Page "General surgery" Paragraph 14

In the United Kingdom, surgical trainees enter training after five years of medical school and two years of the Foundation Programme.

During the two to three-year core training programme, doctors will sit the Membership of the Royal College of Surgeons ( MRCS ) examination.

On award of the MRCS examination, surgeons may hold the title ' Mister ' or ' Miss / Ms ' rather than doctor.

This is a tradition dating back hundreds of years in the United Kingdom.

Trainees will then go onto Higher Surgical Training ( HST ), lasting a further four to five years.

During this time they may choose to subspecialise.

Before the end of HST, the examination of Fellow of the Royal College of Surgeons ( FRCS ) must be taken in general surgery plus the subspeciality.

Upon completion of training, the surgeon will become a consultant surgeon and will be eligible for entry on the GMC Specialist Register and may work both in the NHS and independent sector as a consultant general surgeon.

However, with the implementation of the European Working Time Directive limiting UK surgical residents to a 48-hour working week there are concerns that upon completion of training UK surgeons will not be confident enough to work independently.

The introduction of a sub-consultant grade to enable those who have recently received a UK Certificate of Completion of Training may be necessary.