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Similarities between performance and training of expert musicians and surgeons have previously been identified. 1 Common factors include many hours of deliberate practice, complex fine motor movements, a live performance and elimination of mistakes. 2 A comparison of musical theatre gives insight into training, team structure and current surgical dilemmas. Matilda: the Musical is a multi-award winning production which has the unique challenge of a predominantly child cast. Like our novice surgical trainees, these children start with limited theatre experience and are rapidly trained to a professional level. The lead role of Matilda, typically played by a 9–10 year old, is arguably the biggest, most sophisticated child role in theatre. Entry to the musical is by interactive audition which tests acting ability, and ability to learn both a song and a dance from the show. Training Matilda takes 2–3 months, consisting of specialist singing, accent, dance and acrobatics coaching. 3 While training and working on the show, children continue their school studies. There are limits on how many hours that children can work, and in order to perform eight shows per week, a production consists of three complete casts of children, along with four actors each playing the characters of

Matilda or Bruce. Each Matilda is trained to work with any combination of the children, adults and their understudies without any loss of production performance. The level of interchangeability is such that Matildas have been transferred to different productions, or bought out of retirement. 4 Within each production all children are replaced every 6–12 months, requiring constant training of new …