The way we teach: how I did and how I should teach surgery.
Combined sessions are an important part of teaching surgery in the first years though they are very demanding of staff. During the Junior/Introductory Course the student should be given plenty of time to acquire understanding of and facility with a whole new vocabulary and to feel at ease talking to the sick. At this stage there should be no formal separate surgery course. Students are introduced to the reality of the clinical encounter and are given a rough outline of the areas in standard texts that they should have read. They are also taught about aspects of theatre drill. During the next years students are encouraged to think about simple clinical problems in an algorithmic way, and simulators are used to teach them how to use the simple surgical tools of the trade. In the last year an 'open round' is run to identify problems and students are provided with self-test material. The residency period should be used to enable student locums and preregistration house officers to achieve a measure of organizational experience, a sense of command, and to extend their communication skills by presenting patients at formal meetings. How students acquire clinical method remains to be established.
St Mary's Hospital Medical School and Director of the Surgical Unit, St Mary's Hospital, London, UK.
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Dudley