Indicative operative numbers in urology training in the UK and Ireland

Abstract

Objectives: In 2011 the Joint Committee on Surgical Training (JCST) issued guidelines for the award of a Certificate of Completed Training (CCT) in urology, including a list of 15 operative procedure groups for which a trainee must have achieved a minimum level of exposure (termed indicative number) and competence. This study evaluated whether the expected exposure correlated with that achieved by UK and Irish trainees. Methods: The operative logbooks of trainees who applied for a CCT in urology from 2010 to 2012 were reviewed. All exposure for each operative group, irrespective of the degree of supervision, was combined to give total operative experience. Results: Data on 154 trainees were available. More than 75% achieved the indicative number for radical prostatectomy, nephrectomy, ureteroscopy, PCNL and inguino-scrotal surgery. Only 70%, 68%, 64%, 25%, 21% and 8% reached the required level for cystectomy, TURBT, TURP, andrology, female and paediatric groin surgery, respectively. There was significant geographical variation in exposure, with the majority of trainees not achieving the minimum level for some procedure groups in certain training regions. Conclusions: There is a disparity between the operative exposure expected by the JCST and that achieved by urology trainees. To prevent large numbers of trainees failing to meet JCST requirements, an urgent and significant change to urology training, or further modification of the current guidelines, is required.