Transplant surgeons in training: the present and their future?

Little is known of the numbers of serious trainees in transplantation surgery and their career aspirations. A national audit has been performed in 1992 and 1994. Eighteen registrar (R) and 18 senior registrar (SR) trainees were identified in 1992 and 9 R and 16 SR in 1994. Mean age for R was 32 and SR 36 years. All bar one respondent had been awarded or were pursuing a transplant related thesis. Training received in 1994 was 43 per cent renal only and 57 per cent liver and renal. Only 2/36 in 1992 and 0/25 in 1994 wished to pursue a career in pure transplantation. In 1994 from a score of zero to 10, a career in liver and renal transplantation without general surgery scored, R n = 9, mean 4.3; SR n = 14, mean 2.4. Pure renal transplantation and vascular access without general surgery, R mean 1.4; SR mean 1.4. Transplantation surgery (multi-organ or renal only) and general surgery (eg, hepatobiliary or vascular) R mean 8, SR mean 8. Transplantation surgery in isolation was not considered to be fulfilling as a career and was considered to be making poor use of the considerable level of general surgical skills learnt. There appears to be a growing gap between the aspirations of transplant surgeons in training and the type of consultant post increasingly being offered. This problem has significant implications for future manpower planning as up to 40 per cent of trainees are being lost from the field.