The Papua New Guinea College of Surgeons – past, present and the way forward

This review traces the history and current state of the Papua New Guinea College of Surgeons (PNGCS), from the colonial-era reliance on expatriate specialists and visiting teams, through the training of the first local Master of Medicine graduates in 1979, to the founding of PNGCS in 2023 as a professional body dedicated to surgical training, accreditation, and leadership. Today, 138 General Surgeons, including 23 subspecialists, serve the country's 22 provinces, supported by a regional training initiative that has extended PNG's surgical pathway to other Pacific Island nations and Timor-Leste. Despite landmark achievements, including the nation's first kidney transplant and first coronary artery bypass surgery, the ratio of surgeons to population remains low by international standards, and surgical services remain chronically under-resourced and unevenly distributed. Limited administrative capacity, reliance on a finite number of senior surgeons for supervision, and the absence of robust national surgical data continue to constrain workforce expansion and strategic planning, while PNG's double burden of infectious and non-communicable disease drives rising perioperative demand. The review outlines a reform agenda anchored in the National Surgical Obstetrics and Anaesthesia Policy, encompassing regional training hubs, incentive frameworks for provincial service, telemedicine-supported mentorship, and a national surgical registry. With sustained investment and partnership, the College's surgical capacity can move from fragile to resilient, making surgical care an accessible right for every Papua New Guinean.