National curricula, certification and credentialing.

The education, certification, and credentialing of surgeons is undergoing change brought about by public expectations and by reform within the profession. In the United States, there is a clear trend towards standardization of education, as exemplified by the Surgical Council on Resident Education (SCORE) curriculum. There is an emerging effort to tie certification closely to the national curriculum. Finally, there is clarity emerging from the curriculum development process about the expected operative skills of graduating surgical trainees, and this will ultimately drive the process by which surgeons are credentialed by their hospitals or surgical centers. This period of change is being accompanied by a demand for more assessment of trainees and for outcomes-based training and residency program accreditation.