Time for a rethink of surgical training

We need to totally rethink our style of training in surgery in the UK. It's archaic and outdated. 

What's the ideal?  I suggest it is training which it is maximised, short and free from service commitment. 

In core, time should be spent learning to operate and manage surgical cases. As trainees progress more training in the management  of sick acute patients and elective work is required. 

Training time can be maximised by excluding out of hours work. Towards end of training, trainees could start to be involved in acute take and night time work. 

Training requirements would be managed by trained Assigned Educational Supervisors (AES). The training should be procedural based and not service based.  A trainee attached to an AES should be directed to lists and procedures as defined by the curriculum with a variety of surgeons and the trainee should not be attached to a surgeon or firm. It should be the AES who directs and supervises the training. 

If the above is the ideal, how do we get there from where we are now?  Service is important as one approaches CCT but not in the early core years. 

So in this months 

Jeremie Lefevre suggests that we need to rethink our style of surgical training. 

Is the idea of a 60 hour week really unbelievable?

Many object because of financial constraints, potential service impracticalities, historical traditions and personal aspirations. These need to be ignored. The focus has to be on, and solely on, improving surgical training. If we do this everything else will fall into place. 

Humphrey