Date of Award

12-12-2024

Degree Type

Thesis

Degree Name

Master of Health Professions Education

First Advisor

Dr. Muhammad Tariq

Second Advisor

Dr. Javeria Rehman

Third Advisor

Dr. Shaista Afzal

Department

Educational Development

Abstract

Background: In Pakistan, newly graduated surgical fellows trained in CPSP-accredited hospitals and certified through the FCPS examination in disciplines such as Surgery, Otolaryngology, and Ophthalmology often encounter challenges transitioning from residency to independent practice. This transition can reveal areas where training programs might be enhanced to better prepare fellows for autonomous practice. Given the variations in training environments, mentorship quality, and procedural exposure, understanding the factors contributing to these gaps is crucial. This study explores the factors influencing perceived competence among newly graduated fellows to enhance training programs and improve patient care outcomes.
Objective: The primary aim of this study is to evaluate the perceived lack of competence among newly graduated surgical fellows and identify key factors affecting their readiness for independent practice. Specifically, it examines the impact of training environments, levels of supervision, and exposure to complex cases on fellows’ confidence and competence in performing core surgical procedures.
Methods: A mixed-methods approach was employed, combining quantitative survey data and qualitative interviews for comprehensive analysis. A survey was administered to 417 fellows in 2023, with 193 responses received (response rate: 47.1%). The survey gathered data on fellows’ self assessed competence in core and advanced surgical skills and demographic and institutional information. Logistic regression was used to assess significant associations, while thematic analysis was conducted on in-depth interviews to explore personal experiences with supervision, mentorship, and case exposure.
Results: The study found that 86.5% of fellows reported feeling competent in performing core surgical procedures, but only 38.3% believed residency training alone was sufficient for unsupervised practice. Fellows aged 31–40 reported significantly higher confidence levels (p = 0.005), and those trained in private-sector hospitals demonstrated greater confidence in independent practice readiness compared to their public-sector counterparts (OR = 1.92, p < 0.05). Qualitative findings highlighted barriers such as limited supervision, inconsistent mentorship, and restricted case diversity, which hindered skill development. Regional disparities in resources and supervision further contributed to variations in competency levels.
Conclusion: These findings underscore the need for targeted reforms, such as implementing competency based medical education (CBME), expanding simulation-based training, and developing structured mentorship programs. These interventions could significantly enhance fellows’ readiness for independent practice, ensuring a smoother transition from residency and improving patient care outcomes.

First Page

1

Last Page

110

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