Video-assisted thoracoscopic surgery should be within the armamentariu
m of every thoracic surgeon today. Rapid expansion in this field has l
ed to an unprecedented demand from practising surgeons to acquire the
new skills, Five levels of training can he described: (1) didactic lec
tures; (2) demonstration of procedures: (3) practice on simulators; (4
) animal surgery; (5) preceptorship, The First four are usually provid
ed in training courses or workshops, while the last requires procterin
g or attachment to a training centre. The ultimate goal is to integrat
e all these into the surgical residency programs. Developments in the
virtual reality module may revolutionise training in the future.