“…A reduction in working hours in the UK and Europe, as dictated by the European Working Time Directive (EWTD), has reduced the total training time between qualification and becoming a consultant (specialist) from 30 000 hours to 6000 hours. 4 This five-fold reduction in hours has not only reduced the amount of surgical exposure gained by the resident during training, but has also resulted in significant variability in the orthopaedic caseload for the trainee. [5][6][7][8] In parallel with this, the introduction of consultant-delivered care in an effort to improve patient outcomes may have an indirect effect on surgical training by reducing the number of cases a resident performs as primary surgeon.…”