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Healthcare is a profound process that alters both physician and patient. Medical education is a demanding, exacting, life-altering process that trains physicians to alter the patient's anatomy (surgery) and physiology (medicine). Anatomical alterations are the exclusive domain of surgeons, whose training is the longest and most demanding of all specialties. Surgeons require not just knowledge, but also strength, stamina, speed, dexterity, and acuity. Surgery is so central to healthcare that the history of surgery is the history of healthcare.