SP2.1.17Prognostic significance of competition ratios in surgical specialty training selection. (28th October 2021)

• Record Type: Journal Article
• Authors: Mellor, Katie; Robinson, David B; James, Osian P; Powell, Arfon GMT; Egan, Richard J; Lewis, Wyn G
• Is Part Of: British journal of surgery. Volume 108:Supplement 7(2021)
• Publication Date: 2021-10-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1093/bjs/znab361.037
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Aims: A Competition Ratio (CR) indicates the ratio of total applications for a training post when compared with numbers of specialty posts available. This study aimed to evaluate CRs' influence on National Training Number (NTN) selection in a single UK Statutory Education Body. Methods: Consecutive Core Surgical Trainees numbering 154 (median years since graduation: four, 105 male, 49 female) were studied over a six-year period. Annual specialty specific CRs were obtained from Health Education England's website, and primary outcome measure was UK National Training Number (NTN) appointment. Results: Overall NTN appointment was 45.5%. Median CR was 2.36; range OMFS 0.70 (2020) to Neurosurgery 22.0 (2020). Multivariable analysis revealed that NTN success was associated with: CR (OR 0.46, p = 0.003), a single scientific publication (OR 6.25, p = 0.001), cohort year (2019, OR 12.65, p = 0.003), and Universal ARCP Outcome 1 (OR 45.24, p < 0.001). CRs predicted NTN appointment with a Youden index defined critical ratio of 4.42; 28.6% (n = 8) vs. 49.2% (n = 62), p = 0.018. Conclusions: CRs displayed 30-fold variation, with CRs below 4.42 associated with two-fold better NTN promotion, but strong clinical competence and academic reach again emerged as the principal drivers of career advancement.