Roger Kneebone, Professor of Surgical Education at Imperial College London, recently made comments on the latest generation of surgical trainees. He said that a rise of screen exposure and a decline in hands-on subjects at school was resulting in surgical students showing a reduced physical understanding of the world.

One suggestion to regain these skills was to encourage young people to take part in activities such as pumpkin carving. Although perhaps if Prof Kneebone spent some more time online, he would see that the continued popularity for this particular activity may be due to the opportunity for a picture that can be posted online.

The statements received significant emotional backlash from students both online and on campus. Many trainees from around the country came forward with stories of how they believe their gaming time actually aided them in their training, particularly when using modern robotic techniques.

Those on campus felt it was an unfair assessment and were quick to blame lack of experience in the theatre as a key reason for finding difficulty. 44.8 percent of fourth year medical students surveyed had only scrubbed in to assist twice during their training, with a further 20.7 percent only having done so once. A significant 12.5 percent had never had hands-on surgical experience during their four years of medical school.

Furthermore, there is a lot more academic pressure on today’s trainees, more so than on Generation-X who currently reside in the NHS seats of power. When far more resources and weight is placed on academic performance, why are those who instigated it surprised when students have less experience of ‘softer’ subjects like art, design, textiles and woodwork?

Last Monday Concrete interviewed Mr Haywood, a consultant plastic surgeon at the NNUH who has seen similar issues in his own teaching. He reports spending more time teaching trainee surgeons how to use surgical tools than previously, and that students struggle more with problem solving in a 3D space. Such skills are difficult to teach directly, so Mr Haywood suggests that his trainees go home and build an airfix plane.

However, he also had many positives to say about the ‘swipe left swipe right’ generation, mostly regarding ability to understand data and information at speed.

Mr Haywood told Concrete that when he was training in the 90s, they would work 110 hours a week, spending considerable time in theatre; comparing this to the 48 hours per week now, an effect of the European working time directive. From this, one can see how junior doctors might take longer to learn new skills than their predecessors.

There is no research to back up Prof Kneebone’s statements, which are currently all anecdotal. Perhaps, as Mr Haywood suggested, older consultants have simply forgotten what it is like to learn, the same way experienced drivers are irritated by learners on the road.

A long term cohort study would be useful in this area to see if hands-on hobbies really do improve surgical trainees’ abilities. But in the meantime, prospective surgeons might take up Mr Haywood’s advice to build an airfix plane. Out of all the requirements to get onto a surgical training program, it would probably be the most fun!


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