The drawbacks of overspecialisation.

In the March 1997 issue of Surgery, Professor Irving Taylor of University College London Medical School observed that overspecialisation in surgery may have gone too far. I have, in the February 1998 issue of Surgery, pointed to the damage that specialisation has done to surgery in the third world. The President of the College and the Editor of the Journal have decided, rather than reprinting my essay, to ask me to enlarge on the topic. In this article, by necessity, I will be covering issues that I first raised in the Surgery article. To be invited to partake in a debate of such importance is a great honour. That this honour was bestowed upon a Fellow of the Association of Surgeons of East Africa, which organised the first symposium on "Surgery in the District Hospital", is of great significance to east African surgery.