Abstract

Aims

To quantify the impact of the Covid-19 pandemic on the Annual Review of Competency Progression (ARCP) outcomes of higher specialty trainees in General Surgery in the UK.

Methods

All ARCP outcomes awarded to higher specialty trainees in General Surgery between 2017 and 2022 were collated from Intercollegiate Surgical Curriculum Programme (ISCP). Associations between year, trainee sex, age, stage of training, and outcome were explored using multivariate logistic regression models.

Results

A total of 7,414 outcomes issued to 1,874 trainees were analysed. The Adjusted Odds Ratio (AOR) of receiving a non-standard outcome in 2020 (compared to 2017) was 3.07 (95% CI:2.47–3.81, P<0.001) and this remained elevated through 2022 (2.11, 95% CI:1.69–2.64, P<0.001). Female (AOR 1.27 (95% CI: 1.13–1.43, P<0.001) and older trainees (1.51 (95% CI:1.34–1.70, P<0.001) were more likely to receive non-standard outcomes. Being at a later stage of training during the pandemic did not increase the chances of receiving non-standard outcomes (AOR 1.09, 95% CI:0.97-1.22, P=0.134), but more outcomes advising extra training time were issued to this group (15.5% versus 4.3% in 2021). There was significant regional difference in the use of Covid-19 outcomes. The awarding of non-standard outcomes rose most years, even outside of the pandemic.

Conclusions

The Covid-19 pandemic had significant impact on the training trajectory of UK General Surgical trainees. Female and older trainees were more likely to receive non-standard ARCP outcomes before and during Covid-19. Urgent efforts are required to restore surgical training, and addressing differential attainment is essential for success.

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