Researchers in England have devised a machine that can measure very accurately a surgeon’s dexterity with special cameras that monitor the surgeon’s hands and objectively records the number of movements required for certain surgical steps etc. I think ultimately, this should become mandatory for all residents in ophthalmology- once in a while, we see residents with poor surgical skills who simply should not be operating after residency. Those residents should be required to, say, go to a third world country for a few months and perform dozens of procedures, and then come back and be re-tested. This device could be very helpful in identifying those residents at risk, and give reassurance to those same residents once they have more procedures under their belt. (whether this is fair to the third world patients is a separate discussion!)