The last 40 years have brought about widespread and profound changes in surgery. Improvements in knowledge and technology have lead to safer and less invasive surgery:  the scope has swung from being a last-ditch, life-saving undertaking to become an option to improve quality of life. This has occurred during a time of immense societal change. Public expectations have risen, partly as a result of the revolution in information technology.

The bodies which accredit undergraduate and postgraduate medical education now rightly require that the necessary skills of ethics, communication, evaluation of research and medical jurisprudence be formally taught and evaluated rather than simply absorbed during the course of training.

An aging population is placing increasing demands on an overburdened health care system. Clinical demands may compete with educational priorities.

The fact that we have been able to respond to these changes and difficulties is due to the commitment of both full-time and part-time faculty who have an intense desire to provide excellent care and to offer first-rate educational programs and have consistently worked in harmony to ensure we achieve these goals.

The majority of the surgical faculty is in the hospitals are St. John’s which have to fulfill the triple function of acting as the community hospitals for residents of the greater St. John’s area, as referral centres for complex cases and as the provincial centre for neurosurgery, plastic surgery, pediatric surgery and cardiac surgery.

In the area of medical education, we have contributed significantly to undergraduate teaching during both the pre-clinical and clinical years and helped achieve the outstanding results of our students in the Medical Council of Canada exams. We are an educational resource for the province, for instance providing the direction for advanced trauma courses which have so far trained in excess of 700 physicians in the correct early management of severely injured patients, and have given medical advice to trauma life-support courses for first-responders.

Our general surgery residency is one of the few in the country to have always received full approval from the Royal College accreditation surveys. In 2006-2007, 21 of 27 certified general surgeons in the province trained in our program and of these 16 obtained their MD degree from Memorial.

The orthopedic residency program suffered from problems with recruitment in the late 1970’s but was maintained under the aegis of Dalhousie University. In 1995 with energetic and effective leadership, this problem was addressed and the program has been independent and fully-approved by The Royal College ever since.

Of a total of 16 certified orthopedic surgeons in the province at this time, eight took their residency training at Memorial and 10 were granted their MD from Memorial.

We have the smallest number of full-time faculty in surgery in the country. Despite this and the need to maintain excellence in patient care and in our educational programs, our faculty has contributed nationally to The Royal College and National Specialty Societies.

The challenges in the future will be at least as great as those of the past 40 years. Given the competence and dedication of the faculty and the leadership and vision of the chairmen, each of whom has contributed his own unique and invaluable direction, we will be able to face them effectively.