The subclavian steal phenomenon: A common vascular disorder with rare neurologic deficits

Hennerici, M.; Klemm, C.; Rautenberg, W.

doi:10.1212/wnl.38.5.669

Cited by 235Innovations in Medical EducationDiversity and Career in MedicineSurgical Simulation and Training

The subclavian steal phenomenon: A common vascular disorder with rare neurologic deficits

Hennerici, M., Klemm, C., Rautenberg, W.·1988·Neurology

DOI 10.1212/wnl.38.5.669

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Abstract

This study aimed to quantify core surgical trainee (CST) differential attainment (DA) related to three cohorts; white UK graduate (White UKG) versus black and minority ethnic UKG (BME UKG) versus international medical graduates (IMGs). The primary outcome measures were annual review of competence progression (ARCP) outcome, intercollegiate Membership of the Royal College of Surgeons (iMRCS) examination pass and national training number (NTN) selection. Intercollegiate Surgical Curriculum Programme (ISCP) portfolios of 264 consecutive CSTs (2010–2017, 168 white UKG, 66 BME UKG, 30 IMG) from a single UK regional post graduate medical region (Wales) were examined. Data collected prospectively over an 8-year time period was analysed retrospectively. ARCP outcomes were similar irrespective of ethnicity or nationality (ARCP outcome 1, white UKG 60.7% vs BME UKG 62.1% vs IMG 53.3%, p=0.395). iMRCS pass rates for white UKG vs BME UKG vs IMG were 71.4% vs 71.2% vs 50.0% (p=0.042), respectively. NTN success rates for white UKG vs BME UKG vs IMG were 36.9% vs 36.4% vs 6.7% (p=0.023), respectively. On multivariable analysis, operative experience (OR 1.002, 95% CI 1.001 to 1.004, p=0.004), bootcamp attendance (OR 2.615, 95% CI 1.403 to 4.871, p=0.002), and UKG (OR 7.081, 95% CI 1.556 to 32.230, p=0.011), were associated with NTN appointment. Although outcomes related to BME DA were equitable, important DA variation was apparent among IMGs, with iMRCS pass 21.4% lower and NTN success sixfold less likely than UKG. Targeted counter measures are required to let equity prevail in UK CST programmes.

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When detected with ultrasound, steal is asymptomatic in 64% of cases.
“When detected with ultrasound, steal is asymptomatic in 64% of cases.”
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Authors: Hennerici, M., Klemm, C., & Rautenberg, W.
Affiliations: Heinrich Heine University Düsseldorf (DE)
Venue: Neurology
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1988-05
Volume: 38
Issue: 5
Pages: 669-669
ISSN: 0028-3878 (ISSN-L)
1526-632X
DOI: 10.1212/wnl.38.5.669
OpenAlex: W2119374834
Cited by: 235
References: 0
Citations by year: 2025: 1 · 2024: 3 · 2023: 3 · 2022: 4 · 2021: 7 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 13 · 2014: 11 · 2013: 9 · 2012: 6
FWCI: 9.88
Type: journal article
Language: en
Open access: closed
Locations: Neurology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
Social Sciences › Gender Studies › Diversity and Career in Medicine
Health Sciences › Medicine › Surgery › Surgical Simulation and Training
Keywords: subclavian steal syndrome, vertebral artery, subclavian artery, vertebral artery insufficiency, vertebral artery dissection
MeSH terms: Aged, Basilar Artery, Blood Flow Velocity, Brain Ischemia, Ischemic Attack, Transient, Female, Follow-Up Studies, Humans, Male, Nervous System Diseases, Regional Blood Flow, Subclavian Steal Syndrome, Vertebral Artery

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The subclavian steal phenomenon: A common vascular disorder with rare neurologic deficits

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