Background: The European Board of Surgery Qualification in Vascular Surgery is a pan-European examination for vascular surgeons who have attained a national certificate of completion of specialist training. A 2-year study was conducted before the introduction of a technical skills assessment in the examination.
Methods: The study included 30 surgeons: 22 candidates and eight examiners. They were tested on dissection (on a synthetic saphenofemoral junction model), anastomosis (on to anterior tibial artery of a synthetic leg model) and dexterity (a knot-tying simulator with electromagnetic motion analysis). Validated rating scales were used by two independent examiners. Composite knot-tying scores were calculated for the computerized station. The stations were weighted 35, 45 and 20 per cent, respectively.
Results: Examiners performed better than candidates in the dissection (P < 0.001), anastomosis (P = 0.002) and dexterity (P = 0.005) stations. Participants performed consistently in the examination (dissection versus anastomosis: r = 0.79, P < 0.001; dexterity versus total operative score: r = -0.73, P < 0.001). Interobserver reliability was high (alpha = 0.91). No correlation was seen between a candidate's technical skill and oral examination performance or logbook-accredited scores.
Conclusion: Current surgical examinations do not address technical competence. This model appears to be a valid assessment of technical skills in an examination setting. The standards are set at a level appropriate for a specialist vascular surgeon.