The goal of training programs is to efficiently train competent surgeons to meet the needs of the community. Historically, this was achieved with 4-6 years of specialty training after internship, with the option of additional fellowships in sub-specialties. Over time surgical training has lengthened, with both pre-SET and fellowship duration increasing. Prevocational junior doctors now make up 21% of the junior medical workforce, and on average general surgical training commences PGY 6.3, at 31-years-old. Anecdotally, for other surgical specialties this is even longer. At the same time, fellowships are becoming routine and often multiple years prior to obtaining a consultant position. Despite the prolonged duration there is no evidence to suggest that this has improved training., yet the implications may be understated for trainees, surgeons and patients.