Basic surgical training. 2: Interactions with the undergraduate medical curriculum.

Proposed changes in postgraduate surgical training must be seen in the context of changes being implemented in medical schools. The reorganization of discipline-based departments into large units of biomedical science; the reduction in time allotted to anatomy, particularly to dissection by students; the development of integrated courses with multidisciplinary examinations in which poor performance in anatomy can be compensated by good marks in other subjects; the decline in staff numbers (faculty) with expertise in human anatomy and corresponding enthusiasm for teaching it; and the loss of demonstratorships available to surgical trainees are all factors that leave today's medical graduates who embark upon surgical training programs poorly equipped in their knowledge of anatomy. This deficiency is not easily remedied by the proposed changes in Basic Surgical Training and is not adequately identified by the examination arrangements. It is argued that a structured oral examination with a wide spectrum of components, including dissections, living and surface anatomy, osteology, radiographs and scans, and microanatomy, would be the best way of assessing the familiarity of candidates with anatomy and their suitability to proceed to Higher Surgical Training.