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ANZMOSS - ANZGOSA 2020 Virtual Conference
ANZMOSS – ANZGOSA 2020 Virtual Conference
ANZMOSS - ANZGOSA 2020 Virtual Conference
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Bariatric surgery exposure during general surgery training in Australia

Description
BACKGROUND
Obesity is common in Australia and surgery is its most effective treatment. Obesity surgery is a rapidly growing discipline and included in the syllabus for Surgical Education and Training in General Surgery. Training in obesity surgery is not standardized and while most surgical training occurs in public hospitals, most obesity surgery (>90%) occurs in private hospitals
The volume of exposure that general surgery trainees have to bariatric surgery is currently unknown.

AIM
To quantify Australian general surgeons’ exposure to bariatric surgery during training.

METHODS
Inclusion: Australian general surgery trainees commencing 2013 or 2014 with 10 rotation logbooks submitted via the Mortality Audit Logbook Tool (MALT).
Exclusion: Dismissal, withdrawal, probationary terms, interruption, part-time training, or unsatisfactory terms
A De-identified extract from the MALT databases included number of procedures in each supervision category level for any and all bariatric surgery procedures recorded. 

RESULTS
Data from 118 trainees were included. Throughout 5 years of training, 43 trainees (36%) performed no bariatric operations as primary operator, and a further 62 (52%) performed 1-10 operations. Only 5 trainees (4%) performed more than 15 bariatric operations.

Eleven trainees (9%) recorded no assisting in bariatric surgery and 46 trainees (41%) assisted in 1 -10 bariatric operations, 41 (23%) assisted in 11-20, and 20 (11%) assisted in 21-30 operations. Only 8 trainees (7%) assisted in more than 50 bariatric operations.

CONCLUSION
General surgery training provides minimal exposure to its fastest growing discipline for the large majority of trainees and inadequate preparation for obesity surgery practice. Lack of exposure to obesity care for the majority of surgeons may contribute to bias and stigma.

More structured and standardized obesity surgery training is indicated and expansion of public obesity surgery should include registrar training positions.
Authors
Ahmad Aly - ANZGOSA and Alex Craven - Austin Health