Residency experienced--in pursuit of structured apprenticeship

British surgical training is currently undergoing an upheaval. The introduction of Higher Surgical Training (HST) as a continuum to the consultant grade will have wide implications. I recently undertook a year as a resident in general surgery at the Beth Israel Hospital, Boston, USA; in lieu of a second year as an SHO in the UK. This paper compares the American Residency system with that evolving in Britain.