Core surgical training: The influence of time and date on interview outcome.

INTRODUCTION: Core Surgical Training has become increasingly competitive over the last 5 years with the competition ratio reaching 4.16 in 2021 compared to 2.31 in 2015. This is thought to be due to two key factors: a large yearly increase in the number of applicants and an unchanging number of jobs. Steps are taken by HEE to ensure the process is as standardised and fair as possible. Interview date and time selection remains the only aspect of the process that candidates currently control. We aim to explore whether time and date of an interview has any impact on interview scores within CST. METHODS: This study is a national, retrospective cohort study. A freedom of information act request was submitted to HEE to acquire anonymised interview scores and date/time of interview for all CST interviews conducted for the 2022-2023 cohort. RESULTS: Across the two-week period whereby interviews were held 1264 interviews were undertaken. Candidates with morning interviews had a mean score of 111 (±16) and candidates in the afternoon had a mean score of 108 (±18.5) (p = 0.023). Candidates interviewing in week 1 had a mean score of 107 (±18) and candidates interviewing in week 2 had a mean score of 112 (±16.4) (p < 0.001). DISCUSSION: A small difference in score has a significant impact for candidates with their geographical location, specialty choice or event enrolment in the core training programme potentially impacted. It is therefore imperative that these findings receive further evaluation going forward to ensure the process is fair and robust for all participants.

CCL-11 or Eotaxin-1: An Immune Marker for Ageing and Accelerated Ageing in Neuro-Psychiatric Disorders.

BACKGROUND: CCL-11 (eotaxin) is a chemokine with an important role in allergic conditions. Recent evidence indicates that CCL-11 plays a role in brain disorders as well. This paper reviews the associations between CCL-11 and aging, neurodegenerative, neuroinflammatory and neuropsychiatric disorders. METHODS: Electronic databases were searched for original articles examining CCL-11 in neuropsychiatric disorders. RESULTS: CCL-11 is rapidly transported from the blood to the brain through the blood-brain barrier. Age-related increases in CCL-11 are associated with cognitive impairments in executive functions and episodic and semantic memory, and therefore, this chemokine has been described as an "Endogenous Cognition Deteriorating Chemokine" (ECDC) or "Accelerated Brain-Aging Chemokine" (ABAC). In schizophrenia, increased CCL-11 is not only associated with impairments in cognitive functions, but also with key symptoms including formal thought disorders. Some patients with mood disorders and premenstrual syndrome show increased plasma CCL-11 levels. In diseases of old age, CCL-11 is associated with lowered neurogenesis and neurodegenerative processes, and as a consequence, increased CCL-11 increases risk towards Alzheimer's disease. Polymorphisms in the CCL-11 gene are associated with stroke. Increased CCL-11 also plays a role in neuroinflammatory disease including multiple sclerosis. In animal models, neutralization of CCL-11 may protect against nigrostriatal neurodegeneration. Increased production of CCL-11 may be attenuated by glucocorticoids, minocycline, resveratrol and anti-CCL11 antibodies. CONCLUSIONS: Increased CCL-11 production during inflammatory conditions may play a role in human disease including age-related cognitive decline, schizophrenia, mood disorders and neurodegenerative disorders. Increased CCL-11 production is a new drug target in the treatment and prevention of those disorders.