How much surgical autonomy do you get in residency?

[I<3dermis]

I'm curious as how much surgical autonomy is typical during residency. At my program, it is highly variable based on the attending you work with, but even at the PGY-2 level the vast majority of the time you are performing surgeries unsupervised.

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[chocolatecheese]

Variable based on staff, at a PGY2 level here some will observe for the first little bit if they've never worked with you before but most just leave me to do my own thing.

Cosmetic procedures and larger benign excisions are always observed/assisted.

 

[I<3dermis]

Gotcha. I've done some pretty massive excisions and a few cosmetic procedures without supervision, and I'm afraid 'm learning bad habits. Obviously, autonomy is important, but I just don't think there's any substitute for real-time feedback in improving your technique; you can only get so much from reading/watching videos. I've started petitioning for a little more oversight, just wanted to know if this was the norm; sounds like my program is on the more hands-off side of things. Thanks for responding!

 

[Slack3r]

I think it’s probably closer to the norm. For whatever reason, the surgical training in dermatology residency is very hands off, with a lot of early “autonomy”. While that’s certainly beneficial in some respects, I think if definitely makes for a lot of variability in surgical/technical skill amongst trainees compared to other procedural fields.

 

[I<3dermis]

Weird that it's unique to derm, but I guess our procedures are much less risky overall than basically any other specialty. Thanks!

 

[MrBigglesworth]

It is variable. Generally not much can go 'wrong' but if you want finesse points you should spend time with seniors / Mohs people and ask for specific advice (how can I evert better, how to get faster, how to undermine etc).

 

[I<3dermis]

Appreciate the advice, thank you.