Medical devices and medical training.

There are mandatory standards for the management of medical devices.1,2 Junior doctors must have specific training for the medical devices they use, which must be documented. At first glance, it seems a major undertaking formally to train every junior doctor in the use of every medical device they currently use. However, junior doctors do receive oral training in using medical devices and much of what we are being asked to do can be achieved simply, by formally acknowledging skills doctors currently have. For surgical trainees this can be based upon their log books. Using neurosurgery as an example: no consultant is going to allow a junior doctor to perform a craniotomy (e.g. to evacuate a haematoma) if he or she is not competent to use a perforator or craniotome (powerful air/electric drills). Ergo, any junior doctor who can perform a craniotomy unaided can be signed off to use those medical devices. A list of neurosurgical devices can be linked to the operations that junior doctors currently perform; examples are given in Table 1. As trainees become more proficient, more devices become authorised. This requires minimal increased bureaucracy and is applicable to all junior doctors in training. Table 1 Examples of operations linked to particular neurosurgical devices We will need formal standards for all surgeons (including consultants). Prior to using a device that is new to that surgeon or if a wholly new device is introduced into a department, formal and documented training is required. We might recommend the following prior to operating solo: (i) attendance at a manufacturer's training course; (ii) assisting a competent surgeon; or (iii) being assisted by a competent surgeon. A record of medical device training must be maintained: surgeons must operate within their documented competencies.