In this piece, I want to use the opportunity to acknowledge the Working Party on Sexual Misconduct in Surgery's report on sexual misconduct in surgical environments. I want to express the opinion that this sort of behaviour may well be only one facet of other negative issues occurring in these challenging and largely male-dominated areas; maybe in understanding this and relating it to the hierarchical competitive nature of the surgical training pathway, we can start to solve current problems and so prevent future ones? A recent report reveals unacceptable levels of sexual misconduct in surgical departments.While shocking, these findings are hardly surprising given the historically male-dominated and hierarchical nature of these workplaces.Might the solution to these issues be found partly in a fundamental reviewing of the way surgical clinicians are trained and assessed?