Operative experience in paediatric orthopaedics in UK trainees achieving a Certificate of Completion of Training in trauma and orthopaedic surgery: A descriptive analysis of national eLogbook data

Abstract

Introduction: The Trauma and Orthopaedic curriculum set by the Joint Committee on Surgical Training (JCST) requires that consultant orthopaedic surgeons must have sufficient experience managing children's orthopaedic conditions. In this study, our objective was to describe the paediatric operative exposure of United Kingdom (UK)-trained orthopaedic registrars who obtain a Certificate of Completion of Training (CCT).

Methods: This was a national retrospective cohort study of UK trainees obtaining a CCT between 1 January 2018 and 1 January 2024. ELogbook data for 884 trainees were obtained from the JCST, with 1,994,235 recorded operations. Descriptive analysis was performed on the operative data.

Results: Our results demonstrated that the median number of cases per trainee throughout training decreased each year across both adult and paediatric experience. The proportion of paediatric cases (age <17 years) within the trainees' logbooks remained constant at 11%. Trainees recorded a higher number of cases of paediatric trauma than elective cases, particularly surgery for forearm, wrist and supracondylar fractures. Trainees infrequently performed surgery for lower limb trauma, emergencies such as musculoskeletal infection and paediatric elective procedures.

Conclusions: Paediatric orthopaedics is an integral part of orthopaedic training. Our results suggest that paediatric orthopaedic experience at CCT may not satisfy the requirements of the JCST curriculum. Future curriculum adjustments and additional training methods may be required to ensure trainees obtain the necessary experience to meet both the JCST standards and the demands of paediatric trauma care.

Keywords: Education; Orthopaedics; Paediatrics; Training; Trauma; Workforce planning.