Letter: Taking the bull of competency assessment by the horns

I read with interest the survey by Nel et al.¹ "Procedures most frequently performed by South African-trained general surgeons - implications for training and assessment". I am heartened to see the long overdue move towards workbased assessment (WBA) and procedural competency as key elements of the assessment of fitness to practise as a consultant surgeon. The survey of recently trained surgeons found that 49% of the respondents felt unprepared to undertake one or more of the 10 procedures they most frequently perform. Of these, the procedure they felt most untrained to perform was colonoscopy. Even more revealing is that those who had gone directly into private practice had a 100% expectation that they should be able to perform colonoscopy.