In February 1920 Professor (late Sir Louis) Barnett of Dunedin, proposed that a body be formed in New Zealand to raise surgical standards and recognise surgical expertise. Later that year he wrote to the Australasian Medical Congress, which was to meet in Brisbane, with a proposal, which was now Australasian in its scope. A Surgical Association of Melbourne had been formed in the autumn of 1920, and it might seem the time was ripe for Barnett's ideas; but the Brisbane meeting was hostile and H.S. (later Sir Henry) Newland of Adelaide described the concept as "a dagger in the heart of the BMA".
The American College of Surgeons had been founded in 1913, the first of the 'new' colleges (but owing a good deal to the English Royal College), and it had provided Barnett with a model. After a party from the American College visited Australasia in 1924 and an Australasian group paid a return visit the following year, H.B. (later Sir Hugh) Devine of Melbourne was inspired to seek out support of the doyen of Melbourne surgeons, Sir George Syme. These two, with Hamilton Russell, wrote a letter in November 1925 to senior surgeons in both countries, and events thereafter moved rapidly. Professor F.P. Sandes of Sydney proposed voluntary incorporation and the signing of an Exordium as a means of giving form to the proposal. Forty prospective Founders were identified, who duly subscribed the document, and the result of a poll to elect the first council was declared at a subsequent Medical Congress, held in February 1927 in Barnett's home town. Syme became the first president of what was then called the College of Surgeons of Australasia, Barnett one of his vice-presidents.
The new College came close to basing itself in Canberra, which was in its early stages as a federal capital, but by 1931 Melbourne had been agreed as the site of a future headquarters, and within a year the Spring Street site had been acquired. The original prize-winning building, designed by Leighton Irwin, was opened by Sir Holburt Waring, president of the English College, in March 1935. The young College had already set about acquiring other distinctions: a grant of arms in 1930, the prefix 'Royal' and the name change that went with it. Its Mace was the gift of the English College.
From 1934 the College admitted its Fellows after assessment by a Board of Censors, but after the Second World War it established a Court of Examiners. Its various attempts in the early post-war period, to be fair both to its own pretensions and to the situation of surgeons who had matured on active service, left it open to the charge of vacillation. Not until it proved the merit of structured training programs and an exit Fellowship in the 1970s did its reputation become secure.
Arthur Wyn Beasley, 2001