The Navy trains two types of line officers. One is destined for command. His training involves rotation through a wide variety of specialty departments before he assumes ultimate authority and responsibility as captain of a ship. Another group of line officers, such as engineers, are trained along narrower lines to become specialty technicians. They are designated for limited command. They are not intended to be skippers.
Surgery is fast approaching the point where those of us responsible for training practitioners for the 1980s and 1990s must decide the optimum training pattern for the surgeon practicing for the rest of the century. Will it be for command of total patient care or merely to be a technician?
Unfortunately, directors of surgical training programs are usually cloistered in university hospitals and are, therefore, largely unaware of many unpleasant realities of community practice one of which affects basic responsibility and authority of a