No time to train the surgeons

Editor—Chikwe et al highlight the crisis in surgical training in the United Kingdom.¹ Many of the advantages of the “apprentice” model have been destroyed without a comfortable and successful new structure being in place. Some elements can be rectified with ease—comprehensive academic courses, wet labs, a refashioned senior registrar phase, for example. The previous hours of exposure can clearly not be amassed without an absurdly long training period.

One of our goals should be to have the shortest overall training period that is capable of producing the best doctors fit to do their jobs. To what extent can we take the best from other systems and adapt to our situation? Why does it take four to five years to qualify in medicine in the United Kingdom when in other countries this can be achieved in four years? More importantly, why in the current era can newly qualified doctors do so little?

The current situation comes on the back of several years of deskilling of medical students due in part to the loss of students' integration into clinical firms. This loss is one of the costs of a modular course, fine in concept but unrealistic unless the previous experiential training is fully replaced. And these comments are not new.²

The need for proficiency in appropriate core skills at all stages should be recognised. Beyond a minimum period, progress should be competency based. Medical students, who will be paying for their education, should be vigorous in demanding it.