title: Training and simulation.
abstract: Surgical training is a complex process that continues throughout the professional careers of surgeons. Significant changes in training have taken place during the past two decades, stimulated by the introduction of endoscopic surgery. Simulation is used increasingly for both training and assessment of surgeons in addition to the well-established apprenticeship systems. Currently, surgical and medical simulation is undertaken within the confines of skills laboratories. As virtual-reality simulators improve, skills laboratories will transform into virtual-reality simulation centres. Surgical simulation ensures that the learning curve is completed without jeopardising the outcome of patients, or using live animals.