Quality of surgical training in Germany

Background: One of the reasons for young doctors to leave the clinical work to go abroad or into non-clinical fields is insufficient quality of training under bad circumstances. Aim of the study was to evaluate the surgical training in Germany from the viewpoint of the residents. Methods: A questionnaire was prepared by residents and consultants and approved by the German surgical societies (Deutsche Gesellschaft fur Chirurgie und Berufsverband der Deutschen. Chirurgen). It was sent to surgical residents between June 2003 and June 2004, published in Der Chirurg BDC and distributed among residents taking part in courses conducted by the BDC. It could be answered anonymously by email, mail or online. Results: The questionnaire was sent back by 584 surgical residents (about 30% of all). 58% of the residents declared that they finished the training in the intended time (6 years). Rotation-systems as part of a structured residency program existed for 43%. Standard surgical procedures were discussed or explained before the procedure in only 46%. 61% of the residents were not satisfied with the teaching assistance by their clinical teachers in the OR. Only 33% had regular talks with the Chief about their progress in surgical training. 18% of residents felt, that the hospital is interested in their progress in training. indication-conferences took place in 52% and mortality-conferences in only 20% of programs. Regular seminars on recent issues took place in 62%, and 61 % of residents did not get financial support to attend congresses. 36% of residents had to use their holidays to attend congresses. Conclusions: Surgical training structures are not well established in about 50% of the training hospitals from where we got answers to our survey. The training potential of daily surgical work is not used appropriately. it is therefore imperative to develop guidelines for surgical training, the use of log-books and rotation-programs.