The Teaching of Trauma and Orthopaedic Surgery to the Undergraduate in the United Kingdom

The inadequacy of musculoskeletal knowledge after foundation training in the United Kingdom

“…It has been shown that the average duration of an undergraduate attachment in trauma and orthopaedics was only 2.7 weeks (1.5 to 6) in the United Kingdom in 1999. 9 In the United States, efforts have already been made to increase both the quantity and the quality of musculoskeletal training at undergraduate level. 20 At postgraduate level, our study showed that those candidates who gained exposure to orthopaedics had a significantly higher mean score than their counterparts, and were also more likely to pass, although the latter finding was not statistically significant.…”

“…Foundation trainees with a future interest in general practice performed poorly in our study, with significantly lower mean scores and pass rates. This is of particular concern, as these trainees may not gain further exposure to musculoskeletal medicine, 9,11 and yet a substantial portion of their practice is likely to be devoted to musculoskeletal medicine. [12][13][14][15] Furthermore, with the increasing age of the general population, it is predicted that the prevalence of musculoskeletal pathology is likely to increase.…”

“…8 To date, musculoskeletal medicine has not received adequate attention in the United Kingdom undergraduate curriculum. 9,10 The average length of time spent in orthopaedics in United Kingdom medical schools is five weeks, 9 much of which is combined with training in other specialties, thereby reducing the length of orthopaedic attachments to an average of 2.7 weeks and accounting for only 2% of the available time in the clinical years of undergraduate training (years 3 to 5). 9 Unfortunately, postgraduate training in the United Kingdom has a similar lack of focus on musculoskeletal medicine.…”

“…9,10 The average length of time spent in orthopaedics in United Kingdom medical schools is five weeks, 9 much of which is combined with training in other specialties, thereby reducing the length of orthopaedic attachments to an average of 2.7 weeks and accounting for only 2% of the available time in the clinical years of undergraduate training (years 3 to 5). 9 Unfortunately, postgraduate training in the United Kingdom has a similar lack of focus on musculoskeletal medicine. For example, only 0% to 10.5% of vocational training schemes (general practitioner training schemes) in the North of England include orthopaedics or rheumatology.…”

“…For example, only 0% to 10.5% of vocational training schemes (general practitioner training schemes) in the North of England include orthopaedics or rheumatology. 9,11 This gives cause for concern, as musculoskeletal complaints are the most common reason for patients seeking medical attention. 12,13 They account for 23% to 27.8% of primary care 14,15 and approximately 20% of accident and emergency attendances.…”