Orthopaedic residency education currently faces a number of difficult challenges. Among them are the explosion of knowledge, the need to teach both the basics of orthopaedic research and surgical techniques, work-hour restrictions, the limited number of trainees, the growth in demand for surgery, greater specialization and complexity of patient care, more complicated resident evaluations, and the changing demographics, lifestyles, and values of the residents1-7. Although most orthopaedic residency programs around the country face the challenges listed above, and while several professional organizations recognize the current challenges to traditional orthopaedic residency training, there seems to be a lack of urgency to address them. The Hospital for Special Surgery convened a forum of educators, all of whom were program directors, from well-regarded residency programs across the country. The invited programs were chosen as representatives of a group of institutions that have shown leadership in residency training, have at least twenty residents in their programs, and reflected geographic variety. The invited educators were asked first through a mailed survey and then in a face-to-face meeting to (1) evaluate whether the traditional residency model is appropriate for the training of future surgeons, and (2) discuss current approaches that have been successfully implemented in orthopaedic training programs. The aim of the meeting was to issue a call for action to those who provide oversight to residency requirements by identifying areas where recommendations need to be developed. The aim of the meeting was to identify consensus areas of need, not to suggest solutions. Twelve orthopaedic educators from nine different programs (Table I) participated in the meeting, which was held on May 2 and 3, 2008. The group produced a set of twenty-two general recommendations for improvement. View this table: TABLE I Participants in the Hospital for Special Surgery Orthopaedic Residency Peer Forum To focus the discussion on …