After graduating in Cairo (1991), Mr Francis undertook basic and higher surgical training in Dundee, a well-established laparoscopic training centre. In addition to completing a PhD in laparoscopic surgical skills with Sir Alfred Cuschieri he was also involved in course development and delivery in the Dundee skills training centre. He enhanced his skills in endoscopy and advanced open colorectal surgery at the Western General Hospital Colorectal Unit (Edinburgh). Finally, during a fellowship with Dr Antonio Lacy (Barcelona), he learned what could be achieved in a centre of excellence for laparoscopic colorectal and morbid obesity surgery.