@bachophile said in Unprepared surgeons?:
hole in the stomach-no biggie, just suture it up
trocar in the aorta or vena cava, thats a whole different kettle of fish. thats when the patient can bleed out even before u have time to open the belly, put a clamp on, scream to high heaven for help.
as for what the article says about training, its very multi factorial, and yes includes work limits. i think it also includes residents being a lot less independnet than in the past, because litigation has limited the amount of responsibility on residents and transfered it to attendings. which of course in some sense is a good thing but robs residents of experience of acting independently in the OR. When i was a youngin, i did lot of operations on my own, the night energencies like appendix and incarcerated hernias, with the attending being a phone call away, but still, in the OR i was on my own (with another resident). now, no one has any procedure done in the OR without an attending physically present, which spares the resident the ass puckering feeling of being on your own, which is essential to the learning process. think-learning to fly without ever doing a solo and getting a pilots license. its impossible.
We had Tulane residents. Ortho, Surgery, Medicine, Ob-Gyn and GU. For things like Oral Surgery, Radiology, Pathology etc., we had staff physicians. We were just a meat and potatoes hospital, and referred the neuro and other complicated cases to Confederate (LSUS Med) or Big Charity.
Guys liked and disliked our hospital. Old, creaky, sometimes without the latest tech. But we did a lot of trauma, our OR crew was very good and surgery had some specialty instruments that no other hospital in the area had.
Residents, especially senior residents, functioned much on their own. Especially in the middle of the night, the attending was only called out for the wooly-booger cases. That was a bit different than the big hospitals attached to the medical schools.
Junior residents got stuck with more than their share of ED duty. Didn't matter your specialty, you saw everything from soup to nuts, but at least the junior guys had resident consults to fall back on.
I'd like to think the system turned out some pretty decent docs...