Prof. Dr. Alexandre Mottrie and Dr. Mahesh Desai take a thorough look at how the training of surgeons is being impacted by not only patient-driven changes, but how the European OCERT training program and initiatives in India are providing more effective, safer results. From the course: Surgical education is since many decades based on the Halsteadian method with learning by observing. With the exponential rise of technologies, restricted working hours for the trainees and restrictions in allowance to work on real patients, this no longer applies. We are now implementing “proficiency-based progression” learning (PBP) which has shown in several prospective randomized double-blind studies better results in terms of acquisition of surgical skills compared to traditional training methods. PBP training has a specific methodology and is an objective, transparent and fair approach to training.