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What is the future for General Surgery in Model 3 Hospitals?

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Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Background

General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland.

Aim

The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning.

Methods

General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset. Current consultant staffing was ascertained from hospital personnel departments and all trainees on the National Surgical Training Programme were asked to complete a questionnaire on their career intentions.

Results

Model 3 Hospitals accounted for 50% of all General Surgery discharges. In the elective setting, 51.5% of all procedures were endoscopic investigations and in the acute setting only 22% of patients underwent an operation. Most surgical procedures were of low acuity and included excision of minor lesions, appendicectomy, cholecystectomy and hernia repair. Of 76 General Surgeons who work in Model 3 Hospitals 25% were locums and 54% had not undergone formal training in Ireland. A further 22% of these surgeons will retire in the next five years. General Surgical trainees surveyed indicated an unwillingness to take up posts in Model 3 Hospitals, while 83% indicated that a post in a Model 4 Hospital is ‘most desirable’. Lack of attractiveness related to issues regarding rotas, lack of ongoing skill enhancement, poor experience in the management of complex surgical conditions, limited research and academic opportunity, isolation from colleagues and poor trainee support.

Conclusions

These data indicated that an impending General Surgery consultant manpower crisis can only be averted in Model 3 Hospitals by either major change in the emphasis of surgical training or a significant reorganisation of surgical services.

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References

  1. McCraith Report: Strategic review of medical training and career structure, Department of Health 2014: http://www.lenus.ie/hse/bitstream/10147/317460/1/SRMTCSCareerStructuresReportFINAL.pdf

  2. A strategy for cancer control in Ireland, Department of Health 2006: http://www.cancerscreening.ie/publications/CancerControlStrategy2006.pdf

  3. National Institute of Academic Health Service Research Centre. Anaesthesia National Emergency Laparotomy Audit (NELA) reports. http://nela.org.uk/reports

  4. Report of the Acute Medicine Programme https://www.hse.ie/eng/services/publications/hospitals/AMP.pdf

  5. Report of the investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive at the Mid-Western Regional Hospital Ennis 6 April 2009. https://www.hiqa.ie/system/files/HIQA_Ennis_report_09042009.pdf

  6. Report of the investigation into the quality and safety of services and supporting arrangements provided by the Health Service Executive at Mallow General Hospital 13 April 2011. https://www.hiqa.ie/system/files/Investigation-Mallow-report.pdf

  7. Securing the Future of Smaller Hospitals: A Framework for Development. http://health.gov.ie/wp-content/uploads/2014/03/SecuringSmallerHospitals.pdf

  8. The future of surgical specialties in Ireland, RCSI https://www.rcsi.ie/files/surgery/docs/20100928014305_Forum%20on%20the%20future%20of%20surgica.pdf

  9. Joint Committee for Surgical Training: www.jcst.org

  10. Model of care for acute surgery, National Clinical Programme in Surgery (2013) https://www.rcsi.ie/files/surgery/docs/20131030121710_RCSI_Model_of_Care_for_Acute_S.pdf

  11. Symons NR, Morrthy K, Almoudaris AM et al (2013) Mortality in high-risk emergency general surgical admissions. Br J Surg 100:1318–1325

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Correspondence to K. Mealy.

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Mealy, K., Keane, F., Kelly, P. et al. What is the future for General Surgery in Model 3 Hospitals?. Ir J Med Sci 186, 225–233 (2017). https://doi.org/10.1007/s11845-016-1545-0

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  • DOI: https://doi.org/10.1007/s11845-016-1545-0

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