Pressure of workforce shortages, educational reform, heightened regulatory requirements and increased community expectations and scrutiny, has led to demand for substantial change in the provision of surgical education and training. The Royal Australasian College of Surgeons has responded positively to these external factors through an extensive review of local and worldwide practice and opinion, providing ongoing realignment of its governance and committee structure, substantially adjusting the structure of its educational program and increasing the educational support to trainees and supervisors. The College looks to the Council and its senior Fellows to create the direction and drive, but these changes need to be supported and implemented with care by the management and administrative staff of the College and specialist societies. This is in an opinion-rich zone with substantial regulatory scrutiny.