HOSPITAL surgeons still bully and humiliate the junior doctors they are meant to be teaching, a leading medical college has warned.
The Royal College of Surgeons (RCSEd) of Edinburgh is calling for an overhaul of the way young medics are trained, describing the current "apprenticeship" system as outdated.
It said change was vital to safeguard standards and patient safety as it launched the first standards for consultants who coach the surgeons of tomorrow.
Craig McIlhenny of the RCSEd said a famous US surgeon, William Stewart Halsted, had invented the current surgical training system in 1889.
"If he pitched into an operating theatre today he would not recognise the kit, but he would recognise the way that people were being trained," he said.
Mr McIlhenny, who is director of a faculty created by RCSEd to recognise the importance of training, added: "At the moment, as soon as you become a consultant you get a trainee. We need a system where being a trainer is a badge reserved for the very best surgeons."
Some trainers are innovative and make sure young doctors get to work on the skills they need, he said, while others consider having a trainee "their right" and leave them standing holding incisions open instead of getting them involved.
A RCSEd survey carried out earlier this year also revealed bullying was a common problem. When asked, 60 per cent of trainees admitted they had been a bullying victim, while 90 per cent said they had witnessed it.
Mr McIlhenny, a urologist for NHS Forth Valley, said he became interested in training because of his variable experiences as a junior doctor.
One surgeon, he said, would rap him over the knuckles with a set of forceps every time he tied a knot on a blood vessel that was not square. "I used to go home and I would have a set of red marks over my fingers where I had been rapped on the knuckles," he said. "I do not know if that still happens, but there is still teaching by humiliation."
He suggested the system of training had not modernised because consultants become role models and trainees exposed to behaviour such as shouting in theatre sometimes emulated it themselves.
Mr McIlhenny said: "All these things are detrimental to team working and patient safety. It has been passed down from generation to generation and that is why we need to move to a modern, competency-based system."
The work of the RCSEd means for the first time trainee surgeons across the UK can be taught by accredited consultants guided by a set of standards. Sir Bruce Keogh, medical director of NHS England, has endorsed the move. The standards include organising theatre lists to provide suitable learning opportunities and giving appropriate, regular feedback.
A spokeswoman for NHS Education for Scotland (NES), which organises surgical training, said: "We welcome the RCSEd standards for surgical trainers as a valuable and helpful contribution to the implementation, across Scotland, of the General Medical Council's framework for the recognition and approval of trainers. NES is leading on the development of the Scottish Trainer Framework to support this."
She added that work was under way to reform training following a report by Professor David Greenaway published last year and stressed whenever trainees expressed concerns about bullying and undermining behaviour it was taken extremely seriously. She said such issues were robustly addressed.
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