Neurosurgery in Victoria, Australia: training and practice compared with the united kingdom

In the UK there are currently great changes taking place in both higher sur gical training and consultant practice. Australia inherited the British sys tem, many aspects of which it retains, but has moved to a US type training programme. Recent experience of British and Australian neurosurgical practi ce allows useful comparisons to be made with possible benefit to both. Neur osurgery in Australia is a more consultant based service than that in the U K with 73 consultants for a population of 18 million, Consultants work prim arily from their private rooms and consultant numbers in the public sector are misleading as few of them approach full time. Neurosurgical training is organized on a national basis with a finite training programme. This consi sts of a rotation of different jobs supplemented by consultant led lectures and tutorials. Training is regularly monitored, with a final exit examinat ion. The disadvantages are the relative lack of operating whilst training, many neurosurgeons becoming accredited with the personal operating experien ce expected of a British registrar; and the working hours; most trainees wo rk 1 in 1, which precludes any sort of normal family life. In summary, the relative strengths of the British and Australian systems are largely comple mentary, there being ample scope for each to learn from the other.