“…Our study, like many others [1,6,7,12,14], has demonstrated that the endoscopic simulator can distin- guish between intermediately experienced and experienced endoscopists. Since well-designed prospective randomized studies have shown that simulators also improve the performance of residents in the operating room [10,16] as well as the endoscopy room [15], the question is not if but, rather, when simulators should be introduced into medical training.…”