Trainee
Lisa Kells is an FY2 doctor at the University Hospital Aintree having graduated with her MBChB from the University of Liverpool. She is due to commence her core surgical training in August 2022 at the Royal Stoke Hospital.
Professionalism within trauma and orthopaedic surgery Lisa Kells, Marieta D Franklin and Cronan Kerin
I Marieta Franklin is an ST7 registrar in Mersey where she is newly on the Surgery Training Committee. She is on the BOTA committee as the Women in Surgery Representative and forms part of their Culture & Diversity subgroup. She is also a member of the British Hip Society’s Culture & Diversity Committee and sits on the Royal College of Surgeons of England Women in Surgery Forum.
Cronan Kerin is a Consultant T&O Surgeon for Liverpool University Hospitals. He has a MA in Medical Education and is a Fellow of the Academy of Medical Educators. Since 2019 he has been the TPD in Mersey. He is also an examiner and a member of the Specialist Advisory Committee for Trauma & Orthopaedics.
40 | JTO | Volume 10 | Issue 02 | June 2022 | boa.ac.uk
n recent decades there has been an exponential growth in clinical knowledge and technological development in trauma and orthopaedic surgery. Over the same time period there have been significant changes in work-place culture. Trainees spend approximately ten years between core and speciality training, more if they take time out of programme for family, research or, as is increasingly popular if they choose to go less than full time.
guidance to help doctors in the development of their professionalism1,2. However, unlike operative numbers, professionalism is harder to quantify. Dictionary definitions exist, but how professionalism applies to doctor-patient and doctor-doctor interactions on a practical level is blurred by the lens through which the observer perceives the interaction. Generational theory goes some way to explaining the sometimes differing viewpoints of trainers and trainees on what constitutes professionalism.
Therefore, a greater gulf than ever exists between the speciality’s consultant body and their junior training colleagues. This issue is not exclusive to orthopaedic surgery and is increasingly reported, often in the context of professional behaviour. Surgical teams work best when there is good integration. If trainers better understand their trainees, they can offer better guidance; spot and guard against burnout; and foster and develop a stronger working relationship. Similarly, if trainees better understand their trainers and mentors, they will be better placed to get the most out of their training. This is increasingly important given the current challenges within training brought about by the COVID-19 pandemic working practices. Optimising one’s training opportunities is key. To work well together for our patients, and for future generations of skilled surgeons to care for them, there is a need for mutual respect within the trainertrainee relationship and professional behaviour is required.
Generation theory postulates that cohorts born within common time periods, largely accepted as twenty-year intervals, share common core beliefs as shaped by the socio-economic events that occurred during their early and adolescent years3,4. There are six generational groups discussed in the literature:
Professionalism has, and continues to be, a well-discussed topic within medicine and beyond. It is a widely agreed core attribute for all doctors regardless of their level of career progression1,2. Both the Royal College of Surgeons of England and the Royal College of Physicians have released
1. ‘The Greatest Generation’ – Born before 1928 2. ‘Silent Generation’ – Born between 1928 and 1945 3. ‘Baby Boomers’ – Born between 1946 and 1964 4. ‘Generation X’ – Born between 1965 and 1981 5. ‘Generation Y’ / ‘Millennials’ – Born between 1982 and 2000 6. ‘Generation Z’ – Born after 2000 It is worth noting that there is some discrepancy in the literature regarding the upper year end limit for the generation Y group4,5. This discrepancy highlights that there will of course be overlap in generational beliefs at the extremes of the denoted time periods. Each of these generational cohorts will have experienced different socio-economic and global events compared to the other and this has led to trends in certain characteristics and character archetypes in these cohorts (Table 1).
