The true cost of surgical training

We are all familiar with the financial cost of surgical training, with expenses for mandatory examinations, professional memberships, courses, portfolio platforms and conferences placing an often prohibitive burden on trainees. However, a report by the Association of Surgeons in Training (ASiT) highlights that the financial impact is not the only challenge that trainee surgeons face, with many reporting elevated stress, anxiety, and burnout because of the non-financial costs of training, alongside detrimental impact on their personal lives.

The statistics speak for themselves. 81.5% report that romantic relationships have suffered due to training load. 77% report family relationship strain. 82% say friendships have deteriorated. 89.3% have missed important family events because of rota changes or clinical duties. Over 60% have missed events because of exams, audits or research requirements. These are not one-off incidents, easily written off as part and parcel of having a career that demands a 24/7 rota; these are human beings missing out on critical life events: weddings, funerals, births, deaths, milestone birthdays. International trainees carry an extra weight, reporting isolation, being unable to travel home to spend time with family, while navigating a visa system to determine their right to remain in the country. In any other job, we might be horrified. But seemingly not in medicine and surgery.

While sacrificing time with family, relationships, and wellbeing, surgical trainees are forced to compete for decreasing opportunities for progression, with bottlenecks becoming the norm. Core Surgical Training currently receives eight applicants for each post, which is the highest ever recorded. Rising need should dictate increased training capacity, but this has not been the case.