Surgical training is undergoing profound change worldwide. Increasing demands for patient safety, growing subspecialisation, economic pressures, evolving working-time regulations, and changing expectations among younger generations of doctors are challenging traditional training structures. Yet the central objective remains unchanged: to educate competent surgeons who are prepared to meet the technical, clinical, and human demands of modern surgical practice.
This Swiss Knife Focus was developed through a close collaboration between Swiss Knife and the Swiss Young Surgeons. The aim of this joint initiative is to explore current developments, challenges, and innovative approaches in surgical education from both national and international perspectives. Valuable inspiration for this issue emerged from numerous exchanges with colleagues across different countries, as well as discussions during the ASiT Conference 2026 in Manchester. These conversations highlighted that many of the challenges facing surgical training are shared internationally, even though healthcare systems have adopted remarkably different approaches to addressing them.
We begin with an interview featuring Dr Marie Klein, who offers insights into surgical training at a large Swiss tertiary centre. Her reflections illustrate both the opportunities provided by a structured training environment and the importance of personal initiative, commitment, and a supportive educational culture.
Providing a perspective from the United Kingdom, Isabelle Obrecht examines the characteristics of the British training pathway, highlighting the role of national training programmes, standardised progression, and central workforce planning in shaping surgical education.
An additional international viewpoint is offered by Dr Suna Erdem, who reflects on her observership at MD Anderson Cancer Center in Houston, Texas. Her experience provides valuable insights into the importance of clearly defined training pathways, progressive operative autonomy, and a strong culture of teaching and mentorship. At the same time, her observations encourage a thoughtful comparison of the strengths and limitations inherent in different training systems.
The foundations of surgical education are established long before residency begins. Katrin Werwick, Udo Barth, and colleagues from the Otto-von-Guericke University Medical School in Magdeburg demonstrate how modern surgical teaching extends far beyond traditional lectures. Skills laboratories, digital logbooks, innovative educational formats, and the early integration of practical skills are increasingly important in preparing students for future surgical careers and inspiring interest in the specialty.
A particular focus of this issue is the role of training networks. Torben Schmidt presents the experience of nine years of the Swiss Surgical Training Network, illustrating how collaboration between multiple institutions can provide structured rotations, high-quality training opportunities, and long-term career planning. His article demonstrates the potential of cooperative training models to address some of the most pressing challenges in contemporary surgical education.
In our interview with Dr Viktoria Pfeifle and Dr Maite Jiménez Siebert, the focus shifts to the perspective of a current trainee. Their discussion illustrates how pediatric surgical training combines exceptional clinical diversity with the realities of limited case numbers, increasing subspecialisation, and evolving expectations regarding surgical education.
Finally, Alissa Gübeli, Laurent Wehrli and Michaël Papaloïzos present the four regional hand surgery training networks in Switzerland. Their analysis demonstrates how coordinated rotations, shared quality standards, and long-term workforce planning can strengthen both training quality and the sustainability of specialist workforce development.
By examining different healthcare systems, disciplines, and educational models, this Focus offers an opportunity to reflect on how surgical training can continue to evolve. Innovation often emerges where collaboration, openness, and long-term thinking intersect. Ultimately, the quality of tomorrow’s surgical care depends on the quality of today’s surgical training. It is therefore our collective responsibility to shape that future actively and thoughtfully.
Yours sincerely,
Micheal Demean and Beat Schnüriger
