Medico-legal training amongst UK surgical trainees

Adam G Hague1, Jonathan RL Wild2, Fran Yarlett3, J Edward F Fitzgerald2 and Goldie Khera2
1 Sheffield

Medical School. 2 The Association of Surgeons in Training. 3 Cardiff Medical School.

Introduction As foundational components of professionalism, it is imperative that surgical trainees develop a sound knowledge of medical law and ethics. In the UK, the General Medical Council (GMC) emphasises the necessity for medical practitioners to behave according to ethical and legal principles 1 and increasing emphasis has been placed upon doctors professionalism and accountability. 2 It can be argued that knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. Aims We aimed to assess the provision and views of medico-legal training amongst current UK surgical trainees Methods A self-administered questionnaire was distributed amongst delegates at the 2012 Association of Surgeons in Training (ASiT) annual meeting. This was then followed up via email to the ASiT membership mailing list using the SurveyMonkey online survey tool. Responses were recorded on a 7-point Likert scale. Results 581 completed surveys were analysed. (381 male [66%]; 160 Foundation [28%], 170 Core [29%] and 251 [43%] Higher Surgical Trainees (HSTs), from all surgical specialities and deaneries. Importance of medicolegal training Provision of training in medical law and ethics Trainees experience of malpractice and coroners inquests 8% of trainees reported involvement in a medical malpractice case, the majority (94%) being HSTs, with only 10% stating that they felt adequately prepared for the experience. Likewise, of the 26% of trainees required to provide a statement for the coroner only 16% felt prepared.
Training in medical law is essential

90% of trainees feel that training in medical law and ethics is essential.

68% and 43% who did not receive undergraduate and postgraduate training, respectively, were HSTs.

Consent is the area of medical law considered most pertinent for training.

Received undergraduate teaching

Received postgraduate teaching

Organisations who provided the training received by trainees

Prepared for malpractice case

Prepared for Coroners statement

Areas of medical law by importance scored by trainees

Conclusion and recommendations o Disparities appear to exist in the provision of medico-legal training amongst UK surgical trainees, especially amongst those nearing completion of surgical training, which is cause for concern. o The vast majority of trainees feel that training in medical law and ethics is essential, however only one quarter agree that postgraduate training in medical law and ethics is adequate. o Consent and capacity are areas of medical law identified as being the most important to be accustomed with on completion of training. o Although there are GMC requirements to ensure teaching in medical law and ethics in medical schools,3 improved provision of medicolegal training , especially at postgraduate level, is required to equip future consultant surgeons for a career within a working environment of increased accountability and litigation. o Based upon the findings of this survey, ASiT collaborated with MPS to host a one day conference at the RSCEng - Getting to grips with medical law and ethics: Medicolegal Skills for Surgeons in Training, in Autumn 2012. The first conference attracted more than 100 surgical trainees and the event is to be run again on 23rd September 2013. A further one day workshop focussed on consent is also planned for July 2013 Consent for Trainees; Principles and Practicalities has also been organised by ASiT, based upon the results of this survey. References 1.Preston-Shoot M, McKimm J. Prepared for practice? Law teaching and assessment in UK medical schools. J Med Ethics. 2010 Nov;36(11):694-9 2.General Medical Council. Good Medical Pracice (2006):22-26 3.Stirrat GM et al. Medical ethics and law for doctors of tomorrow: the 1998 Consensus Statement updated J Med Ethics. 2010 Jan;36(1):55-60

The authors would like to acknowledge the Medical Protection Society for their help and support with this study