Table 1.

Thematic analysis of responses in the six identified areas.

Theme	Sample responses
Limited case complexity	“IS has been cherry picking cases with DSD score 1, and leaving more complex cases for NHS trust.” “All straightforward cases on high-volume lists.”
Limited case numbers	“Infrequent lists or trainees only allowed a limited number per list.” “Two separate sites, one offering up to eight cases per list, another offering no more than two per list (as the remaining eight are private patients).”
Suboptimal training for juniors trainees	“No teaching microscopes so juniors trainees weren’t allowed to operate.” “There is an unspoken time pressure as it’s a high volume list, but no trainee has been told to hurry up.” “No opportunity to learn to train others.”
Administrative burden	“Significant paperwork burdens and administrative inefficiencies.” “Commuting distance and difficulties managing timetables.” “The IS provider asked me for a huge amount of paperwork, but not until I got there! Turned up for an all-day list and wasn’t allowed to operate at all that day.”
Complications	“Often complications were handled at the local NHS trust.” “Good experiences managing complications in our deanery with very good plan for post-op follow up. The trainees had the opportunity to follow up their own patient where appropriate with consultant input where needed, otherwise the consultant followed up one of the patients with a complication at the IS provider.”
Positive training experiences	“Many of the members of the wider theatre team are known to trainees from their NHS department, so it is a friendly and familiar environment. The phaco machine and other equipment were largely the same.” “Really gave me confidence as I had low numbers and little opportunity to do more theatres.” “Good experience overall, would be even better with more cases.”