Surgical trainees struggle with Commission on Cancer standards.

• Only 30% of trainees have formal training on COC operative standards.
• Correct answer rates: 30% for standards, 50% for cancer surgery principles.

Incorporating education on these standards in training is crucial for improving surgical quality.

• Fellows have much higher familiarity (68%) compared to residents (24%).
• A significant 71% of residents participate in operative documentation, indicating a role in compliance despite knowledge gaps.