What is going on in surgery? Why are young surgeons are coming out of residency programs unprepared for clinical practice? A 2013 Annals of Surgery report revealed that 40 percent of surgical residents lacked confidence to practice independently after five years of training, the typical length of a full general-surgery residency. According to the same report, one in five surveyed program directors “felt that new fellows arrived unprepared for the operating room,” and program directors deemed 66 percent of new fellows incapable of operating unsupervised for more than 30 minutes in a major surgery.
While these statistics are frightening, that report is 11 years old. Have things gotten better since? Judging by more recent reports and my conversations with peers, they have not, and in fact, have probably gotten worse. Surgeons I have recently spoken to have observed that too many young surgeons are poorly prepared and need remedial help, such as operating with a more experienced surgeon before they can be trusted to operate on their own. The young surgeons themselves seem to realize their inadequate preparation, as nearly 80 percent of post-general-training surgeons pursue a one or two-year fellowship in a subspecialty, which for some may be a way to get more surgical experience and put off entering general practice.
One possible explanation for young surgeons’ lack of preparation stems from the American Council on Graduate Medical Education’s 2003 decision to limit residents in training to 80-hour work weeks and no more than 24 consecutive work hours. For surgery residents, fewer work hours means less time spent caring for patients and performing surgeries. Only with time and repetition do surgical residents develop the requisite cognitive and technical skills necessary to learn sound surgical judgement—knowing when to operate and what operation to do—and how to operate safely under all circumstances. The hour reductions also have resulted in less continuity, as residents hand off patients to one another, diminishing residents’ sense of responsibility for patient care.
Click this link for the original source of this article.
Author: Ruth King
This content is courtesy of, and owned and copyrighted by, http://www.ruthfullyyours.com and its author. This content is made available by use of the public RSS feed offered by the host site and is used for educational purposes only. If you are the author or represent the host site and would like this content removed now and in the future, please contact USSANews.com using the email address in the Contact page found in the website menu.