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  1. Southgate, W. Michael MD
  2. Annibale, David J. MD


There have been significant changes in the graduate medical (resident) education in the United States over the last two decades. These changes have been the result of a wide range of societal, governmental, and regulatory alterations which have either directly or indirectly impacted today's physicians-in-training experiences and autonomy, raising concerns about their readiness for independent practice at the completion of training. This article reviews the evolution of these changes and the promise that simulation training holds as one of the keys to ensuring continuing excellence in the training of today's and tomorrow's physicians.