We read with great interest the recent Drug Safety Communication issued by the US FDA about prolonged (>3 hours) or repeated anesthetics in children under age 3 years and potential long-term effects on cognitive ability, memory, language, and behavior. In addition to the concerns over neurodevelopmental effects, there is a significant facet to the FDA warning that has potential for widespread impact on graduate medical education and the future of surgical and anesthetic care in young children.

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