Neurointerventional training and education, like most surgical and interventional disciplines in their original and most effective forms, is an apprenticeship for an extended period. The requisites vary by geography; but in essence, committed physicians enter a period of ‘fellowship’ during which they observe, participate, and perform actual procedures alongside experienced mentors as they conduct their business of providing clinical care to patients. Essentially, they learn through ‘live cases’ where they are standing next to experienced physicians through thick and thin, experiencing the invigoration of success and torment of failure. This is true for all fellowships and is the standard mechanism for generating proficiency in trainees.

At most major academic centers, the stress of performing a procedure under scrutiny from faculty, mentees, and other observers is the norm, rather than the exception. There is no perceived additional stress to those who do this day in and day out with observers. Similarly, at most major centers with multiple neurointerventionalists, it is routine for their partners to join in cases, be consulted during a case, or offer opinions during a complex case or complication management, with or without solicitation. Their opinions are usually valued and entertained and at other times ignored as the primary physician manages the case as deemed necessary. This is all routine, commonplace, and a daily occurrence.

The use of live cases for surgical education has been in place since the beginning of the field. Live case broadcast became a more commonplace event when in-person observerships declined during the recent coronavirus disease 2019 (COVID-19) pandemic. Multiple platforms allow for live case broadcasts, such as Tegus Med (Hamburg, Germany), Avail Medsystems (Santa Clara, California, USA), Proximie (London, UK), and SKILL Assist/Careprod Technologies (Fremont, California, USA), among a slew of others. During these broadcasts, either an experienced interventionalist is providing a live …