BRITISH MEDICAL JOURNAL j JUNE 19/1 tunities for surgical consultants have therefore changed little in the past quinquenium. Similarly, with regard to the senior registrar grade in general surgery, again there has been only small improvement. The average age of the senior registrar group has decreased considerably, and parity has almost been established between the number of senior registrars completing training and the number of consultant vacancies available each year. This is certainly a step in the right direction, but there has been no appreciable increase in the number of senior registrars completing training each year or in the number of new consultant posts available. On the other hand no attempt whatsoever has been made to deal with the registrar problem, to which we drew attention three years ago.3 In 1965 there were 626 general surgical registrars competing for 153 senior registrar posts and in 1970 there were 644 surgical registrars competing for 138 senior registrar posts. Thus probably at present there are five middle-grade registrars in post for every senior surgical registrar-clearly a situation which cannot be allowed to continue. Further progress cannot be made unless the number of registrar training posts is substantially reduced and related to the 46 or so vacancies occurring each year in the senior registrar establishment. These proposals are inextricably linked with those of coping with the work load and the service commitment to patients, especially in the district hospitals. The present proposals for an appreciable increase in the number of surgical consultants will, in part, help to rectify this, but it is also vital that a realistic career structure should be devised if the present anxieties of the hospital junior staff are to be allayed. What has been achieved *for the senior registrar grade now needs to be attempted for the registrar grade, and the Joint Committee for Higher Surgical Training and other interested bodies should consider this urgently. The gentle breeze we noted in 1968 continues to blow in the field of postgraduate surgical education. But it is not yet a wind of change, and furthermore not all the nods it has produced are those of acquiescence.