Surgical training and the RCSI

Sir, – Prof Damian McCormack's description (November 20th) of surgical training at the Royal College of Surgeons in Ireland (RCSI) as a "monopoly" that "degrades the quality . . . of the end product" because it has no competition from other Irish universities and medical schools is an interesting perspective. So too is his identification of that "monopoly" as a significant root cause of the manpower crisis in surgery in Ireland. However, there are other perspectives, both on the quality of surgical training available and on the shortage of surgeons in Ireland.

As lecturers in healthcare ethics for a number of years on the masters in surgery (MCh) course at RCSI, we see things somewhat differently to Prof McCormack. The trainee surgeons it attracts each year include a majority who have done their undergraduate medical studies in all the other Irish universities and medical schools, as well as some RCSI graduates and some from various other countries.

The diversity of individual trainees from different educational, cultural and social contexts enriches the course greatly and the students benefit immeasurably from the shared experience, insights and knowledge of their peers. The surgical training facilities at RCSI are superb. Each year we are always struck by the calibre of the surgical trainees at RCSI; they are amongst the finest physicians we have met anywhere in the world.

The personal and professional relationships that are begun on the surgical training programme contribute in no small way to the maintenance of the highest standards in surgery in every country in which those surgeons work, as knowledge of skills and experiences are shared congenially among friends and colleagues. These men and women attest to the quality of surgical training at RCSI. – Yours, etc,