To the Editor .—We read the article by Shaked et al 1 in the May 1991 issue of theArchiveswith interest. We would like to share our opinion, and convey a few suggestions. Yes, we too believe that surgery performed by residents under "painstaking supervision" and guidance of a consultant who is aware of his or her resident's capabilities and drawbacks, is safe. The constraint in such a study is judging whether it is really possible to obtain "true consent" from a patient who would, obviously, like to get operated on by a consultant. Second, the need for intraoperative assistance or to have a consultant take over the case for tackling an unusual anatomical/pathological difficulty will make correct interpretation of such a study difficult. Practice being an inseparable part of training, the training would suffer unless the surgeon-in-making gets to perform surgery. Hence, a variable is required that