A (relatively) junior doctor

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A (relatively) junior doctors perspective on
medical statistics

• Carl Ilyas
• CT1 Anaesthetics Leeds

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Contents

• Medical stats teaching -
• Undergraduate
• Postgraduate
• A small survey
• What YOU can do to get the message across

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6 weeks later

• You are an F1 doctor providing medical ward cover
  overnight.
• You are fast bleeped to MAU as a 45 year old man
  has started profusely vomiting blood. He is an
  IVDU, has hepatitis C , and a previous endoscopy
  showed varices.
• He is tachycardic, is hypotensive, and has a
  reduced GCS.

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What do you do?

• A) Panic
• B) Find the nearest enclosed space, throw your
  bleep away, and begin to emotionally and mentally
  unravel
• Commence immediate resus efforts, contact a
  senior and the anaesthetist
• All three of the above

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Undergrad experience

• Hull York Medical School (HYMS)
• Formal critical appraisal and stats teaching
  throughout the course
• Theme C examination
• Further access to a stats consultancy service,
  mainly for students doing research
• Very variable focus throughout med schools in the
  region

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Foundation years

• First 2 years
• Foundation syllabus 86 page document
• No formal teaching on stats PDP days
• Opportunity for research and stats experience
  CV stacking

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Core training the next step

• First steps into speciality training
• Formal examinations MRCP, MRCS, FRCA etc
• MCQ based knowledge mandatory
• More opportunity/encouragement re. research,
  especially in certain specialities.

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Registrar training

• Further examination on stats
• Greater involvement/emphasis on research
• Access to courses, closer work with statistical
  departments
• Honing of career path.

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Teaching interests
Research interests
Consultant doctor plus
..or just a jobbing doctor?
Management
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So, what do doctors think of stats teaching?

• A survey of 42 doctors experiences and opinions
  of training in medical statistics.

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In your opinion, how could postgraduate teaching
in medical statistics be improved?

• Any teaching welcome/more teaching ad nauseum
• Teaching, not necessarily by statistics experts
• Optional formalised teaching some enjoy,
  others hate
• Weekly journal clubs, with critical appraisal
  by trainees
• It doesnt need to be great, as we dont use
  stats very often
• Teaching of stats beyond basic level is
  probably best reserved for those using them on a
  regular basis i.e research clinicians

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• Include stats in regional teaching days
• Journal club meetings and to explore stats
  techniques
• Needs to be more clinical orientated
• Regular talks from statisticians in
  departmental meetings with relevant examples from
  journals
• Make it more understandable, enjoyable and
  interesting
• Include in matrix/ PDP days
• Sign up sessions

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Survey outcome

• Generally poor view of statistics teaching
  throughout all levels
• Many doctors having minimal, if any, formal
  teaching on stats until later stages of training
• Many not comfortable doing basic appraisal

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• So whats to be done?

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Suggestions from survey

• Not all doctors need to be able to perform stats
  calculations, but all require appraisal skills
• For greater statistical literacy, widespread
  changes necessary from early stages of training
• Greater incorporation of statistics into formal
  teaching programmes, and in the CME matrix

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What can YOU do?

• Greater levels of work with doctors from an early
  stage offering teaching on basic appraisal and
  statistical methods
• Departmental/formal teaching utilising relevant
  clinical scenarios and journal articles to help
  make information more accessible
• For those junior doctors interested in research,
  access to courses to improve ability to
  understand and perform statistical analysis
• Using/developing online resources for convenient
  access

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Summary

• Stats teaching often neglected, especially in
  early stages of training
• No formal foundation teaching, variable medical
  school delivery, out of context content at core
  level
• Generally perceived poor standard of
  delivery/accessibility of stats teaching
• Doctors keen to learn about stats if given
  opportunity

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Thanks for your attention. Questions/comments?