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This article was migrated. The article was not marked as recommended. Background: Medical education has long recognized the importance of competence in high value care (HVC) but only recently have these concepts been codified. Comprehensive HVC curricula in surgery have not been reported and little is known about graduates' perceptions of HVC education. Our objective was to investigate the perceptions of surgery residency graduates regarding education in HVC and its importance in clinical practice. Methods: Our General Surgery graduates (2012-2016, n=23) were surveyed regarding perceptions of HVC education they received during training and the importance of HVC in their current practice. Results:Thirteen of the 23 graduates responded (57%). While only half of respondents reported receiving instruction in HVC during residency, all reported participating in quality improvement (QI) projects. A minority (n=5, 38%) felt that they had adequate knowledge and skills to lead a QI effort in practice. The majority, however, agreed that knowledge and practical skills in HVC are important to their clinical practice (92%, 77% respectively). Conclusion: General surgery graduates value knowledge in HVC concepts in their current practice, however, most do not feel they possess the knowledge and skills to lead QI efforts. Given that QI work is valued in practice, our results suggest a need to improve HVC education in residency.