A few months ago I read an essay by Dr. Herbert Fred of Houston, Texas. After reading his essay, “Medical Education on the Brink,” I was inspired to start a revolution in surgical education.

His essay ends with the following recommendation:

“…raise the bar of performance in all training programs to a distinctly higher level, with excellence as the perpetual goal.”

As the Fourth of July approached, I began to view his remarks as a call to arms for a revival of classic medical education.


Coming from Massachusetts, I felt that I could take some liberties in re-writing the original call to arms document – the Declaration of Independence.

I decided to rewrite it after reviewing Medical Education on the Brink as well as several articles bemoaning the increasing board failure rates in internal medicine, surgery and thoracic surgery.

To their credit, influential members of the American College of Surgeons reviewed the current state of surgical education and revealed that the exam failure rate had increased to almost 30 %.

Their assessment was:

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