An important recent change in surgical training in the Netherlands is the regulation of the working hours of residents. During the early 1990s, Dutch surgical residents worked between 80 and 100 hours per week. The government determined that the long working hours compromised the quality of health care and the well-being of residents, and it intervened. Within a few years, the working hours of residents were reduced to 48 hours per week. In addition, strict rules indicate the number of consecutive hours that a resident is permitted to work. Although the basic principles of limiting working hours are admirable, the extent of the reduction of hours has met great opposition in the medical field. However, a law has been passed obligating hospitals to follow the regulations, and violation results in steep fines. Surprisingly, the working hours of specialists have not been subjected to governmental intervention. The consequences of the reduced work week are far reaching. Continuity of patient care is deregulated, attendance at meetings of the department of surgery is fragmented, and, foremost, the available time for training has become less. Considering this fact and the increasing specialization in various fields of surgery, the format of the training in general surgery will be adjusted. In 1999, the sixth year of residency will be designated the "differentiation year." Four differentiations are possible: surgical oncology, gastrointestinal tract surgery, vascular surgery, and trauma care. The future will show whether the quality of the surgical training suffers owing to the reduced working hours.