BrettMD: Medical Students do much more than merely observe. I performed approximately 1/3 of an umbilical hernia repair as a medical student. The ACGME may want a monopoly on the regulation of medicine. However, quality is not measured by someone who does not know the difference between a clinical sign and a symptom. How can there not be risks when the ACGME assumes whatever the person with a higher academic title is true without making a preliminary investigation. Read the lumpectomy surgical pathology reports from the UMKC Pathology Department form November 2010 - June 2011 and you will not find the "ischemic time." as the DIO assured Amy Beane at the ACGME that they document. #PtSafety matters.