Unlike the airline industry, where pilots first learn to fly on simulators before navigating planes, physicians practice invasive procedures on real patients. To determine the need for the simulated training of invasive procedures prior to working on patients, we studied the views of physicians-in-training. Five hundred medical students, residents, and fellows at Harvard Medical School were asked if there was a problem with the way medical procedures presently are learned in health care. Next, they were surveyed to inquire whether using a simulator would be beneficial. Finally, they were asked what specific procedures would be most suitable for virtual training. The effects of respondent gender, level of training, specialty, and previous experience using simulation on survey results was tested using Student t-tests. One hundred and fifty-eight trainees responded that they were uncomfortable learning to perform invasive procedures on patients. Students and physicians were very interested in obtaining simulated training prior to practicing on patients. The more complicated the procedure, the greater the feeling that it should be simulated prior to attempting it on patients. Respondents most preferred that simulation be used to teach chest tube placement. Respondent gender, specialty, level of training, and prior simulation experience did not affect survey results (p greater than 0.05). Simulation should be incorporated into the education of medical students and residents as a tool to practice invasive procedures prior to working on patients.