Recently, I was fortunate enough to visit the gastronomic and Romanesque town that is known as Modena. The home of tortellini, balsamic vinegar and lambrusco sparking wine, there was little a foodie could fault. However, for me, a champion of the three had emerged.

The granddaddy of all vinegars – traditional balsamic vinegar of Modena. This dark brown, syrupy, complex vinegar has the perfect taste combination of sweet and sour. In fact, it can only be produced in this region and is different to usual balsamic vinegars. It is certified by a special agency to meet strict standards and can cost up to hundreds of pounds a bottle. After my intriguing visit to an Acetaia, let me share with you how this delicious stuff is made.

Traditional balsamic vinegar is different because it is made just from grapes. Typically, the sugary and white grapes that grow around the low hills of Modena are used. Trebbiano grapes are harvested late in season to take advantage of the last touches of sun to enhance the sweetness.

Once harvested, the grapes are crushed and the liquid, which is called must is immediately boiled. This prevents the liquid fermenting and the sugars turning to alcohol. It is slowly cooked over twenty-four hours until the right concentration is achieved, roughly half the original liquid is left. It is then filtered and is ready for the batteria – this is a set of wooden barrels that are successively smaller to give the vinegar its distinct flavour.

The must has to be aged for a minimum of twelve years to qualify as traditional balsamic vinegar of Modena. Each year, fresh must is added to the biggest barrel while must from the big barrel is fed into the next smaller barrel and so on. So every year, each barrel gets younger must to mature and act on. The vinegar gets thicker each year as it evaporates in each barrel. Usually, must from the last and final barrel can be classed as the traditional vinegar. There are certain rules that need to be followed. For example, only a certain amount can be removed from each barrel, usually about ten percent per year. Therefore, the quantity of the ‘real’ stuff is limited and expensive as it takes incredible skill and time to make.

I was fascinated by the owner – A true expert with years of learning but equally interesting was the whole ageing process of the vinegar. Can it be compared to medical training?

1. From my own experience I can say that every year I sought to become a better doctor, with more skills and hopefully wiser – A process of maturing and ageing akin to the vinegar process.
2. The process of training a doctor is complex, with multiple influences and a number of things that could go wrong – Likewise, changes in humidity and temperature affect the vinegar making process.
3. A tutor guides a doctor in training, just like an expert guides the vinegar process. It’s takes a long time to create the finished product, a minimum of twelve years to become a general practitioner in the UK (the fastest training route for the medical profession) and twelve years for the first batch of balsamic vinegar of Modena.
4. The finished product is not truly finished. Continual professional learning helps the doctor improve with time. Similarly, further ageing improves the taste of the vinegar.
5. Training a doctor is expensive but necessary. Balsamic vinegar is expensive but has now become a necessity in my life.

Are there any food products you would compare medical training or your work with?