The keynote presenters included Prof Johan Fagan who gave the overview of the CMSA and gave the history of CMSA in the past 70 years, The successes and transformation that the college had that included partnerships, advocacy, collaboration, change in examinations and digitalising the process. The launch of the Journal (JCMSA) which has publications and attracted funding and a remarkable milestone for the CMSA. Prof Zach Koto who gave insights on future of access to surgical care for all, emphasised the surgical life saving techniques in low income settings and successes thereof, 5 billion people not having access to this care, he highlighted the solutions that can come to the surgical challenges such as use of mobile units, upgrading infrastructure and leveraging on technology, increase surgical workforce by expanding the training platform and encourage surgical specialist to cover rural areas. Prof Ntobeko Ntuli who explored the future models for research in specialist medicine. Research that is versatile, relevant and responsible is essential and needs to be part of the training. The MEC for health WC, gave a keynote address and message to CMSA and congratulated the CMSA on the 70th milestone. 

Keynotes also highlighted the impact of resource constraints in expanding the training platforms, ensuring capacity building to train nurses, GP in Primary health care to support specialist medicine, Furthermore, issues related to unemployment crisis due to lack of posts and registrars were raised, registers leaving due to overwhelming work environment pointing to a need for better psychosocial support structures and not just salary issues are involved WC has 707 paid registrars posts and a high number of superluminal medicine posts. 

Discussions emphasised the importance of strengthening academic–clinical partnerships, research outputs and expanding training platforms beyond tertiary centres, and implementing standardised, competency-based training frameworks. Stakeholders called for greater collaboration between the Colleges of Medicine, universities, the National Department of Health, private sector, and provincial health authorities to address implementation, funding, accreditation, and regulatory challenges. 

In conclusion, the seminar underscored that addressing the multifaceted challenges in specialist medicine training requires coordinated policy reforms, investment in training and research, and an equitable distribution of training opportunities in urban and rural spaces to ensure a sustainable and inclusive pipeline of medical specialists.