The Office of Inspector General (OIG) performed an inspection at the W. G. (Bill) Hefner VA Medical Center, Salisbury, NC, to determine the validity of allegations that: surgeons at the facility performed procedures that they did not have the clinical privileges to perform, resulting in poor surgical outcomes; and surgical residents were not supervised appropriately. OIG substantiated that four surgeons did not have privileges for one or more procedures they performed. However, we found no poor outcomes as a result. We also substantiated that surgical residents were not supervised 2 days per week in the outpatient clinic. While not an allegation, we found deficiencies in required pre-operative documentation by surgeons. The complainant’s allegations and our findings resulted in recommendations to the VISN and Medical Center Directors.