Since 1996, elected members of the Section and Board have recognised the drive towards specialisation in surgery but see the need to maintain an excellent common trunk of training. Elected members have recognised that there will be an inevitable thrust towards specialisation but there is concern about the on-call rotas and that the patients shall end up in the right hands by day and by night.The Section of Surgery and European Board of Surgery is united in its view that a very adequate common trunk of training is crucial. The Section and Board recognised that the length of the common trunk need not be the same for every division of the Section.

Introduction: The Grapefruit Concept

A federal structure for surgery has emerged. The Section and European Board of Surgery can be visualised as a grapefruit with a rather larger pithy centre.

The skin of the grapefruit represents the European Board of Surgery and Section of Surgery.

The pithy centre represents the common trunk of training, which unites all surgeons. Having undertaken a common trunk of training, surgeons often concentrate on a specialty of surgery for research purposes followed by two years of training programme in their chosen specialty.

This is the system for vascular surgery, coloproctology, trauma, transplantation, thoracic surgery and so on. The segments of the grapefruit therefore conveniently depict the Divisions of the Section of Surgery and their Boards. The specialties are thus separated by a thin "partition" but linked by the common trunk of training and united within the "skin" of the grapefruit which respresents surgery as a whole.

The Section of Surgery and European Board of Surgery is opposed to fragmentation of surgery.

The UEMS's strength is as a lobbying body and surgeons must relate together as a group to be effective. We recognise that to splinter will be to our loss.