On 15 June the Royal College of Surgeons published its report From Theory to Theatre: Overcoming Barriers to Innovation in Surgery,1 which outlined the problems that surgical research faces and how they might be solved. Surgery has advanced spectacularly in the past 50 years, but many advances have not come from carefully planned research using valid study designs. Consequently, neither the public nor the surgical community seems convinced that we need scientific research into surgery, as opposed to research into diseases that surgeons can treat. That this perception is dangerously wrong is one of the key messages of the college’s report.

The report highlights past surgical achievements to a degree that might lead the naive observer to ask why—if surgeons are doing so well—they need to change anything. However, it also cites the decline of academic surgery in universities, the disappearance of meaningful contact with research from surgical training programmes, and the enormous practical difficulties caused by past failure to build a robust research infrastructure or an intellectual support network within surgery. The most …