For years, external safeguard of quality has been continuously practised in the field of surgery by several local medical societies. Beside its original task of comparing and reviewing given standards of all surgical departments, other clinically or scientifically relevant questions can be answered on the basis of the enormous numerical data, too. The patient data, available to the chamber of physicians of Westphalia-Lippe, German, are showing that the experiences of clinical research rapidly and almost ubiquitously find their expression in the daily routine work of surgeons. Examples like the introduction of routine thrombosis prophylactics of changes in the surgical techniques for inguinal rupture and gallstone show how progress in medicine by postgraduate medical education is realized in the daily clinical workday routine.