At Mayo Clinic, we have incorporated many of the principles used by the National Transportation Safety Board (NTSB) into the Department of Anesthesiology. For instance, we have a continuing medical education (CME)-approved, Federal Aviation Administration-style reporting program that is mandated for all anesthesia providers. This program takes four cases per quarter from our performance improvement reviews, summarizes them in three paragraphs (issues, findings, and links to appropriate literature) and has CME-accredited questions for each case. If anesthesia providers fail to complete these reviews in the required time, they receive a gentle warning and, if necessary, suspension from the practice. This same model has been adapted by the American Society of Anesthesiologists and will become a required module for all candidates in the American Board of Anesthesiology Maintenance of Certification program. The education pilots receive from the monthly reports of the NTSB is a valuable aspect of aviation safety in the United States. Medicine would be well served to adopt this validated, time-tested, and legally accepted mechanism of peer review and reporting.