1. A ( RELATIVELY ) JUNIOR DOCTOR ’ S PERSPECTIVE ON MEDICAL STATISTICS Carl Ilyas CT1 Anaesthetics Leeds

3. C ONTENTS Medical stats teaching: - Undergraduate Postgraduate A small survey What YOU can do to get the message across

5. 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.

6. W HAT DO YOU DO ? A) Panic B) Find the nearest enclosed space, throw your bleep away, and begin to emotionally and mentally unravel C) Commence immediate resus efforts, contact a senior and the anaesthetist D) All three of the above

7. U NDERGRAD 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

8. F OUNDATION YEARS First 2 years Foundation syllabus – 86 page document No formal teaching on stats – PDP days Opportunity for research and stats experience – ‘ CV stacking’

9. C ORE 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.

10. R EGISTRAR TRAINING Further examination on stats Greater involvement/emphasis on research Access to courses, closer work with statistical departments Honing of career path….

11. Consultant doctor plus… …..or ‘just a jobbing’ doctor? Teaching interests Management Research interests

12. S O, WHAT DO DOCTORS THINK OF STATS TEACHING ? A survey of 42 doctors experiences and opinions of training in medical statistics.

19. I N 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 doesn’t need to be great, as we don’t 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”

20. “ 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”

21. S URVEY 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

22. So what’s to be done?

23. S UGGESTIONS 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

24. W HAT 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

25. S UMMARY 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

26. Thanks for your attention. Questions/comments?