The practice patterns of general surgery have changed significantly in the last decade as a result of the increasing use of flexible endoscopy, both diagnostic the introduction of laparoscopic endoscopy as a and therapeutic, and also therapeutic technique. These changes have occurred over a short period of time and continue rapidly with the increasing use of advanced laparoscopic proce dures. Residents who have completed their training and are entering the prac tice of general surgery must be very familiar with, and must be well educated in, these two areas. Flexible endoscopy and laparoscopy will be a significant part of their practice and with time will become more important and more widely used. Residency programs are struggling to develop educational programs that will adequately prepare residents for the future of endoscopy and laparoscopy. This is difficult in some programs because of the lack of clinical endoscopic material, the lack of understanding of the importance of endoscopic techniques in their medical communities, and a lack of interest and training of their staff. There is also a lack of good textbooks or educational tools aimed directly at residents to help these programs. There is a definitive need for a comprehen sive textbook directed at the education of residents.