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Timelines showing major advances in surgical technique, education, and technical skill assessment. Major innovations in surgical technique are illustrated on the inside of the arc on the left. Landmarks in graduate surgical education in the United States are shown on the outside of the arc. Abbreviations: ACGME, Accreditation Council for Graduate Medical Education; NOTES, natural orifice transluminal endoscopic surgery; OSATS, objective structured assessment of technical skills.
