Surgical training - the challenge of change.

The healthcare environment is continuing to change and so too is education and training of surgeons. We now live in an age of increased specialisation, of technology, of accountability, of greater patient education and expectation and mass media attention. The traditional apprentice method and emphasis too much on examinations will have to be changed to a more structured system of training with training standards, regular assessment and feed back. There are new skills to be learnt for future surgical practice and new ways to learn them to become competent. We need to make changes in the institutions and departments to create a learning environment and an organisational system to implement the training programme. The current shortage of surgical work force in the institutions and lack of sufficient teachers committed to teaching and training are major issues that need to be addressed.