Junior doctor training in pleural procedures: a quality survey

Pleural effusion is a common medical condition encountered by doctors. This study was conducted to ascertain the level of junior doctor (physician-in-training) training, knowledge and supervision in the management of pleural effusion. The information was collected with the help of a proforma, from 49 junior medical doctors working in a metropolitan health service. All the doctors who participated in the survey had come across pleural effusion in their practice, but only 67% of doctors had any experience with the procedure of diagnostic thoracentesis. Sixty-seven percent of doctors conveyed that they will refer the majority of cases (75-100%) for radiological-guided thoracentesis. The main reasons for referral for radiologically guided procedure were lack of experience (65%), fear of complications (61%), lack of supervision and guidance (49%), and lack of time (38%). A significant proportion of doctors interviewed (47%) was unaware of the major indications for intercostal tube drainage of parapneumonic effusions. This survey highlights deficiencies in junior doctor knowledge and procedural skills. Junior doctor training should be tailored to increase the 'hands-on' training time and increased patient contact. Senior clinicians should be given sufficient 'protected time' for teaching and training.