Experts agree that there is substantial waste in the US health care system.1 This waste drives up costs, threatens the government's long-term fiscal stability, suppresses incomes, and reduces resources for public education and other essential services. Similarly, there is substantial waste in the education and training of US physicians. Years of training have been added without evidence that they enhance clinical skills or the quality of care. This waste adds to the financial burden of young physicians and increases health care costs. The average length of medical training could be reduced by about 30% without compromising physician competence or quality of care.