Traditional surgeons, trained in the old-fashioned apprenticeship system, are often bemused by new training models, and the role of modern training methods such as surgical simulation. Regulation of work time for junior doctors and expectations of the public have led to an increasing role for simulation. Now there is even official recognition of ‘simulated cases’ in trainees' logbooks and as part of their work-based assessments. So, is this revolution for better or for worse? Traditionally surgeons have always advocated dissection, simulation and courses using cadavers. How does operating on cadavers and synthetic models compare? Cadavers can be useful for teaching and appreciating anatomy but how useful are they for simulation of surgical procedures and operations?