Posted by Bill Sandweg on 10 June 2019.
It is human nature to criticize the younger generation. What’s the matter with them? They don’t do things the way we did when we were young, etc. In the world of surgery, there may be valid reasons to be concerned about young people who are entering surgery residency programs. According to a recent story in the New York Times, those who run these surgery residency programs are concerned that their new residents do not have the manual dexterity necessary in a good surgeon. The most likely reason is that young people no longer sew, knit, build models, woodwork, play musical instruments or do the other things that children used to do and that build manual dexterity. Nowadays, instead of developing dexterity of their fingers, young people use their thumbs to play video games or to text their friends.
The successful surgeons interviewed for the article point out that by the time doctors complete medical school and enter a surgical residency program, it is too late to develop the same level of dexterity as someone who has been doing “hand things” all their lives. They note that the earlier a person starts developing manual dexterity, the easier it is to develop and the better it becomes over time. Late starters will rarely be as good as those who start early. A suggestion has been made to consider manual dexterity among the factors considered in selecting surgical residents.
Another “problem” pointed out by those who run these programs is that there are now limits to the number of hours a resident can work. For a long time there were no limits and some surgical residents would work as much as 120 hours in a week. They would literally live at the hospital and operate at all hours, catching a nap here or there when they could. This was not good for either the health of the resident or that of the patients upon whom she was operating at the end of a 120 hour week so limits were put in place to protect the residents and the public.
Paradoxically, these limits may be affecting the quality of those graduating from surgical residencies today. One residency program director quoted in the Times’ article stated that today’s residents may complete the program with 900 operations under their belts. He, on the other hand, had double that number by the time he completed his surgical residency. The number of operations is important as “practice makes perfect.” The more surgeries a resident has performed, the more she or he has seen and the more she or he has learned.
As usual, there are lessons for us to learn. Always check the background and experience of your surgeon. Always ask how many of your surgery he or she performs a year. The more the better. Always ask about your surgeon’s rates of complications. Always check the medical board web site for information about your surgeon. If your surgeon is not happy to be questioned by you about these issues, find yourself another surgeon.