Use of the operative logbook to monitor trainee progress, and evaluate operative supervision provided by accredited training posts.

The Surgical Education and Training (SET) program of the Royal Australasian College of Surgeons (RACS) represents a change from a time-based program to a competency-based program and much greater emphasis is placed on formative assessment and timely feedback (to Surgical Training Boards - STBs - as well as to the trainee). It demands early recognition of the trainee who is struggling to progress, the so-called "marginal trainee". Many of these are simply failing to acquire the desired competencies at the desired or expected rate, although some have more profound underlying deficiencies. SET also places a demand on training posts--with the expectation that they are providing an environment that is conducive to learning and that the trainees are getting adequate learning opportunities. In the domain of operative skills, this largely implies that levels of operative teaching and supervision should be appropriate to the trainee's stage and ability.