There is no unified national training system for orthopaedic surgeons in China. With such rapid progress in many aspects of life in China, there is an imminent need for improvement in the training of orthopaedic specialists. Since 2003 the orthopaedic community in Hong Kong has been working in collaboration with their colleagues in mainland China to develop a training system for orthopaedic surgery. We adopted the system from the Royal College of Surgeons of Edinburgh (RCSEd), setting up a trial centre in the Beijing Jishuitan hospital in 2006, with trainers and trainees attaining the standards set by RCSEd and the Hong Kong College of Orthopaedic Surgeons (HKCOS). This trial is ongoing, with the success of two trainees who passed the exit examination in 2010 and became the first Chinese orthopaedic surgeons with a joint fellowship of both the RCSEd and the HKCOS. Following this inaugural success, we are confident that China will develop a training system for orthopaedic surgeons to a consistently high international standard.

Procedures performed at the incorrect anatomical site are commonly perceived as being relatively rare. However, they can be a devastating event for patients and doctors. Evidence from the United Kingdom and North America suggests that wrong-site, wrong-procedure and wrong-patient events occur more commonly than we think. Furthermore, their incidence may be increasing as NHS Trusts increase the volume and complexity of procedures undertaken in order to cope with increasing demands on the system. In previous studies from North America orthopaedic surgery has been found to be the worst-offending specialty.

In this paper we review the existing literature on wrong-site surgery and analyse data from the National Patient Safety Agency and NHS Litigation Authority on 292 cases of wrong-site surgery in England and Wales. Orthopaedic surgery accounted for 87 (29.8%) of these cases. In the year 2006 to 2007, the rate of wrong-site surgery in England and Wales was highest in orthopaedic surgery, in which the estimated rate was 1:105 712 cases.