Competence based surgical education is gaining acceptance in many residency programs around the world. Changing and fluctuating working hours for residents, the need for vast knowledge acquisition during residency, as well as the application of new emerging technologies in surgical practices, call for the modification of educational platforms and domains in surgical teaching. Milestones of cognitive knowledge, as well as surgical and other essential skills needed for the "formation" of a competent resident are judiciously laid during the residency process. These educational requirements are then measured for their proper acquisition by the trainee. Assessing surgical skills and other performance competences of the novice in the operating theatre need to be longitudinally evaluated and measured as well.