A cross-sectional study examining MRCS performance by core surgical training location

Abstract

Background

In the UK, core surgical training (CST) is the first specialty experience that early-career surgeons receive but training differs significantly across CST deaneries. To identify the impact these differences have on trainee performance, we assessed whether success at the Membership of the Royal College of Surgeons (MRCS) examinations is associated with CST deanery.

Methods

A retrospective cohort study of UK trainees in CST who attempted MRCS between 2014 and 2020 (n = 1104). Chi-squared tests examined associations between locality and first-attempt MRCS performance. Multivariate logistic regression models identified the likelihood of MRCS success depending on CST deanery.

Results

MRCS Part A and Part B pass rates were associated with CST deanery (p < 0.001 and p = 0.013, respectively). Candidates that trained in Thames Valley (Odds Ratio [OR] 2.52 (95% Confidence Interval [CI] 1.00–6.42), North Central and East London (OR 2.37 [95% CI 1.04–5.40]) or South London (OR 2.36 [95% CI 1.09–5.10]) were each more than twice as likely to pass MRCS Part A at first attempt. Trainees from North Central and East London were more than ten times more likely to pass MRCS Part B at first attempt (OR 10.59 [95% CI 1.23–51.00]). However, 68% of candidates attempted Part A prior to CST and 48% attempted Part B before or during the first year of CST.

Conclusion

MRCS performance is associated with CST deanery; however, many candidates passed the exam with little or any CST experience suggesting that some deaneries attract high academic performers. MRCS performance is therefore not a suitable marker of CST training quality.

Keywords:

• Post-graduate
• training
• education
• assessment
• surgery

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Acknowledgements

The authors would like to thank Professor Peter Johnston for his valuable insights and expertise in reviewing an earlier draft of this paper. The authors would also like to acknowledge Iain Targett at the Royal College of Surgeons of England and John Hines and Gregory Ayre from the Intercollegiate Committee for Basic Surgical Examinations for their support during this project.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Author contributions

RE wrote the first draft of the manuscript and performed statistical analyses with AL’s supervision. All authors contributed to, edited, and reviewed the manuscript.

Additional information

Funding

This work was supported by Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of Ireland, and Royal College of Physicians and Surgeons of Glasgow.

Notes on contributors

Ricky Ellis

Mr. Ricky Ellis, MBChB, BSc, Urology Specialist Registrar and Intercollegiate Research Fellow, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, United Kingdom.

Jennifer Cleland

Professor Jennifer Cleland, Ph.D., Professor of Medical Education Research and Vice-Dean of Education, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.

Amanda J. Lee

Professor Amanda J. Lee, Ph.D., Chair in Medical Statistics and Director of the Institute of Applied Health Sciences, University of Aberdeen, United Kingdom.

Duncan S. G. Scrimgeour

Mr. Duncan S. G. Scrimgeour, Ph.D., Colorectal Specialist Registrar and Past Intercollegiate Research Fellow, Department of Colorectal Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.

Peter A. Brennan

Professor Peter A. Brennan, Ph.D., Professor of Surgery, Consultant Maxillo-Facial Surgeon and Research Lead for the Intercollegiate Committee for Basic Surgical Examinations, Department of Maxillo-Facial Surgery, Queen Alexandra Hospital, Portsmouth, United Kingdom.