Following nearly 1 year of development, trials, surveys, and educationalprograms, in November 2009, the orthopaedic in-training examination (OITE)was successfully converted from the traditional print format and administeredby DVD-ROM on local computers to more than 4,300 residents in 20 countries.A resident survey indicated a high level of satisfaction with the new examination.Questions with video and multislice image formats, presented as trial questions,performed well. Future versions of the OITE on DVD-ROM will eliminate someof the few difficulties experienced in 2009. The new electronic format offersexcellent possibilities for improved imaging, the development of new and innovativequestions, and an enhanced ability to approximate the practice environmentallof which can result in a better assessment of orthopaedic medical knowledgeand an improved educational experience.