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Surgical Competence Today: What Have We Gained? What Have We Lost?

The complexity of modern surgical practice and the cognitive and technical overload to which trainees are subjected places practitioners and residents alike in jeopardy of developing areas of incompetence. Inadequate exposure to essential operations during residency forces trainees to seek further expertise in fellowships. At the same time, practice burdens increase stress levels on academic and community surgeons, resulting in a 30 to 40% burnout rate. Solutions include modification of restricted duty hours for residents and the institution of a simulation-based national surgical curriculum.