# Perceptions of Plastic Surgery Training in the United Kingdom: A Mixed-Methods Trainee Survey

## TL;DR

UK plastic surgery trainees report moderate satisfaction with their training, but express concerns about research opportunities and work-life balance.

## Contribution

This study provides new insights into UK plastic surgery trainees' perceptions of training quality and satisfaction through mixed-methods analysis.

## Key findings

- Most trainees believe six years of training is sufficient for key competencies.
- Trainees expressed moderate satisfaction with mentorship and case variety but low satisfaction with research opportunities and work-life balance.
- Qualitative feedback highlighted issues like limited operative exposure and inconsistent mentorship.

## Abstract

Background: Plastic surgery training in the United Kingdom (UK) is a highly competitive and evolving field. Recent reforms have aimed to standardise operative exposure, academic opportunities, and mentorship, yet the perspectives of current trainees remain underexplored.

Objective: This study assessed UK plastic surgery trainees’ perceptions of their training quality, satisfaction, and preparedness for independent practice.

Methods: A cross-sectional, anonymised online survey was distributed to UK plastic surgery trainees. The questionnaire included demographic items, views on training duration and fellowship structure, and satisfaction ratings across key domains of training using a five-point Likert scale. Free-text comments were thematically analysed to identify recurrent qualitative themes.

Results: Fourteen trainees from multiple UK deaneries responded. Half reported three to four years of training (n = 7, 50%), and four (29%) had less than one year of training. Most respondents (n = 9, 64%) believed six years of training was sufficient to achieve key competencies, while two (14%) disagreed and three (21%) were uncertain. Opinions on fellowship structure were divided: seven (50%) supported integration within the six-year programme (5+1), six (43%) preferred a separate post-CCT (certificate of completion of training) fellowship (6+1), and one (7%) was unsure. Mean overall satisfaction was 3.2/5 (median = 3). Highest domain scores were supervisor involvement (mean = 3.5/5, n = 14) and case variety/hands-on opportunities (mean = 3.5/5, n = 14); lowest were research opportunities (mean = 2.9/5, n = 14) and work-life balance (mean = 3.0/5, n = 14). Qualitative responses highlighted five themes: limited operative exposure, inconsistent mentorship, regional variation, restricted research time, and the lasting impact of COVID-19.

Conclusions: UK plastic surgery trainees report moderate satisfaction overall, with particular concern regarding research access and work-life balance. Qualitative feedback revealed recurring issues around mentorship and operative opportunities, consistent with national trainee trends.