2026

Survey of the current experience of colonoscopy training for colorectal surgical trainees in the UK (2026)

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Type of publication:

Journal article

Author(s):

Siggens K.; Williams S.; Yiu A.; El Sayed C.; Fletcher J.; Mills S.; Yeadon K.; Reza L.; Rabie M.; Drami I.; Green S.; Tamanna R.; Couderq D.; Javanmard-Emamghissi H.; Argyriou O.; Okocha M.; Khasawneh F.; Kat-Zsummercorn A.; Shakir T.; Anya L.; Bramwell C.; Haji A.; Johnston R.; Joshi H.; Oliphant R.; Piramanayagam B.

Citation:

Frontline Gastroenterology. 17(4) (pp 306-311), 2026. Date of Publication: 01 Jul 2026.

Abstract:

Introduction: The primary aim was to understand the current experience of colonoscopy training among general surgical trainees with a subspeciality interest in colorectal surgery. Method(s): An electronic survey was developed and disseminated by members of the Dukes' Club (colorectal trainees network) and Association of Coloproctologists of Great Britain and Ireland colonoscopy subcommittee between February and April 2024 to assess key themes identified through formal and informal feedback from colorectal trainees of endoscopy training experience. Result(s): The survey was completed by 196 participants. This included 13.3% from core trainee (CT) 2-speciality trainee (ST) 4, 28.6% from ST5-ST6, 36.5% from ST7-ST8, 13.3% from post-certificate for completion of training fellows, senior clinical fellows and speciality and specialist (SAS) doctors and 8.7% from early years consultants. The median number of colonoscopies performed by respondents was 121.6 (range 0-8000). Only 33.7% (66/196) reported having one dedicated training list per week, and 56.6% (111/196) were not allocated to any regular training list. The barriers to training were service provision (71.9%), lack of dedicated training lists (69.9%) and access to training lists due to other trainees or healthcare professionals (42.3%). Only 25% of respondents had experience of immersion training, but they consistently reported high numbers of colonoscopy during these periods, with 40% achieving more than 30 colonoscopies. Conclusion(s): There is an urgent need to improve access to colonoscopy training. Regular endoscopy training lists and funding of academies and immersion training centrally are likely to greatly improve the experience of colonoscopy training. Senior colorectal trainees should be prioritised to avoid delay in the completion of training.

DOI: 10.1136/flgastro-2025-103106

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The changing landscape of traumatic brain injuries at a district general hospital in a trauma network (2026)

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Type of publication:

Journal article

Author(s):

Abualsaud, Suhaib; Elmahdi, Ahmed; *Youssef, Mohamed; Jayakumar, Nithish; Lahart, Ian; Ashwood, Neil.

Citation:

British Journal of Neurosurgery. 40(2):351-356, 2026 Apr.

Abstract:

BACKGROUND: Major trauma networks were introduced in 2012 onwards with a major trauma centre (MTC) linked to district general hospitals (DGH). Most traumatic brain injuries (TBI) are managed in DGHs, without on-site neurosurgical services. It is unclear whether the characteristics of TBIs at DGHs have differed since the network was introduced. We compare outcomes of TBI patients pre- (2008-2012) and post-MTC (2013-2021) network implementation.

METHODS: We conducted a retrospective analysis of TBI patients admitted to a 500-bedded DGH, before and after the introduction of a trauma network. We compared the characteristics of patients, including age, mechanism of injury, imaging findings, and length of stay. All statistical analyses were carried out in SPSS v29 (IBM).

RESULTS: Overall, 876 patients (males = 56.1%; median age 67 years) were included. Mean yearly cases pre-MTC was 76 compared to 55 in the post-MTC period. Mean age was significantly higher, and patients had more co-morbidities, in the post-MTC period (p < 0.001). Mean GCS at presentation was not significantly different between the pre- and post-MTC periods (13.7 vs 13.8, respectively). Referrals to the regional neurosurgical centre were significantly higher in the post-MTC period. The overall mortality rate was 33.7%. Increasing age (OR = 1.072), higher comorbidities (OR = 1.243) and intracerebral haematoma (OR = 6.269) were associated with a higher risk of death. The post-MTC period was associated with a lower risk of death (OR = 0.501).

CONCLUSIONS: Fewer patients with less severe mechanisms of injury, and a more elderly population are now being managed at our DGH in the post-MTC period. Mortality was similar to published literature but the introduction of the trauma system was associated with lower risk of death. Although fewer TBIs help to optimise service delivery by maintaining orthopaedic bed capacity, the reduced exposure to these patients may lead to lowered expertise in managing these complex cases.

DOI: 10.1080/02688697.2025.2468951