GENERAL SURGICAL TRAINING - IMPROVEMENTS AND PROBLEMS

Surgical training in this country was coveted by many trainees from ab road, who remember their period of clinical apprenticeship with affect ion. The twin pillars of this success were the considerable clinical w orkload and a school of surgeons that were well trained and skilled in the full breadth of general surgery (see Figure I). This led to a deg ree of complacency and little effort was made to change a system that produced experienced, well trained surgeons (even if some were a littl e jaded and embittered by the time they finally obtained a consultant post). More recently surgical training has been in a state of flux and standards have adapted to both market forces and European directives on doctors' hours. The Calman Report addressed these issues and has wi de reaching implications. The prospect of a more focused and organised training that could produce consultants by the age of 32-33 was welco med by most. The vagaries of an apprentice system needed to be address ed and tightly focused training programmes developed. Following endles s committees the structure of general surgical training is now defined and will be dealt with in the first part of this paper. Having define d the structure we then need to assess the trainers'/training programm es and finally the trainees.