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Surgical training in the UK: is cost a barrier to entry?
  1. Zak Vinnicombe1,
  2. Max Little2,
  3. Jonathan Super3,
  4. Raymond Anakwe4
  1. 1 Department of Plastic and Reconstructive Surgery, St George's Healthcare NHS Trust, London, UK
  2. 2 Department of Orthopaedic Surgery, Whittington Hospital, London, UK
  3. 3 Department of Gastroenterology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK
  4. 4 Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London, UK
  1. Correspondence to Zak Vinnicombe, St George's Healthcare NHS Trust, London, UK; zvinnicombe{at}


Background There is good quality evidence linking socioeconomic background and the likelihood of a surgical career. Additionally, training in surgery is more expensive than in other specialties. Our aim was to assess the awareness and perceptions of trainees and medical students of the relative costs of surgical training and to determine whether perceptions of cost deter potential surgical trainees.

Methods Medical students, foundation doctors and core trainees in England were surveyed over a 2-week period. χ2 tests of independence were used to assess statistically significant associations between measured variables

Main findings A total of 284 responses were received. More than half of respondents (54%) were not previously aware of the high costs of surgical training. More than a quarter of respondents (27%) did not take out a student loan. There was a significant association (p=0.003) between familial income and being less likely to consider a surgical career due to the costs. Respondents who reported receipt of a student loan were also significantly less likely to consider a surgical career due to the costs (p=0.033).

Conclusion Our study demonstrates an important relationship between perceived costs of surgical training and future career aspirations. This suggests that access to surgical training may still be difficult for many. This study also highlights a general lack of awareness of high surgical training costs. It is important that surgical training is accessible. Financial status should not be a significant disincentive and widening access to surgical training can only serve to enrich and advance the specialty.

  • surgery
  • medical education and training

Data availability statement

Data are available upon reasonable request. Survey data available on request.

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Data availability statement

Data are available upon reasonable request. Survey data available on request.

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  • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

  • Contributors ZV and ML developed the questionnaire, collected the data and were involved in write-up. ZV is responsible for the overall content. JS developed the questionnaire and was involved in data analysis and write-up. RA was involved in study design, supervision and write-up.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.