Recruitment to UK cardiothoracic surgery in the era of public outcome reporting

Westaby, Stephen; Baig, Kamran; Silva, Ravi De; Unsworth‐White, Jonathan; Pepper, John

doi:10.1093/ejcts/ezu509

Cited by 27 publications

(24 citation statements)

References 12 publications

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“… 3 This is similar to the experience in the UK where recent studies revealed a decline in interest in CTS among UK graduates. 4 , 5 The entry point into a CTS programme in the West African sub-region is similar to that of the UK, where the application for entry is made at the level of PGY-2, unlike in the USA, where most cardiothoracic surgeons complete an initial general surgery training.…”

Section: Discussionmentioning

confidence: 99%

Factors affecting interest in cardiothoracic surgery among junior surgical residents in Nigeria

Kesieme

Umar

Olusoji

et al. 2017

CVJA

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SummaryObjective:A survey was undertaken to determine the factors that affect interest in cardiothoracic surgery (CTS) among junior surgical residents in Nigeria.Methods:A cross-sectional study was done using a pilottested, 56-item, semi-structured questionnaire, which was filled in by 238 junior surgical residents in accredited hospitals in Nigeria.Results:Few of the respondents (8.4%) were committed to specialising in CTS. A minority of them, 28.2 and 2.1%, had assisted in major thoracic procedures and open-heart surgeries, respectively. The relationship between the level of training, rotation in CTS in junior residency and interest in CTS were statistically significant (p < 0.05). The main important factors responsible for the low interest in CTS include the lack of equipment (92%), limited training positions (64.9%), poor or lack of exposure in CTS as a junior resident (63%) and in medical school (58.8%).Conclusion:There is a dire need to provide facilities and training opportunities to improve the cardiothoracic workforce in Nigeria.

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Section: Discussionmentioning

confidence: 99%

Factors affecting interest in cardiothoracic surgery among junior surgical residents in Nigeria

Kesieme

Umar

Olusoji

et al. 2017

CVJA

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“…In the United Kingdom, 2 cardiothoracic training pathways exist-a 6-year program after 2 years of core surgical training and, as of 2013, an 8-year specialty ''run-through'' program. 2 A move toward earlier specialization, as well as recent difficulties identified in trainee recruitment, 3 indicates a need for early exposure to not only stimulate interest and provide career insight, but to obtain experience necessary for an informed application to a competitive process.…”

Section: Cardiothoracic Surgery Exposure In Medical School--a United mentioning

confidence: 99%

Cardiothoracic surgery exposure in medical school—a United Kingdom student perspective

Taylor

2020

The Journal of Thoracic and Cardiovascular Surgery

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“…When Donald Berwick was asked by the British prime minister to review the state of the NHS, he reiterated, "Hospitals, not individuals, must be held accountable for poor outcomes" [24,25]. Nevertheless, the process did reduce mortality to low levels in a system where most cardiac centers were not funded for circulatory support equipment and team consistency was poor through the European Working Time Directive.…”

Section: International Experiences With Public Reporting Of Cardiac Smentioning

confidence: 99%

“…There is broad agreement that the individually focused "name and shame" agenda has affected recruitment to cardiothoracic surgery in the United Kingdom. Currently, only 40% of pediatric cardiac surgeons, 54% of thoracic surgeons, and 64% of adult cardiac surgeons had their medical training in the United Kingdom [25]. From the General Medical Council Specialist Register, we know that 68% of trainees entering cardiothoracic surgery at the time of the Bristol children's heart scandal (2000) were UK graduates.…”

Section: International Experiences With Public Reporting Of Cardiac Smentioning

confidence: 99%

Our New Reality of Public Reporting: Shame Rather Than Blame?

Moffatt-Bruce¹,

Nguyen²,

Fann³

et al. 2016

The Annals of Thoracic Surgery

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T he number of organizations issuing reports on hospital and physician quality performance has increased markedly over the past decade. Differences in the measures, data sources, and scoring methodologies produce contradictory results that lead to confusion for the public, providers, and governing boards, and impair the public's ability to make well-informed choices about health care providers [1]. This variability continues today and points to concerns about validity and the ultimate reliability of the measures used by these groups.The hospital community and surgeons as a whole support the principle of accountability through public reporting of health care performance data. However, performance data that are inappropriately collected, analyzed, and displayed may add more confusion than clarity to the health care quality question [1]. For data to be understood and for results to be comparable, publicly reported data should adhere to a set of guiding principles. With that goal in mind, the Association of American Medical Colleges (AAMC) convened a panel of experts in 2012 and 2013 to develop a set of guiding principles that can be used to evaluate quality reports. The principles were organized into three broad categories: purpose, transparency, and validity.Under the domain of purpose, the AAMC recognized that public reporting and performance measurement should occur for a variety of reasons, including consumer education, provider quality improvement, and purchaser decision making. Relative to transparency, the AAMC believed that methodologic details should be clearly discerned as they can impact both providers' performance data and the appropriate interpretation of the data. Transparency also requires that all information necessary to understand the data be available to and interpretable by the reader. Limitations in data collection and methodology as well as relevant financial interests should always be disclosed in language that is discernable. Lastly, validity of the data must ensure that the methodology, data collection, scoring, and benchmarks produce an accurate reflection of the characteristic being measured and reflect the care being provided by the hospital or physician. These guiding principles were expanded and proposed by the AAMC to facilitate adherence and to ensure appropriate interpretation of performance as public reporting becomes truly a cottage industry. Federally Facilitated Quality and Patient ProgramsIn the recent and final Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the LongTerm Care Hospital policy for fiscal year 2015, the Centers for Medicare and Medicaid Services (CMS) aimed at promoting high-value and high-quality care using a program that is targeted at a specific set of preventable infections, events, and conditions that occur in the inpatient setting, referred to as hospital-acquired conditions (HAC). Similar to CMS value-based purchasing and readmissions reduction programs, this HAC reduction program has significant implications for academic centers...

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Recruitment to UK cardiothoracic surgery in the era of public outcome reporting

Abstract: Repeated negative messages have had a detrimental influence on recruitment. Because 55% of UK medical graduates, but less than 5% of CT surgeons are female, recruitment problems may worsen. Action is needed to restore interest in the specialty.

Cited by 27 publications

References 12 publications

Factors affecting interest in cardiothoracic surgery among junior surgical residents in Nigeria

Factors affecting interest in cardiothoracic surgery among junior surgical residents in Nigeria

Cardiothoracic surgery exposure in medical school—a United Kingdom student perspective

Our New Reality of Public Reporting: Shame Rather Than Blame?

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