Considerations in the training of surgeons

: There are several reasons why this topic has been chosen by the Royal Belgian Surgical Society: the general malaise in the profession; the increased number of applicants; the interference of the government in the organization of surgical postgraduate training; the misjudgment which probably has been made in the past in the organization of surgical training programs. The many factors which have led to the present "misgrown" situation are discussed: principally there has been a fundamental oversight: general surgeons have promoted themselves as procedural specialists rather than surgical experts in specific organ systems or a well defined pathology. Finally a certain number of proposals are made to adjust the surgical training programs to the needs in this era: Junior year: in depth study of anatomy; in depth study of pathophysiology; specific training in basic surgical techniques, skills, and handcraft, all three with a test at the end of that year. 2nd-3rd-4th year: acquisition of surgical skills in a wide range of surgical interventions (elective and emergency cases). Final training years (2): acquisition of: a specific "general surgery attest" specifying the conditions where it is exclusively applicable (suburban or small town district hospitals), or an attestation of special interest in a specific organ or in a well defined pathology; formal study of management and meeting techniques; acquisition of a flexible contemporary philosophical and ethical insight.