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Background Ensuring high quality surgical training remains a challenge as demands on the NHS rise. This study aimed to explore the differences and potential conflicts between service provision and dedicated training activity and recommend solutions. Methods Participants were drawn from the Association of Surgeons in Training national council. Nominal Group Technique (NGT) was employed by members of the ASIT executive addressing 3 key domains (1) defining differences between training and service tasks, (2) impact of service-provision on training and (3) ways to improve training. A two round Delphi process was conducted via electronic survey to ASIT council. Consensus was considered achieved for any statement where 80% or more of respondents indicated agreement. Results 47 statements, generated through NGT, were put to the Delphi process. Consensus was reached on a total of 24/47 statements. Educational or training tasks were identified as those which progressed a trainee’s skill set, could be tailored to a trainee’s own ability, or involved training more junior colleagues. The negative impact of excess service provision included training quality, trainee mental health, and surgical trainee recruitment. Potential measures to improve training included increasing hospital staffing and resources, protected training times, trainee-specific or competency-based learning and training or incentivising trainers. Conclusion This trainee-based study provides several consensus recommendations on the characteristics that define surgical training and how a balance between service provision and training can potentially be achieved. Policy makers and health systems may be guided by these to ensure high quality training and a satisfied workforce.

british journal of surgery

SP2.1.15Consensus recommendations on balancing educational opportunities and service provision in surgical training: An Association of Surgeons in Training Delphi study