A chapter in emergency: a surgical trainee's experience

Abstract

Objectives: To assess (1) the exposure a senior house officer (SHO) gains while training in accident and emergency (A&E) and (2) how much this experience benefits a surgical trainee.

Methods: An SHO trained in A&E for a period of six months as part of his surgical rotation. Besides regular daily duties, he prospectively collected details of patients in a logbook. For each patient records of name, age, sex, address, presenting symptoms, specialty, and treatment outcome were noted. Also recorded were courses attended, certificates achieved, and audits performed during this period.

Results: A total of 1249 patients were seen during this period. This included 423 (33%) medical, 374 (30%) orthopaedic/trauma, and 268 (21%) paediatric cases. Some 153 (12%) were surgical, 55 urology, 41 patients presented with "pain" symptoms in different body regions (excluding abdominal pains), and 120 patients included all other specialties (psychiatry, ENT, ophthalmology, dental, gynaecology). Twenty (1.6%) practical procedures were performed. The SHO attended two courses (ATLS, ALS), achieved two certificates, and was involved in two audits.

Conclusions: Wide exposure in all specialties and branches of medicine including internal medicine, orthopaedics and trauma, paediatrics, and surgery was gained. As a surgical trainee, training in A&E did not provide hands on practical experience, but was useful in contributing towards general clinical skills.