In 2011 Palmer Luckey, aged 18, produced the first prototype of the Oculus Rift virtual reality headset in his parents’ garage. Although the term 'virtual reality' (VR) was coined in the 1980s, early prototypes were unsatisfactory as computer hardware was not sufficiently advanced. In the past few years, though, advances in technology have brought about another explosion of interest in VR, and we are already beginning to use augmented reality in clinical practice, with superimposed images of perfusion and lymph nodes on our video screens. The potential for the widespread adoption of VR in surgical education and training is put compellingly. Like all new technologies, there has been a lag phase between the early pioneers and the more mature introduction of properly functioning systems. The surgeons of the future will be practising their operations the day before in a virtual environment, and trainees will learn their craft outside the operating theatre. The big news of the day is the current impasse over the new junior doctors’ contract supposedly being revised to allow seven-day working with no extra cost. At one time the BMA Junior Doctors Committee was refusing to join negotiations, and the Secretary of State has threatened an imposed contract before the new intake of house staff in August 2016. The economist John Maynard Keynes rightly pointed out that, if the final outcome of negotiations is likely to be a compromise, it is reasonable and to be expected that the opponents will initially take up extreme positions. But this can inflame the situation and then emotion gets in the way of the facts. Certainly the current generation of surgeons in training and young consultants have a hard road ahead, with likely reductions in income and pensions, a longer working life, an increasingly hostile regulatory and medicolegal environment, and a perceived indifference by management to the aspirations of young professionals. There is not much needed to pull the trigger. Add in an insensitive government and you have a recipe for disaster. The College has made it clear that the imposition of a contract without negotiation would be unacceptable both for doctors and patients. But the junior doctors don’t see it like that, and feel the College has been unsupportive. In a letter in our correspondence section the very real concerns are presented and the sense of frustration well put. The College has taken a reasonable position on the issues, but the problem is our fellows and members seem not to know it. We are failing at the moment to clearly articulate our support for our trainees, and repeatedly affirm our interest in the best outcome for patients and surgical staff. It is a problem of perception. As we go to press, the College – after a lively meeting of Council – has made a clear statement of support for our junior colleagues (reproduced on page 420), and the Secretary of State has agreed to look again at the contentious issues in the government’s proposals. President John F Kennedy, in his inaugural address on 20 January 1961, famously said: ‘Let us never negotiate out of fear, but let us never fear to negotiate’. There has to be an atmosphere of trust for this to happen and our College needs to help create it. Tell us what you think
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Nov 7, 2016
Abi Rimmer 
Open Access