The approach to generalism is daunting for all trainees.How exactly do you start to gain confidence working in a discipline of such breadth? in a classical legend, Alexander the Great is faced with the challenge of the 'Gordian knot1, which is seemingly impossible to untie because the ends are not visible: ...most writers say that since the fastenings had their ends concealed, and were intertwined many times in crooked coils, Alexander was at a loss how to proceed, and finally loosened the knot by cutting it through with his sword, and that when it was thus smitten many ends were to be seen (Plutarch tr.Perrin, 1989) As GP trainees, can we, like Alexander, find a way of overcoming what initially seems impossible? Taken at face value, Alexander's approach could be interpreted as cheating.I prefer to see it as a clever and rapid way of thinking outside of the box and getting to the core of the issue.It is not practical to presume that trainees will be able to become speedily proficient in all areas of medical practice: I think we can learn something from Alexander, and take a short-cut to understanding where we need to focus our learning initially.
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