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Surgical training in crisis: 'We’re at the tipping point'
Surgical training in crisis: 'We’re at the tipping point'
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Surgical Trainees aren’t getting enough exposure to the experience they need, slowing down the pipeline of new surgeons joining the under-staffed health system, according to the Royal Australasian College of Surgeons (RACS).
The crisis in surgery, particularly around planned care surgery (otherwise known as elective surgery), has been particularly felt at Te Whatu Ora Waitaha (Canterbury). It is adversely affecting patients and the health and wellbeing of our communities. The College says the reduction in access to the operating theatre has the further consequence that Trainees are not getting required exposure to the operative training they need to become competent surgeons.
RACS’ Aotearoa New Zealand (AoNZ) National Committee Chair Associate Professor Andrew MacCormick says “we’re at the tipping point” where anaesthetic technician workforce shortages and other disruptions to operating lists are hampering the College’s ability to train new surgeons.
“Trainees need theatre access to train. They need to be involved with patient care of all types within their specialty. Every delayed operation and cancelled theatre list means lost opportunities to provide education and training to Trainees.
“We have heard planned care surgery is down more than 30% in Canterbury, with some specialties more affected than others. Surgeons are saying they have access to fewer theatres and are being forced to cancel even more urgent and cancer surgeries.”
One of the College’s Surgical Advisors to AoNZ, who also heads the Paediatric Surgery Departments in Christchurch and Wellington, Professor Spencer Beasley, says:” The frustration being felt by our patients who frequently have their surgery cancelled, delayed or not done at all is also being felt by surgeons who feel increasingly unable to provide the service their patients need”.
“What is also causing great concern to RACS is the difficult situation faced by Trainees, our future surgeons.
“Trainees’ voices are often left out of the loop and their concerns and best interests may not be heard. They are gaining minimal exposure to planned surgery, even though this is a major part of what they will be expected to do for the rest of their practicing lives.
“Their training is being disrupted and may end up taking longer than it should. This has the potential to exacerbate the shortage of surgeons in the pipeline and has huge ramifications for them as individuals, partners, parents, as they try to balance life with training.”
Professor Beasley says the current situation not only disadvantages the Trainees themselves but also has adverse consequences on succession planning and the future surgical workforce.
AoNZ Surgical Advisor Dr Sarah Rennie says: “We need to ensure this doesn’t happen and think creatively about how adequate exposure to operating can be achieved for our future surgeons”.
Last week senior RACS officials, including President Dr Sally Langley, a plastic surgeon based in Christchurch, Dr Rennie, Professor Beasley and Associate Professor MacCormick, met with Health Minister Dr Ayesha Verrall and senior representatives from Te Whatu Ora, Health New Zealand, and the Ministry of Health on this and other issues facing surgical services.
Dr Langley says the College has been calling for government action for some time and is grateful the door is now open. She says RACS in AoNZ is looking forward to working with Te Whatu Ora officials to make positive change and will be reporting back to the Minister if no progress is seen within a month.
“The problems in the health system can seem so many and varied it is overwhelming, but we have identified some priority areas for which we are working on solutions with the Minister that can be done now and could begin moving things in the right direction.”