We have utilized the subject outline for part II of the National Board of Medical Examiners Examination listed under surgery to identify the areas our students should learn and our faculty should teach. We have identified the essential elements of surgery by subdividing the above areas into segments of these broad anatomic and general categories. We identified each essential element as knowledge or skill. We developed these into two categories of expected expertise. We believe that self-paced individualized instructional packages are a valuable addition to education in surgery.