World Journal of Surgery

, Volume 33, Issue 2, pp 174–179

Surgical Training and Certification in the United Kingdom

  • Andrew J. Smith
  • Rajesh Aggarwal
  • Oliver J. Warren
  • Paraskevas Paraskeva


Training in surgical disciplines in the United Kingdom has undergone tremendous change over the past two decades. The introduction of specialist training programmes, working time directives, quality ratings and a drive toward ambulatory and minimal access surgery have led to challenges with respect to training and service commitments of healthcare professionals. A structured and centralised training system was introduced, with the concept of core followed by specialty-specific progression, in an openly competitive manner. Within this system is the need to commence training on simulation models, and to demonstrate proficiency prior to performance of tasks on patients. This should be underpinned by objective measures such as video or dexterity-based tools. There is also a clear need to provide personal, professional and leadership development in the form of mentorship and appraisal systems. Though continuing to develop, the profession must be mindful of current and future advances to ensure the delivery of surgeons for the future who aspire toward excellence.


  1. 1.
    Calman K (2003) Hospital doctors: Training for the future. Department of Health, LondonGoogle Scholar
  2. 2.
    Donaldson L (2002) Unfinished business: proposals for reform of the senior house officer grade. Department of Health, LondonGoogle Scholar
  3. 3.
    The 4 UK Health Departments (2004) Modernising medical careers: the next stepsGoogle Scholar
  4. 4.
    The MTAS Review Group (2007) Review of the medical training applications service and selection process 2007Google Scholar
  5. 5.
    Tooke PSJ (2007) Aspiring to excellence: findings and recommendations of the independent inquiry into modernising medical careersGoogle Scholar
  6. 6.
    The European Working Time Directive—interim report and guidance from The Royal College of Surgeons of England, 2003Google Scholar
  7. 7.
    Halsted W (1904) The training of the surgeon. Bull Johns Hopkins Hospital 15:267–275Google Scholar
  8. 8.
    Smith R (1998) All changed, changed utterly. British medicine will be transformed by the Bristol case. BMJ 316:1917–1918PubMedGoogle Scholar
  9. 9.
    Joice P, Hanna GB, Cuschieri A (1998) Errors enacted during endoscopic surgery—a human reliability analysis. Appl Ergon 29:409–414PubMedCrossRefGoogle Scholar
  10. 10.
    Mughal M (1992) A cheap laparoscopic surgery trainer. Ann R Coll Surg Engl 74:256–257PubMedGoogle Scholar
  11. 11.
    Krummel TM (1998) Surgical simulation and virtual reality: the coming revolution. Ann Surg 228:635–637PubMedCrossRefGoogle Scholar
  12. 12.
    Aggarwal R, Undre S, Moorthy K et al (2004) The simulated operating theatre: comprehensive training for surgical teams. Qual Saf Health Care 13(Suppl 1):i27–i32PubMedCrossRefGoogle Scholar
  13. 13.
    Day M (2007) Health service management: The rise of the doctor-manager. BMJ 335:230–231PubMedCrossRefGoogle Scholar
  14. 14.
    Principles of Medical Leadership. Joint Statement from the British Association of Medical Managers and the British Medical Association, 2007Google Scholar
  15. 15.
    Lewellen-Williams C, Johnson VA, Deloney LA et al (2006) The POD: a new model for mentoring underrepresented minority faculty. Acad Med 81:275–279PubMedCrossRefGoogle Scholar
  16. 16.
    Poole A (2003) The implications of modernising medical careers for specialist registrars. BMJ 326:s194PubMedCrossRefGoogle Scholar
  17. 17.
    Warren O, Smith A, Humphris P et al (2007) Management development in academic surgical trainees: a pilot formalised mentoring programme. Developing careers in surgical education: management, training and research conference, The Royal College of Surgeons of EnglandGoogle Scholar
  18. 18.
    Donaldson L (2006) Good doctors, safer patients: proposals to strengthen the system to assure and improve the performance of doctors and to protect the safety of patients. Department of Health, LondonGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Andrew J. Smith
    • 1
  • Rajesh Aggarwal
    • 1
  • Oliver J. Warren
    • 1
  • Paraskevas Paraskeva
    • 1
  1. 1.Department of Biosurgery and Surgical TechnologyImperial College LondonLondonUK

Personalised recommendations