Most Canadian med school grads lack basic surgical skills

Many medical school graduates in Canada have not received adequate training in basic surgical skills, such as suturing and tube placements, says a new study published recently in the Canadian Journal of Surgery.

"There is compelling evidence to suggest that undergraduate surgical education may fail to provide appropriate instruction in basic surgical skills and principles, writes Dr. Daniel Birch, a professor in the University of Alberta Department of Surgery and the lead author of the study.

The researchers gathered their results from surveys of 123 recent medical school graduates and 55 surgeons. The results show that the respondents felt there are at least 8 to 10 surgical skills that are highly relevant to current medical practices; however, the average medical graduates will achieve proficiency in only three of them.

"You want to believe that med graduates feel comfortable with their basic surgery skills, but many of them don't. And this is important because it's very likely that they will have to use these skills at some point in their careers," Birch added.

There are a number or reasons for the deficient surgical training in Canada, with the prime one being a lack of time and resources, Birch noted. Currently, when medical students go through surgical clerkships (usually lasting about four weeks), the skills they learn are related to whatever situations they encounter during their clerkship.

To correct the situation, Birch suggests that a minimum number of basic surgical skills could be created as guideline, and then medical schools across the country would be required to train their students in these skills. Also, students could keep log books, and surgeon-educators could check them to see what skills the students have learned to that point.

"But then you have to ask who will teach these skills and how will they teach them? Do surgeons or surgery residents have the time to teach these skills? And are they willing to make the effort? Ideally, these skills would be taught in a non-rushed, non-stressful environment. All of these questions need to be worked out," Birch said.

There are "dramatic variations" in the way surgery is taught to medical students at the 17 medical schools in Canada, and, therefore, it would be difficult, if not impossible, to mandate that a specific program be implemented to teach surgical skills in Canada, Birch said.

"At the moment, I don't know of any medical schools in Canada that formally teach and evaluate basic surgical skills of medical students, but maybe they should. Certainly, this study highlights the need to address this issue," Birch said.

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Dr. Birch can be reached at 780-735-4786 or dbirch@ualberta.ca.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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