“…Examples include: The Objective Structured Assessment of Technical Skills, 7,8 which involves a task checklist and a global rating score; the McGill Inanimate System for Training and Evaluation of Laparoscopic Skills, 9 which tests generic laparoscopic skills; and the Imperial College Surgical Assessment Device, which tracks trainees' hand movements via sensors and provides an effective index of technical skill in both laparoscopic 10 and open 11,12 procedures. Anesthesia knowledge, clinical judgment, and communication skills are all tested in postgraduate exams, 13 but there is currently no formal evaluation of procedural skills. Given that numerous studies have shown that the time required to achieve competency at specific procedures varies widely depending on the individual learner, 4,14 there is a great need for a reliable and valid method for demonstrating procedural competency and for identifying struggling trainees who require additional support.…”