I’ve distilled the UK surgical skill competency levels into three simple categories based on my personal experience:
Level 1–2: The Beginner/ Novice (House Officer/ Junior Registrar)
Doesn’t know where to cut, what to cut, or, most importantly, what not to cut.
Level 3: The Amateur (Registrar)
Has learnt where to cut, what to cut, and crucially, what not to cut.
Level 4: The Expert/ Specialist (Consultant)
Knows alternative places to cut, when to cut the structures usually avoided (during complex cases), and how to manage complications or repairs once the wrong structures have been cut (usually rescuing mistakes by those at Levels 1–3).
It’s essential to recognise that one person might be a Level 4 in one speciality or procedure and a Level 1 in another.
Self-awareness is key to playing this game.