I support Manchester United http://al4a.fun/al4avideos/ al4a Currently, surgical certification and recertification are "influenced primarily by having satisfactory performance on a multiple-choice test and by achieving a certain amount of continuing medical education credits," said Birkmeyer, who also is a professor of surgery. "Those things get at the cognitive side of being a good surgeon ... but at the end of the day, being a good surgeon is also about how skilled you are in the operating room. Right now, we don't do anything with regards to that really crucial aspect."