Congratulations to Dr Hemmila and colleagues on another strong article in the arena of surgical outcomes research using novel, cutting-edge, advanced biostatistical methods. The authors are among a new breed of surgical scientists who are changing the face of surgical investigation and resident training. Cutting-edge surgical research has historically been based in basic science laboratories using bench assays, cells, and animal surgery as the standard fare. Only more recently has the world of surgical outcomes research begun to flourish. It would have been an absurd request for me to spend my research time during residency doing “outcomes research” and taking epidemiology or biostatistics classes 15 years ago. However, times are changing, and surgical educators see the benefit in training residents (and faculty) for the research they will eventually perform. I am not the only surgical faculty member who has not performed a “laboratory experiment” or written a basic science article since my research years during residency. We do clinical research; we should follow the lead of these authors and invest the time and energy needed to learn the important tools of the trade.
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