Documenting failed obstetric intubations [1] provides a valuable barometer of trainee performance in the most fundamental technique of our specialty – but Rahman and Jenkins seem to have been less diligent in studying other crucially relevant work. Firstly, they state that the deterioration in performance is not statistically significant, but omit a recent large survey [2] with a failure rate three times worse than the first report [3] 20 years ago, 43/4801 vs. 9/2517 (p = 0.01); both surveys were from the north of England. If fewer intubations are done, then performance will deteriorate, unless special measures are taken. Secondly, they state that results from different regions do not differ significantly, but that is not correct, even if we omit Meek's survey [2]. A closer examination shows that the data falls into two groups (Table 1). For Group I the failure rate is close to that of the first survey, about 1 in 250, whereas in Group II it is about 1 in 800. Group I shows progressive deterioration and the difference between the two groups is significant, p = 0.003. The common factor in Group II is that high importance was given to the gum elastic bougie. Thirdly, we are certainly not telling any experienced anaesthetist how to handle difficult intubations, but we are saying that a consensus is needed on what to teach the beginner – teaching different methods in every hospital produces inefficient training. The importance of training is especially clear from the Durban study [3], where the overall failure rate was 1 in 1500, not significantly different from 1 in 2000 for general surgery [4]. This refutes the myth that obstetric intubation is uniquely difficult, studied in depth by Pilkington et al. [5], who concluded that failed intubation in obstetrics was mainly due to inadequate training – currently under scrutiny by the Royal College of Anaesthetists Training Committee. If the main problem is lack of practice then it would help if, at an early stage, trainees were to use the bougie for most, if not all, intubations, as argued recently [6]. The safety of this simple method was demonstrated 40 years ago in 18 000 cases [7]. The novice gets some instruction in easy intubations, but what about Grade 3's? This was the main question raised by the paper which they criticise [8], but have they read it? This seems doubtful since they do not even mention training. They discuss antacids and failed intubation drills; these will be redundant if failed intubation can be eliminated and that is surely the right objective. Fourthly, they state that laryngoscopy grading is not useful because diverse incidences are reported. These discrepancies were comprehensively explained many years ago [9]. For example, cases reported as Grade 3 were converted to Grade 1 simply by the application of cricoid pressure. If laryngoscopy is correctly performed then the incidence of Grade 3 is about 1.3% in general surgery [10] and 1.7% in obstetrics [5]; if laryngoscopy is inexpert, then incidences of 10% can occur. Thus grading highlights deficiencies of training in the art of laryngoscopy, which is one reason why textbooks worldwide include it. Their paper illustrates the point since one of the failures was Grade 2, which even a beginner can manage if properly trained. A letter can cover only a small fraction of this subject, which was debated in more detail by the Difficult Airway Society [6]. The recent sharp rise in maternal deaths demonstrates almost complete lack of training in some areas. The available evidence suggests that failed intubation can be eliminated, but that depends crucially on teamwork by those responsible for training, that is, by all senior anaesthetists. If the novice is thoroughly drilled with the bougie, then ‘first-up’ failed intubation will be a rare event; the ‘overall’ rate would be zero if each hospital had a cadre of expert ‘fibreoscopists’. The Army and Police have shown the value of elite units for special tasks. More than 2000 years of medical tradition commands us to train the next generation, a core item of the Hippocratic Oath.