Intended for healthcare professionals


No time to train the surgeons

BMJ 2004; 328 doi: (Published 19 February 2004) Cite this as: BMJ 2004;328:418
  1. Joanna Chikwe, specialist registrar (,
  2. Anthony C de Souza, programme director (,
  3. John R Pepper, chairman of London Deanery Cardiothoracic Speciality Training Committee (
  1. Cardiothoracic Surgery, Royal Brompton Hospital, London SW3 6NP

    More and more reforms result in less and less time for training

    Surgical training in the United Kingdom is beset by fundamental problems raising what has been described as “considerable disquiet amongst trainees and trainers.”1 Basic and higher surgical trainees progress through a system comprehensively reformed five years ago to emphasise structured training, supervision, and regular assessment. So why are senior house officers' skill levels regarded by trainees and trainers as “very shallow”?2 Why is there insufficient capacity in the system to train surgeons in the way that their trainers want?3 And why is it that, in a recent poll of consultant surgeons, two thirds would not wish to be operated on by a Calman trained consultant colleague?4

    In 1993 Sir Kenneth Calman proposed reforms of the registrar grades to bring the United Kingdominto line with a European Union directive on medical training. It was hoped that encouraging structured learning and supervision would compensate for reducing training time. The European Working Time …

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