Continuing education at German university hospitals is individually organized within the framework of the continuing education regulations. In the personal organization (University Medical Center Schleswig-Holstein, Campus Luebeck) three sections (common trunk, medical specialist for visceral surgery and additional qualification in special visceral surgery) and two lines (clinical line and academic clinical line) are differentiated. The whole training is flanked by the mediation of technical competence even outside the operating room (Lübeck toolbox, RoSTraC curriculum, suture courses etc.). Future concepts for continuing education must take the healthcare structure in hospitals, the increasing specialization and the increasing technical complexity into account.