67 Surgical Foundation Doctor Placements: Does Team Structure Alter Training and Support?

Abstract Aim Surgical foundation placements lay the groundwork for a surgical career. Many units run individual teams comprising consultants and trainees in the same subspecialty whilst others have adopted ward-based placements where foundation doctors are responsible for patients belonging to several teams. Belonging to a ‘firm’ is said to increase trainees' access to professional and emotional support. To accommodate for COVID-19 pressures, foundation doctors in our unit became ward-based as opposed to team-based. Our aim was to explore what impact this pandemic-enforced change in team structure had on foundation doctors’ training experiences. Method We conducted a single-center, cross-sectional study. We sent out a questionnaire to foundation doctors who had undergone both pre-COVID and COVID surgical placements. Domains such as training opportunities, support from seniors, and whether their experience impacted their interest in pursuing a surgical career were measured using Likert Scales (1 = low; 5 = high). Statistical analysis was conducted using Microsoft Excel. Results A total of 30 foundation doctors completed the survey. Foundation doctors felt that they were significantly more supported when team-based (p = 0.005) and found they had greater training opportunities (p = 0.002). Despite this, there was no impact on their interest in pursuing a surgical career (p = 0.255). Furthermore, for foundation doctors already interested in surgery, their COVID experience did not impact their career aspirations (p = 0.104). Conclusions Foundation doctors subjectively preferred individual team-based placements. The change to ward-based work led to perceived fewer training opportunities and less support. However, despite this negative impact on training, there was no impact on whether they would pursue a surgical career.