Microsurgical fellows were prospectively evaluated using the validated Structured Assessment of Microsurgical Skills (SAMS) tool by 24 attending plastic surgeons at the commencement and completion of the fellowship.9 Fellows underwent a condition-standardized clinical evaluation during free flap reconstruction and laboratory-based evaluation during rat femoral artery anastomoses. SAMS is composed of 12 components that are divided into four major categories of microsurgical skills: dexterity, spatial awareness, operative flow, and judgment. Higher scores indicate better performance. Scores are presented as initial (beginning of fellowship) or final (end of fellowship) scores, and clinical or laboratory. A comprehensive description of SAMS and its components can be found in the Supplemental Digital Content 1. (See appendix, Supplemental Digital Content 1, which displays the supplementary materials. http://links.lww.com/PRSGO/C429.)