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POST‐FELLOWSHIP TRAINING AND THE SURGICAL COLLEGES – HAS THE HORSE ALREADY BOLTED?
Author(s) -
Collins J.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04930_16.x
Subject(s) - specialty , subspecialty , medicine , workforce , accreditation , medical education , general partnership , curriculum , trainer , modalities , scope of practice , health care , family medicine , political science , psychology , pedagogy , social science , sociology , computer science , law , programming language
A large percentage of surgical trainees on completion of their specialty education and training program seek further experience and instruction frequently in a sub‐specialty area. It frequently leads to a narrowing of the spectrum of surgical service the individual will provide with significant workforce implications. This “progressive specialisation” or voluntary narrowing of scope of practice which in the past occurred gradually over the course of most surgeons” careers is now increasingly linked to post‐fellowship training. It is driven by patient demands and the emphasis on health‐care quality, the constant growth in new modalities of treatment and personal factors by the surgeon. With the exception of a few areas like colorectal surgery the arrangements surrounding this training tends to be haphazard. In order to achieve the best outcome for society and the individuals embarking on this training a number of important issues must be addressed. These include workforce considerations within a particular specialty, the accreditation of suitable posts, wide advertising, selection and subsequent allocation of successful applicants, the provision of a formal education and training program with appropriate assessment in the subspecialty area, and recognition of completion of this program by a post‐fellowship qualification. Clearly the College in partnership with the specialty associations should sponsor administer and monitor these programs and issue appropriate qualifications. However “when the wind blows, some build walls, others build windmills”. The winds of change have been too fast for some and complicated by turf protection. Into this void has entered the universities which now offer degree programs in Minimally Invasive Surgery with others soon to follow. The horse has already bolted but in the long run society will be best served by proactive and cooperative partnerships between the many stakeholders involved.