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Education And Debate

Commentary: The obituary of general surgery?

BMJ 1994; 309 doi: (Published 06 August 1994) Cite this as: BMJ 1994;309:388
  1. R Greenhalgh
  1. Department of Surgery, Charing Cross and Westminster Medical School, Charing Cross Hospital, London W6 8RF.

    Good organisation of vascular surgical services need not be accompanied by the emergence of vascular surgery as a separate specialty, but J A Michaels and colleagues are right to point to the need for change. Patients referred to a surgeon by their general practitioner often ask the surgeon whether he or she is a specialist in their problem. By the next century no patient will wish to be sent to a general surgeon. The obituary of general surgery is in view.

    Vascular surgery is a good example of these trends, and so the main thrust of the comments of Michaels and colleagues should be supported. Patients can indeed expect emergencies to be managed by expertly trained vascular surgeons doing elective vascular surgery during the day, and patients must have proper access to the necessary skills. The current requirement …

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