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Letters

Health workforce Letter to the Editor 8 September 2026 Free

Medical Colleges Have an Obligation to Ensure Full Participation in Clinical Quality Registries

In Reply: We thank Hugh for his comments [1] on our article [2] and the opportunity to reply.The monthly morbidity and mortality meetings have been central to surgical quality since the founding of the American College of Surgeons in 1913. However, as Hugh notes, their quality is highly variable and their conclusions not robustly reported. Further, many are inwardly focused and do not assess care against external evidence-based or peer benchmarks....

Robert J. Aitken, Julian A. Smith, Guy J. Maddern

Medical education Letter to the Editor 7 September 2026 Free

Medical Colleges Have an Obligation to Ensure Full Participation in Clinical Quality Registries

To the Editor, I read with interest the perspective by Aitken and colleagues on the role of medical colleges in ensuring participation in Clinical Quality Registries [1]. The authors should be commended for discussing this issue and for calling for stronger accountability. Although they highlighted the importance of clinical audit, the reality is that, despite long-standing guidelines from the Royal Australasian College of Surgeons (RACS) and state health departments [2, 3], clinical audit is performed inconsistently and often poorly. Morbidity and mortality meetings, although universally endorsed, vary widely in quality and many fail to deliver genuine quality improvement. High-quality, effective clinical audit meetings (surgical mortality and morbidity meetings) are rare, notwithstanding RACS guidelines or the administrative box-ticking exercises often done by clinical governance departments [4]....

Thomas J. Hugh

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