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When was his last re-certification as a general surgeon? What are the criteria for registration with the GMC, especially, for an individual that completed his training in West Africa? The author stated that he is a senior surgeon and that he has been in the employ of the teaching hospital since 2001. How good was his last performance review? Do you even conduct those reviews in the UK? Quite strange and unbelievable that a senior surgeon would fail in a procedure that is considered simple, even for trainee surgeons, anywhere in the world.