But there is another important feature to this story. with such a high volume of surgery - 200,000 plus cases per year, with each doctor carrying out around 2600 operations/year (against an Indian average of around 400) - comes a rich learning opportunity. The principles of the 'experience curve' (which demonstrates that the more we do something the better we become at doing it) have applied across many different industrial sectors - and there is no reason to suppose that healthcare is any different. Learning by doing is a