In this era where training faces restrictions due to theatre time, fewer sessions available to trainees and requirements of consultant-led and consultant-delivered services, one unit confirmed that myringoplasties given to trainees reduced from 34.2% to 16%. This study compares outcomes of 118 operations, comprising cortical mastoidectomy, atticotomy, atticoantrostomy, modified radical mastoidectomy, combined approach tympanoplasty and revision mastoidectomy. Of these, 35% were carried out by trainees under supervision and 65% solely by consultants. The recurrence rate for cholesteatoma was 5% for supervised trainee operations and 7.8% for operations performed solely by consultants. No other complications developed in either group. There may be some bias because consultants would have performed more complicated operations themselves. Despite the reported figure of 34% as extra time across the specialities required by trainees to perform operations, this study is useful in that it encourages trainee involvement to promote their learning. Even though mastoid surgery has one of the steepest learning curves, this comparison between consultant and supervised trainee operations shows that trainee involvement does not compromise patient safety.
A comparison between trainee and trainer outcomes in mastoid surgery
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