• John G Mosley.
• Department of Vascular Surgery, Leigh Infirmary, Leigh, Lancashire, UK. john.mosley@wwl.nhs.uk
• Ann R Coll Surg Engl. 2007 Jul 1;89(5):457-63; discussion 464-5.

AbstractThe surgical profession, more than any other medical specialty, is constantly in the limelight. Frequently, concerns are expressed about our colleagues. The concerns may be personality clashes rather than failure in behaviour or performance. Most concerns can be addressed locally with support from the Royal College Invited Review Mechanism of the National Clinical Assessment Service. Unfortunately, if the concern is sufficiently serious or repetitive it may warrant referral to the General Medical Council (GMC) who alone has the right to withdraw a surgeon's medical registration. The surgeon will then be unable to work in the medical profession in this country. The procedures the the surgeon must undergo if referred to the GMC are stressful and protracted. Even if successful the surgeon will probably be expected to undergo a period of retraining that will prove difficult to arrange. New proposals to modify the GMC procedures will reduce the standard of proof to one of 'balance of probabilities'. The surgical profession should be accountable to its patients and colleagues. Will our Royal College rise to the challenge to establish itself as the bulwark of the surgical profession?

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