Evaluating neurosurgical training: a national survey examining the British trainee experience

Abstract

Purpose

Neurosurgery training in the UK has undergone significant changes over the past few years, including the new competency-based curriculum and a reduction of elective operating due to the pandemic. We conducted a comprehensive survey to assess UK neurosurgical trainees’ experiences and perceptions to develop targeted action plans.

Methods

An online anonymised survey was developed and distributed amongst the BNTA mailing list. Question types included 10-point Likert scales and free text options. Descriptive statistics, non-parametric testing of Likert scores, and Spearman’s rank correlation were used to analyse responses. Pearson’s chi-squared test was used for subgroup analysis of categorical data.

Results

A total of 75 trainees with a National Training Number (NTN) responded. Overall trainees feel they are well trained, well supported, and have caught up with training emerging out of COVID. Funding for training varied between deaneries. There is significant concern amongst trainees regarding the workforce crisis. This, as well as financial concerns are leading to more than a quarter of trainees considering quitting. Half of the trainees are considering going OOP. More than one third of the trainees and more than half of the female trainees are considering working Less Than Full Time (LTFT). Most important supportive mechanisms towards completion of training were social support, along with personal satisfaction from work. An independent mentoring scheme is a preferred additional support mechanism.

Conclusions

Overall training experience for neurosurgery trainees in UK and Ireland was positive. There are significant concerns regarding the workforce crisis and costs of training, with a large proportion of neurosurgery trainees considering resigning. OOP and LTFT are popular means of becoming more competitive for consultant posts and to spend time with their families. Deanery experience, senior and peer support does, and will improve trainee experience and protect against attrition.

Keywords:

• Neurosurgery
• education
• workforce planning
• attrition
• training

Acknowledgements

We would like to thank Ahmad Ali for his thorough review and helpful comments for our manuscript. We would also like to acknowledge the BNTA committee for their contributions towards the design, dissemination and comments for results of the survey.

Disclosure statement

SM is an NIHR-funded Academic Clinical Fellow in Neurosurgery.

Data availability statement

Further breakdown and sub-group analysis of data is available, subject to review of request. Format of data in this manuscript has been presented to protect anonymity of responders. Deanery specific data was analysed but is not reported in this manuscript.

Additional information

Funding

No funding was received for the generation of the BNTA survey or manuscript writing.