Challenges facing surgical practice in the immediate future will not only be in the fields of clinical and operative surgical techniques, but will also involve a new complexity of clinical, para-clinical and economical issues. The impact of casemix, clinical carepaths, evidence-based medicine, high-technological advances, minimally invasive surgery, teleconferencing, robotic surgery, etc will transform the scene of surgical advancement in a dynamic way. Whatever the winds of change may be, ultimately patient's good and welfare must be uppermost in our minds. The challenge is how to maintain and achieve the 4Cs in this age of medical and surgical revolutionary changes. Commitment, Continuing medical education, Consistency, Compassion and a Caring spirit are the Cs we must always keep alive in our clinical practice.
Firstly may I thank the Academy of Medicine and the Chapter of Surgeons for giving me this great privilege and honour to deliver the final lecture of the century for our series of Chapter of Surgeons lectures to close the 20th century and begin a new dawn in the next millennium.
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