Ever since medical school, the infamous tick-box proof of your (in)competence is relied upon as the Holy Grail of whether you're performing well enough to progress. In actual fact, however, it is common knowledge that it is a pure numbers game. So what's the point of this ongoing farce?
Having been through General Surgery rotations for the past three years, I still can't place laparoscopic ports. Is that my fault? Maybe. But what I've faced is little interest in my seniors to actively train me because they are Staff Grades or long term locum with a commitment for service provision. I end up holding the camera: "Oh no Steth, I'll show you how to dissect the appendix because we need to finish this case quickly".
Are the consultants interested in training? Sadly, very few nowadays. They are all aware we are trainees and need to be trained - but they acknowledge our limited experience and exposure (EWTD - another discussion) and complain about our incompetence. Additionally, their focus is on the private work load. When your Clinical Supervisor writes in your report "I've never seen this trainee operate" - who is that a failure of?
So where does that leave the validity of WBAs? When I might have done only 5 mastectomies from start to finish whereas peers have done 25 local anaesthetic abscess drainages - who is more experienced surgeon? In the eyes of the Deanery, my peers, sadly. Focus should be on quality, not quantity with Consultants and Registrars under pressure from the Deanery to actively train their trainees.
