https://www.city-journal.org/article/surgery-safe-american-college-of-surgeons
I have been a surgeon for 38 years. Three of those I spent as a general surgeon in the Navy, the remainder as a plastic surgeon in private practice. I have never been more alarmed about the state of my profession than I am today.
My concerns began surfacing about 25 years ago. I was collaborating with a newly trained general surgeon on a bilateral breast reconstruction, a procedure that utilizes tissue flaps from the patient’s abdomen. This is a significant and lengthy operation, and I appreciated the young surgeon’s offer to close the abdominal donor site. To my horror, however, he began taking excessively wide needle “bites” of the abdominal wall using a heavy-gauge suture, visibly distorting the abdominal wall as he pulled these sutures tight. After watching in disbelief for a few minutes, I thanked him and said that I could manage without help. The young surgeon subsequently gained a reputation for handling tissues roughly and for being difficult to work with. It came as no surprise when he left our hospital after less than a year.
Every colleague whom I have spoken with has noticed the same thing: an alarming number of surgical residency graduates are unprepared for professional practice. The problem has only gotten worse. I recently worked with another young surgeon on a breast cancer patient, for example, and was shocked to discover that he had never performed an axillary node dissection—a common operation to remove lymph nodes from a cancer patient’s armpit. How could a surgeon have completed five years of training without learning how to do this?
