Training in Aortic Surgery Requires Radical Change

Surgical training in the United Kingdom is undergoing major changes due to many factors including Modernising Medical Careers, the European Working Time Directive and the development of new technology. Further reduction in working hours threatens to jeopardise the effective continuation of patient care and compromise training, which may result in less experienced surgical trainees. The traditional model of apprenticeship, based on ‘learning-by-doing’, has been challenged, and clinical experience will have to be supplemented or replaced by workshops and simulators using virtual reality software in a non-clinical environment. 1,2 There is emerging evidence that the assessment of technical skill using inanimate procedural simulation such as sapheno-femoral junction dissection, carotid endarterectomy, (thoraco-)abdominal aortic aneurysm surgery, and femoro-popliteal bypass can translate to actual surgical performance within the operating theatre. 3 Many senior surgeons may even argue that simulation is now the preferred mode of practice for commencement of surgical training, not only to familiarise the trainee with the operations, but also to provide simulated surgically stressful situations which can be used to develop effective coping strategies. 4 Furthermore, it has been