Is there a problem with surgical training? What is broken and what needs fixing? In considering these questions, I should state at the outset that my thoughts, while shaped by deliberations and debates within the American Board of Surgery (ABS), do not state the position of the Board, which has yet to formulate its position. My concern is that although we are successful in providing excellent general surgical training, we may need a new mechanism for providing further special training to general surgeons.
Certification in surgery requires a broad training in the basic science of surgery and documented experience and skill in the nine primary components of surgery, as defined by the ABS. It also demands significant exposure to the four secondary components and an understanding of the management of common problems in other areas related to surgery (Table 1). The breadth and scope of the educational task is formidable