William Stewart Halsted (1852–1922) was another founding father of Johns Hopkins Medical School. He set up the first formal training programme in surgery in the United States. This was a competency-based programme where trainee surgeons moved on to the next level of training once Halsted was satisfied with their current competence. According to Cameron, it is Halsted’s contribution to medical education that will be his most lasting legacy: ‘no matter how great the magnitude of advances by Halsted and his peers during the evolution of the modem era of surgery in this country, without a mechanism for passing them on to others and a mechanism for educating young clinicians-scientists, such as is provided by the Halsted surgical residency training system, their continuation could not be assured, nor their promulgation and extension promoted’ ( 2 ). Halsted put himself in the place of trainees and developed much insight into the minds of those in training.