Basic surgical training. 4: American and British scenes compared.

This report outlines the surgical residency program in the United States, with special reference to examinations in anatomy. During each of the 5-6 years of the program and in the first part of the surgical board examination, there are written (MCQ) examinations. The final board examination is oral. The anatomic content of each of these examinations is very small. This situation compares unfavorably with that in the UK in the 1940s and 1950s, when the colleges of surgeons demanded a high standard of anatomic knowledge, so that holders of the Fellowship (FRCS) displayed confidence in their diagnostic skills and in the operating room. In the United States today, surgical residents and attending surgeons (British = consultants) alike seldom have a sound overall knowledge of anatomy. They may become proficient in localized regions, but when drawn out of their area of expertise, their anatomic knowledge may be less than expert. It is disappointing to learn that the surgical colleges in the UK and Ireland are making changes in their Basic Surgical Training program that will inevitably result in a decline from their former high standards.