Orthopedic residency programs in the U.S. initiated surgical skills practice requirements for all Post Graduate Year -1 (PGY-1) residents. Orthopedic professional organizations; ABOS/AAOS, AANA, and others collaborated on the development of 17 skills modules that are the minimum requirements for practice in proficiency of skills such as casting, suturing, arthroscopy,internal and external fixation, etc. The San Marcos Residents in August 2016, added these modules to their curriculum and have completed the 1st 7. Here are photos of weekly skills sessions followed by exams in proficiency; 1-4, sterile draping, suturing, microsuturing,tissue handling.