EDITOR, - There is increasing pressure on the royal colleges to introduce some form of accreditation and assessment of practical skills in minimally invasive surgery. This is partly driven by attention in the media to cases that have had an unfavourable outcome. There has never, however, been a demand for such accreditation in general surgical skills. Theoretically, a doctor who has never performed surgery can obtain a fellowship of the Royal College of Surgeons or membership of the Royal College of Obstetricians and Gynaecologists. Yet there are no calls for assessment of the technical competence of general surgeons or gynaecologists. Perhaps it would be more appropriate if assessment of technical skill in surgical specialties generally, rather than just in innovations such as minimally invasive surgery, was addressed.

C M S Royston and colleagues discuss different modes of training in laparoscopic surgery and suggest that the porcine model is useful.1 They do not make clear …