The introduction of minimally invasive technique in the surgical practice has significantly changed the image of thoracic surgery in our country. In the recent decade most of thoracic surgeons adopted a technique of different minimally invasive approaches for the treatment of wide spectrum of intrathoracic diseases. In our institution the greatest advancement in recent years has been made in the field of major lung resections with around 80% of resections being performed using video-assisted thoracic surgery.

Keywords: minimally invasive surgery, training programme, surgical skills.

In contrast, our residency training programme has not undergone the modifications dictated by the principles of minimally invasive surgery. The programme is outdated and is calling for renovation. To some point it is unrealistic and not feasible with regard to the quantity of performed procedures. Key reasons are volume of the surgery we have on the national level on one side and relatively high determined number of some surgical procedures that are becoming increasingly infrequent on the other. And most importantly it is insufficient in gaining the knowledge and skills of minimally invasive surgery as it does not employ specific training steps of minimally invasive surgery and does not have a standardized protocol of the evaluation of the competence. Learning curve is steep and training usually extends for years after board exam to achieve a satisfactory level of skills.

Considering all this it is of great importance to establish a programme that will result in a fully skilled thoracic surgeon that is competent in most frequent minimally invasive procedures. To realize this, we should introduce a new training programme based on the following key steps: practice on the simulator, practical courses with hands on sessions, visiting a high volume foreign centre and evaluation of the trainee that is focused on the skills and not the volume of performed surgery.

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