The safety of trainee surgeons: an interview with Prof Calvin Coffey
Published on August 31,2012 at 10:21 AM
Please could you give a brief introduction to surgical training? At what point are trainees involved in operations?
Surgical training begins at an undergraduate medical student level where students are involved in operations to a minor degree, and educated using a combination of didactic and problem-based approaches.
Newly qualified doctors (often termed "house officers" in Europe and "residents" in North America) are involved to a degree in that period, but are mainly involved in ward level service provision.
Involvement in operations increases in a graduated manner, an approach for which we are always going to be indebted to William Halsted for introducing. North America and Europe differ in terms of the training thereafter.
ln North America, residents enter a five year training program called residency during which they gain increasing exposure and involvement in surgical operations. During this period they go from "scrubbing into" operations and playing a Iimited role, to playing major roles as chief residents. They then undergo a specialist training period referred to as a fellowship, in which they are immersed in operations on virtually a daily basis and obtain enormous experience at performing operations. This is all done under close supervision.
Even after training and gaining a staff level position (i.e. consultancy in Europe) they are slowly introduced to increasingly complex procedures, rather than immediately starting on complex procedures as independent operators. Of course biologic diversity is such that realistically surgeons must aim to continue to learn on a Iifelong basis.
Slight differences exist in Europe where the general pattern involves training as senior house officer for approximately two years, after which the trainee enters a higher specialist period of training lasting 4-6 years. Typically the trainee then undergoes a fellowship-style period of immersive training at the end of this period.
Although differences exist across European countries in respect of the precise duration of these intervals and the nomenclature utilized at each stage, the overall trend of graduated increases in intraoperative and perioperative responsibility is common to all programs.
DE ACORDO COM O TEXTO ACIMA ...
O trabalho do médico residente consiste principalmente em __________ .
