A competent surgeon must be knowledgeable, decisive and dextrous. In addition, surgeons must be able to lead and communicate effectively with patients and colleagues. These features are derived from Bloom’s work describing cognitive, affective and psychomotor domains of learning (Bloom 1956). Social, political and legal developments now demand that surgeons must be able to demonstrate their competence, become accredited and engage in a process of life-long continual development and
re-accreditation.