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Mughal M et al. - Many current specialist registrars in general surgery feel unprepared to perform complex operations unaided at the end of their training, despite having been awarded the certificate of completion of training. Satisfactory records of in-training assessment (RITAs) are a prerequisite for the certificate. The RITA process gathers evidence of ability, including knowledge, operative ability, clinical judgment, leadership skills, and team working. Although a trainer can get a good idea of a trainee’s operative abilities by being on the other side of the table, decision making in complex situations can be tested only if the trainee is left to make those difficult decisions. The authors describe a way of incorporating such a transition phase into the last year of a general surgical specialist registrar’s training.

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