High volume surgeons and high-volume centres of excellence have been shown to improve outcomes, lower mortality and reduce health care costs. The same is true for hernia surgery. There has been an in evolution in abdominal wall reconstruction, with major advances in understanding pathophysiology, hernia prevention, pre-operative and post-operative management and surgical technique. General surgical trainees in Australia and New Zealand have limited exposure to the treatment of complex abdominal wall pathology and as a result outcomes for repair are suboptimal. Dedicated training programs for abdominal wall surgery are established in Europe and the United States, they produce surgeons who have appropriate expertise in the modern management of hernias. They encompass pre, peri and post-operative management, excellence in surgical technique, a focus on quality control and research. These advanced hernia programs are carried out in accredited centres of excellence, which are high volume, follow internationally recognised guidelines for treatment performed by experienced, specialist hernia surgeons. They invariably have robust quality control monitoring, documentation of outcomes and access to multidisciplinary services. Under the auspices of ANZHS, it is proposed to set up an advanced training (post fellowship) program within Australia and New Zealand. Training will occur, in a select number of centres that satisfy strict inclusion criteria.