Will modernised medical careers produce a better surgeon?

BMJ 2005; 331 doi: (Published 01 December 2005) Cite this as: BMJ 2005;331:1346
  1. Luke Devey, Medical Research Council and Royal College of Surgeons of Edinburgh clinical research training fellow (
  1. tissue injury and repair group, University of Edinburgh

    I was asked to use this question as the topic of a talk for a recent interview for a specialist registrar post in general surgery. Getting to grips with the topic provided some scary insights into the future of training and led me to think about how training would need to be structured to provide surgical services into the future.

    There is now a consensus that the Department of Health's modernising medical careers initiative (MMC) will shorten surgical training. Under the old system, our predecessors worked long hours for an average of 13 years between qualifying as preregistration house officers and starting work as consultants. This amounted to a training time of more than 30 000 hours. Alarmingly, the combined effect of the European Working Time Directive and MMC will reduce the number of hours of surgical training to at most 15 000, or 50% of what it used to be. Add to this the greater …

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