Training for vascular surgery: a template for the future.

Training in vascular surgery is inevitably going to change radically over the next few years and we no longer have the luxury of an apprenticeship where the trainee matures and develops by prolonged contact with patients and senior colleagues. The EEC and Department of Health are insisting on a more focused training, by reducing the hours to 72 per week and suggesting accreditation as a surgical specialist after six years in higher surgical training. These goals, which have already been accepted by the Royal Colleges (and have been welcomed by the trainees), will inevitably lead to an entirely different approach to training, offering vascular surgeons an opportunity to develop coherent and more uniform programmes. To date many trainees have complained that their experience has been patchy, and sometimes poorly supervised. The task of developing a practical scheme is daunting, but we must start with the patient. Clearly, the patients' needs come first so that the training programme must lock on to the best standards of care. Only in this way can we ensure that the trainee is exposed to the best practice and modern techniques.