The programme breaks down microsurgery into bite size chunks and basic elements. Trainees must reach a target score (figure 3) in the tasks in each stage before moving on to the next stage. 

All trainees are advised to read the course material and are given a didactic session on the programme microsurgical techniques by an MI4 trainer. They then have a pre programme baseline microanastomosis assessment on a chicken femoral artery microanastomosis (chicken artery dissection). Once this is recorded they then go progress the steps.