Proficiency-Based Progression Training

Today, novice apprentices still perform their first surgical steps on patients. However, the emergence of scientific data linking perioperative morbidity and mortality to surgical skill has raised some ethical concerns [1, 2]. Furthermore, reduced work hours and by default training hours for surgical trainees [3], as well as the rapid expansion of advanced technologies to support and perform procedures, challenge the traditional Halstedian approach to training and are forcing the surgical community to rethink new teaching modalities [4].