Observations by a James IV traveler on British surgical centers.

In Great Britain and Ireland there were many well-trained, technically excellent, clinical surgeons practicing the art of surgery in a system that guarantees an equitable and even distribution of quality care. University departments tended to be small but were very effective and stimulating units without the administrative and clinical burdens of a large teaching hospital. Surgical training programs were superb, but long, and continued to be molded by service requirements. Clinical research protocols were everywhere in evidence and were patient oriented, well controlled, and of the highest quality. Although there are several new impressive clinical plants, hospitals tended to be old and facilities somewhat dated. There are fewer intensive- and critical-care units than we have become accustomed to. As hosts, the British and Irish are unsurpassed as the most gracious, interesting, and educated people I know.