The future of Urological Surgical Training
Dear Urology Trainees and Trainers,
Here are some thoughts stating my reasons for resigning as an educational supervisor – please add your views and help form and drive the debate. Keeping them to yourself, and doing nothing, won’t change anything!
“I have resigned as an official educational supervisor / trainer. This does not mean that I am going to cease to train – far from it: I shall continue to lecture, teach, educate, support, nurture and mentor urological trainees in general, and those who have a subspecialist interest in “EndoLuminal EndoUrology” in particular. But it has become increasingly clear to me (and the senior trainees that I have had over the last decade) that the process of form-filling actually gets in the way of training rather than enhancing it.
As the current round of achieving the appropriate number of Work based assessment (WBA) and Multi-source Feedback (MSF) forms reaches fever pitch, my senior trainee needed to miss the educational opportunity of my monthly super-specialist metabolic stone clinic to have time to complete all his forms. And we both missed half of our stone committee meeting to “sign them off”. The discussions are valuable (we have these continuously); the process is not.
Time is finite, and sadly in inadequately short supply. Part of my role as a consultant is to decide how to spend it most wisely; part of my role as a trainer is to teach my trainee how to do the same. We have reached the conclusion that a form-filling box-ticking exercise, in which regardless of seniority and competency we still have to attest his ability to appropriately prepare and drape a patient for every single case, is not fit for purpose. I would willingly complete these forms ad infinitum if my trainee said they were useful and helped them, but they do not.
So, as stated above, I have decided, until such time as the fixed and rigid process that we work to becomes more flexible and adaptable to the specific and individual needs of trainees, that I can no longer waste their time (or mine) adhering to a rule just because it is a rule. I reiterate my second line to emphasise that this does not mean I am going to discontinue to train; it simply means that I am going to discontinue to complete the forms that are used as evidence that I have. I think the “final product” of a more senior, technically adept and consultant-ready surgeon that leaves the unit at the end of the year, compared with the one that arrived at the start of it (as judged by an independent expert colleague) would provide far better evidence of that than any number of electronic forms.”
It would be particularly good to hear comments from trainees because this is not just for your immediate future, but as the soon-to-be trainers of the future. So yours are the key opinions needed to get this right!
Daron Smith, Consultant Urological Surgeon, Endoluminal Endourology Unit, UCLH.
@endoluminalendo