Background Documentation of pregnancy status (PS) is an integral component of the assessment of women of reproductive age when admitted to hospital. Our aim was to determine how accurately PS was documented in a multicentre audit of female admissions to general surgery. Methods A prospective multicentre audit of elective and emergency admissions was performed in 18 Scottish centres between 08:00 on 11 May 2015 and 07:59 on 25 May 2015. The lower age limit was the minimum age for admission to the adult surgical ward and the upper age limit was 55 years. Results There were 2743 admissions, with 612 (22.3%) women of reproductive age. After 82 exclusions, the final total was 530: 169 (31.9%) elective and 361 (68.1%) emergency. Documentation of PS was achieved in 274 (51.7%) cases: 52 (30.8%) elective and 222 (61.5%) emergency. In 318 (88.1%) of the emergency admissions, the patient had abdominal pain. Of these, 211 (65.1%) had a documented PS. The possibility of pregnancy was established in 237 (44.7%) cases. Discussion Establishing the possibility of pregnancy before surgery is poor, particularly in the elective setting. Objective documentation of PS in the emergency setting in those with abdominal pain is also poor. Our study highlights an important safety issue in the management of female patients. We advocate electronic storage of pregnancy test results and new guidelines to cover both elective and emergency surgery. PS should form part of the pre-theatre safety brief and checklist.

Background It is currently not known how many trainees leave vascular surgery, and their reasons for doing so are unclear. This paper is the first to publish the number of UK trainees leaving the training programme and interrogates their reasons for doing so. Methods An email survey was distributed to current and recent Training Programme Directors (TPDs) to quantify the number of trainees resigning between 2013 and 2019. Trainees resigning a National Training Number (NTN) were surveyed regarding their reasons for doing so. Results Since 2013, 23 UK vascular surgery trainees have resigned NTNs, representing 15.4% of the 149 NTNs awarded between 2013 and our analysis. Reasons for leaving, as relayed by TPDs, included availability of an academic career, geography, health and many other reasons classified as “work-life balance” factors. Data from the trainees surveyed also highlighted work-life balance but also identified pressures within the training system and NHS. Conclusions UK data of this sort has not previously been available. The authors’ primary recommendation is that prospective data collection on trainee retention is carried out, with structured exit interviews with trainees who decide to leave. Our secondary recommendations include improvements to the inter-deanery transfer process and early realistic exposure to vascular surgery for junior doctors to improve trainee retention rates in vascular surgery.

Background Undergraduate medical students’ time is precious, and with increasingly limited exposure to surgery, learning at every opportunity needs to be facilitated. The operating theatre is a unique classroom and factors related to this environment could impact on learning opportunities. We aim to help surgical faculty overcome these barriers and develop the operating theatre’s potential as a learning environment. Results Reports in the literature frequently mention the emotional aspects of attending theatre and trying to fit in with the surgical team, and often report negative feelings such as feeling unwelcome. Students also report feeling confused about what they should be hoping to learn from their theatre experience, and what their role is in theatre. Conclusion We suggest ways in which surgical faculty can help the student fit into the theatre environment and hope that this will improve undergraduate surgical education and enthusiasm for surgery.

Background: It is currently not known how many trainees leave vascular surgery, and their reasons for doing so are unclear. This paper is the first to publish the number of UK trainees leaving the training programme and interrogates their reasons for doing so. Methods: An email survey was distributed to current and recent Training Programme Directors (TPDs) to quantify the number of trainees resigning between 2013 and 2019. Trainees resigning a National Training Number (NTN) were surveyed regarding their reasons for doing so. Results: Since 2013, 23 UK vascular surgery trainees have resigned NTNs, representing 15.4% of the 149 NTNs awarded between 2013 and our analysis. Reasons for leaving, as relayed by TPDs, included availability of an academic career, geography, health and many other reasons classified as “work-life balance” factors. Data from the trainees surveyed also highlighted work-life balance but also identified pressures within the training system and NHS. Conclusions: UK data of this sort has not previously been available. The authors recommend prospective data collection, structured exit interviews with trainees who decide to leave, improvements to the inter-deanery transfer process, increased consideration of flexible training options and early realistic exposure to vascular surgery for junior doctors to improve trainee retention rates in vascular surgery.

When to Defer and When to Operate Recommendations concerning the management of abdominal aortic aneurysms (AAAs) 5.5 cm during the COVID-19 pandemic from societies, such as the Society for Vascular Surgery and the Vascular Society for Great Britain & Ireland, recommend deferring repair. However, neither document quantifies the optimal deferral time periods, stating that clinicians should consider factors such as COVID-19 transmission risk and rupture risk. The European Society for Vascular Surgery AAA guidelines specify that rapidly growing AAAs ( 1 cm/year) should prompt fast track vascular referral; 1 these recommendations were developed and published before the COVID-19 pandemic. McGuinness et al. recently reported the results of their risk modelling to address this issue. 2 They include patient, AAA, and COVID-19 risk parameters. This analysis, however, was limited owing to the data on which they based annual rupture risk, which seemed to be an overestimation; and their estimation of peri-operative COVID-19 related mortality, which seemed to be an underestimation.Annual AAA rupture rates used by McGuinness et al. were based on a prospective cohort study of 198 patients turned down for elective repair between 1995 and 2000: 9.4%, 10.2%, and 32.5% for 5.5 e 5.9 cm, 6.0 e 6.9 cm, and 7 cm AAAs respectively. 2 Peri-operative COVID-19 related