Simulation centres are now a mainstream teaching venue in academic medical centres, and medical simulation training is now required in several residency programmes.1–3 Simulation centres have varying operating budgets from the startup ‘one room school house’ lab to the multimillion-dollar brick and mortar centre responsible for training thousands of students annually. Many centres around the world struggle to keep up with the needs of learners, especially as it relates to disposable materials utilised during simulation training. These materials can be very expensive and as many centres face increasing budgetary demands and cutbacks, the failure to acquire such materials limits the ability of faculty to offer the highest level of instruction. The USA produces between 2 and 4 million tons of medical waste annually, and a large portion of this is expired materials or single-use devices.4 5 The reutilisation of some of these medical supplies can help save on purchases for a simulation centre, while also helping to reduce the healthcare cost associated with incineration and landfill fees.4 Expired materials play a role in care delivery in low-resource settings. This has resulted in the WHO creating four guiding principles for use of old or unwanted supplies for donation in an effort to reduce the burden of inappropriate supplies on the receiving organisation.6 It is estimated that around 70% of equipment donated to low-income and middle-income countries is not suitable for the needs of the population.7 Simulation centre leadership must ensure that their centre’s vision, goals and objectives can be met within its current operating budget. Creative and strategic opportunities to acquire and utilise equipment must be identified by simulation leaders to meet the growing demands of students.8 Several strategies exist to keep budgets balanced, find additional materials and equipment, as well as leverage community resources not …
