The parlous state of the Defence Medical Services ('Conflict of interest', news focus, pages 14-15, 16 March) comes as no surprise.
The problem lies not only with financial cuts but also with the training and retention of staff.
I began my basic surgical training in the armed forces in the early 1990s. It quickly became apparent that the volume and diversity of surgical cases encountered in shrinking military hospitals were insufficient to provide the experience needed for satisfactory surgical training. At the time surgical trainees were retained not by the provision of high-quality training but by contractual timebars to prevent them from leaving.
As a result, many surgical trainees left as soon as their contracts would allow, to return to more intensive and diverse surgical training in the NHS. Hence, few trained surgeons remain in the armed forces.
Only the NHS can provide UK surgical trainees with the necessary experience to become effective surgical consultants. I would advise medical students contemplating a surgical career against joining the armed forces under present circumstances.
Simon Britten Specialist registrar in orthopaedics Bristol higher surgical training scheme
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