I thank Dr. Olivier for his comments regarding my article.1Although I appreciate Dr. Olivier’s recommendations to develop ambidextrous skill as well as his “adjunctive measures,” the purpose of my article was to propose a standardized approach for ultrasound-guided internal jugular access as opposed to offering “pearls” that develop with experience. As Dr. Olivier states, his “points were obtained over 15 years.” Clearly, self-training is integral to proficiency in all aspects of medicine. The astute physician constantly reviews their technique and style with an attention toward self-improvement. Self-training should, however, be used in conjunction with, and not instead of formal didactics and instruction from experts/mentors. In an article by Mey and colleagues,2when performed with the two-operator technique, the experience of the physician controlling the needle did not influence procedural success or complication rate, whereas both were significantly reduced when the physician manipulating the sonographic probe was experienced. This illustrates the fact that there is a learning curve associated with sonography, and that guidance based on misinformation can harm our patients. The responsible way to develop skills in any procedure is to understand the concepts of the procedure, learn the psychomotor skills, and integrate them with clinical judgment and experience. Medical simulation combines deliberate practice and feedback with the goal of achieving mastery.3 By combining didactics, simulation, and mentorship, the learning curve may be significantly reduced. It is the responsibility of our collective societies to develop formal training guidelines before they are imposed on us from third parties. Until these guidelines become available, it is my hope that the recommendations I proposed will lay some of the groundwork to improve training and education in ultrasound-guided central venous catheterization.