The practice of medicine has, for millennia, relied upon a master-apprentice system of learning, with patients providing the necessary anatomy from which one learns how to perform surgery and other procedures. The advent of high-power computing and real-time graphics representations allows medicine to advance beyond this traditional methods of teaching and to begin to educate physicians without putting patients at risk. With innovative haptics interface devices, computer-based training will enable novice physicians to learn procedures that have been developed since their training was completed. Specialty boards and credentialing organizations will, for the first, time, have metrics upon which to base the decisions regarding who is qualified to practice medicine, and both sides of the learning curve, the acquisition of skills and their deterioration, will be discovered. The paper presents the concepts, challenges, and visions of the authors, both of whom have been actively developing simulation for the specialty of interventional radiology. It includes expectations for the future of simulation in other procedural specialties.