Surgical educators and the contemporary training of generalists

The national agenda calling for an increase in the number of generalists has resulted in several curricular recommendations, ones which might seriously compromise the training of medical students in surgery. Review of the curricular needs of family physicians reveals that substantial and broad education in surgery is necessary to achieve full competency. Currently, many such curricular objectives are met through special surgical courses and rotations during postgraduate training in family medicine. The argument suggesting that close student interaction with surgeons is unnecessary, and will discourage students from entering generalist disciplines, does not take into account a number of important factors. With appropriate modifications in the core third-year surgery clerkship and inclusion of an appropriately designed fourth-year surgery subinternship, it is possible for surgical educators to provide students with the experience in surgery that is essential for the training of generalists.