Master and Commander

I received the following in a group email from a dear friend, another woman surgeon, a few weeks ago:

“I recently went on an interview where I was asked if I was a ‘master surgeon’ and it took me aback . In thinking about it, I am not sure what that means. Does that mean that your results are better than others ? does that mean that people call you when you when they are in trouble ? does that mean people call you for advice? about interesting cases ?”

I spent some time pondering her question, realizing I wasn’t sure what the answer was either.  While all of her questions she asks are salient and are probably part of the puzzle, I’m not convinced that they’re the comprehensive definition of whatever a Master Surgeon might be.  A comment raised later in her email alluded to the idea that this may be a somewhat dated term, or perhaps a term harkening to the days when surgeons were almost exclusively male.

I next turned to Google for a definition.  I came up dry, unless you want to look at the Canadian Association of General Surgeons definition of general surgeons and general surgery, which states, “The General Surgeon is a Master Surgeon.”  I did a PubMed search and found homages to a number of individuals who were described as Masters, but no definition.

Thus, my next stop:  Crowdsourcing on Twitter.  What better way to get answers, right?

• From @bwnwomeh “she has such phenomenal judgement and technical skills she teaches the operation with ease. Not a master without teaching!”
• From @jdimick1 “A master surgeon is someone who has made every possible mistake and has learned from each one of them.”  (This is currently the winner on re-Tweets, if anyone is keeping score.)
• From @LVSelbs “How to recognize: the surgeon who operates on attendings/residents families, better than everyone & humble.”
• From @mtnmedstudent “perhaps Gladwell’s 10,000 hour rule applies?”
• From @PorterOnSurg “Term conjures different era, but: known for technical perfection in particular procedure/area” …generating these responses from @jdimick1:  “Yes, a cynical view is that a Master Surgeon is a mythological “über being” used to reinforce a hierarchy”  and “We now know that we all actually have strengths and weaknesses” and thoughtful follow-up from @LoggheMD “And perhaps the greatest strength lies in knowing your weaknesses?”
• And, from @TomVargheseJr “Beyond technical, master surgeons create new knowledge via collaboration, research & problem solving” with this link  providing a wonderful framework.  @SarahB_MD responded with, “Excellent! Masters demand knowledge & competent (e.g. residents) need “practice and coaching””

Lots of food for thought in there, with some definitely focusing on technical and clinical skill, incorporating the importance of dissemination of the Master’s knowledge.  I also find the discussion about fallibility and learning from our mistakes to be an important one; even the greats do have an Achilles’ heel, after all.

So, dear reader, help me out.  How would YOU define a “Master Surgeon”?  How does leadership come into this, if at all?  And is a  Master Surgeon born, made, or a bit of both?