Announcement

Examinations leading to the FRCS diploma

At the Annual Meeting of the Association of Surgeons of Great Britain and Ireland, with the President, Professor Sir Patrick Forrest in the Chair, it was unanimously agreed that the following statement represented the views of the Association:

The Association of Surgeons of Great Britain and Ireland accepts that the FRCS diploma is no longer a qualification which signifies sufficiency of knowledge in all areas of surgery. This position has arisen by the step-to-step development of a series of major specialties (e.g. orthopaedics, urology, etc.) within what used to be general surgery, each of which requires an extensive period of training following acquisition of the FRCS diploma as we now know it. These specialties do not accept that the present Fellowship is appropriate to their needs. They recognize the need for, and indeed demand, a stringent assessment of competence during the training period.

General surgery, as is now defined, i t . gastrointestinal, breast and endocrine, vascular and transplant surgery, trauma, etc. is no different from any other surgical specialty, demanding similar periods of specialty training and assessment of knowledge. Logically this assessment can only be held during that period of specialist training, i.e. after the time of the present FRCS. The Association believes that it is at this stage that the FRCS diploma should be awarded, as we understand is also the view of other specialty associations.

Were this to be agreed, a period of basic training before training in a specialty (including general surgery) is necessary during which time the young surgeon is exposed to surgery in all its various forms. This allows him or her to experience different surgical specialties and to decide about the direction in which his or her career should go. At this stage the young surgeon must be examined in knowledge which is common to all forms of surgical practice. This test of basic core knowledge should be in depth in selected areas. Detailed knowledge of much of general surgery is acquired during the higher surgical training period and cannot be assessed during this basic training period.

The Association cannot see that such an assessment of this basic core knowledge should require two separate examinations. It should be possible within the structure of a single examination, which would form Part I of the FRCS (new type). It would clearly be important that the young surgeon received some formal affiliation to a College after passing this examination; but it is inappropriate that this should be the Fellowship.

Those currently enrolled in higher training programmes in general surgery require special consideration and should not be eligible to take any additional examinations.

The Association therefore wishes to state as its views that:

1. General surgery (i.e. surgery of the gastrointestinal tract, breast and endocrine, vascular and transplant surgery, trauma, etc.) must now take its place alongside orthopaedics, urology, etc. as a specialty in its own right which merits similar periods of training and methods of assessment 2. Two examinations only should be necessary to assess the competence of a general surgeon to practise: the first an assessment of core knowledge including basic sciences common to all surgical specialties including general surgery; the other a test of knowledge in general surgery as a specialty 3. Although some form of college affiliation will be necessary after satisfactory completion of the first assessment, the FRCS diploma proper should be awarded only after both parts have been satisfactorily completed 4. Those enrolled in higher training programmes in general surgery at the time of these changes should not be eligible to sit a further examination.

Barry Jackson Honorary Secretary

Br. J. Surg., Vol. 76, No. 10, October 1989 1091