In the year 1949, George Orwell wrote a book entitled 1984. His book predicted how life would be 35 years later. Nineteen eighty-four is here and, if we look back over 35 years of colon and rectal surgery, we can see how far we have come. A review of the past, stimulated by Orwell's predictions, compels us also to forecast the future and to predict what the next 35 years will hold. Where will the specialty of colon and rectal surgery be in the year 2019 and what will make it strong?

Before we attempt predictions of the future, let us look first at some of the key factors in the progress of colon and rectal surgery during the last 35 years. AI though Orwell's predictions for the years spanning 1949 to 1984 were ones of gloom, those years contained many positive developments for colon and rectal surgery.

In 1949, the year Orwell wrote his book, the first examination by the American Board of Proctology was given. Twenty-two applicants were certified; these applicants had been trained in a variety of situations. There were only eight residencies. The majority received their training in an approved preceptorship. In contrast, today there are 27 approved training programs producing 50 candidates per year who are eligible to write the examination of the American Board of Colon and Rectal Surgery. All of these candidates have passed the qualifying examination of the American Board of Surgery.