But by then, four other doctors at a competing practice had left him in the dust, implanting 75 devices. They chose a separate training program, provided free and tailored to their liking by a little-known device maker named Biotronik. Only one of the four doctors so far has taken the recommended daylong competency test. The training also apparently had unorthodox elements: two doctors sometimes trained together on one patient, a technique that experts called highly unusual.
Then there's always the issue of conflict of interest and bias when the company does the training, which the article goes into at some length. Definitely worth a read.