Curtailment of higher surgical training in the UK

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Examining the potential impact of the proposed two-year cut in otology training, Jaydip Ray and colleagues conclude that intensification of training would be necessary to eradicate the significant difference in specialist surgical experience between current year-four and year-six otology trainees (June 2005 JRSM1). In our opinion their article misses the point regarding the changes. The proposed model of four years' general training followed by two years of specialist training will not require future year-four trainees to have comparable operative experience to today's year-six trainees, as implied. The Specialist Advisory Committee for Otolaryngology has set stage-specific criteria of required operative competencies for higher surgical trainees.2 Georgalas et al.,3 in a recent survey of otolaryngology trainees, concluded that all stage-specific criteria were currently being met, and that training standards were satisfactory across the UK. They concluded that current training is adequate and that a system of two-tier trainees, with four years of general training and two years devoted to the subspecialties, would be an adequate option for the vast majority of specialist registrars, provided that current standards are maintained.2 Training in specialist otological surgery will not be offered or assessed in the new four-year ‘generalist’ higher surgical rotations, since specialist experience will be gained in accredited otology fellowships for prospective otologists.