatre) as north american fellows. But that was just my observation. UK training is recognised in Canada and vice-versa. Having your FRCS allows you to sit the FRCSC once your training has been verified.

The european working time directive is never followed by dedicated surgical trainees. In cardiothoracic surgery for example, the concept of me doing a 48 hour work week is nothing more than a joke. And if you happen to get stuck in a centre that enforces it (if such a place exists) then use the time to build up your CV! Free time is great for publications!