No easy answers

I spent last weekend and the early portion of my week in Napa for the annual Western Surgical Association meeting.  I’ll start with the statement that this is one of my favorite meetings every year; it’s rich in high-quality general surgery research and I always get to hear interesting new findings in areas I don’t necessarily work in.  And, of course, it’s a meeting I always enjoy because of the people.  I love the fact that I get to spend time catching up with two of my mentors from medical school every year (Sam Snyder and Randy Smith).  It’s nice to know that they are still as terrific as I thought they were when I was a starry-eyed MS3/ MS4.

During the scientific sessions I Tweeted out a few key items from various papers that were presented, and one deserves further mention here, if for no other reason than to continue the dialogue it started on Monday morning.  Here’s a screen shot of the abstract in question:

Can chief residents not do open choles any more?
Can chief residents not do open choles any more?


Tyler Hughes, rural surgeon advocate extraordinaire- and fantastic human- addressed the elephant in the room- can someone pass their certifying exam (CE = oral boards) in general surgery in this day and age if they say they would either get an intraoperative consult from a specialist colleague or abort the case and refer a difficult cholecystectomy because they don’t know how to do them open due to lack of experience?

Or should we give a candidate credit for knowing when to call for help?

Do we need to modify our training paradigm to emphasize acquiring relevant experience, as proposed by the authors?  Is this yet another reflection of the need for us to update/ refine training for people to become a “true” general surgeon?

I look forward to a robust dialogue continuing on Twitter, on FB, and/ or on the comments here.