General surgical training--improvements and problems. Vascular Advisory Committee of the Vascular Surgical Society of Great Britain and Ireland.

Surgical training in this country was coveted by many trainees from abroad, who remember their period of clinical apprenticeship with affection. The twin pillars of this success were the considerable clinical workload and a school of surgeons that were well trained and skilled in the full breadth of general surgery (see Figure 1). This led to a degree of complacency and little effort was made to change a system that produced experienced, well trained surgeons (even if some were a little jaded and embittered by the time they finally obtained a consultant post). More recently surgical training has been in a state of flux and standards have adapted to both market forces and European directives on doctors' hours. The Calman Report addressed these issues and has wide reaching implications. The prospect of a more focused and organised training that could produce consultants by the age of 32-33 was welcomed by most. The vagaries of an apprentice system needed to be addressed and tightly focused training programmes developed. Following endless committees the structure of general surgical training is now defined and will be dealt with in the first part of this paper. Having defined the structure we then need to assess the trainers'/ training programmes and finally the trainees.