Knowledge gap among surgeons?

[roinom]

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The advancements in the surgical field has been profound during recent decades. What once was a relevant knowledge area might not be that today. Since the old docs are the one that are supposed to teach the younger, it might be a knowledge/teaching delay. Or am I wrong? It might be so that the old docs are very dynamic in their teaching, but I guess some of them still teach what they once was taught, with just a little modification.

Do you feel there is any knowledge gap in a specific area that most surgeons lack, that you now realize would have 'made your life easier' if you knew better?

The question came up when I talked to a neurosurgeon attending, when he was in medical school it was "get out from medical school and come here learn how to handle a scalpel", while he thought we should become "masters of basic science".

For clarity, I'm a MS1 (hence not that used to being taught clinical science) and not from an english-speaking country, so there might be some errors.

 

[ajimd]

True, there has been a paradigm shift over the years (or since the 80 hour work week), to try and get surgical residency programs to adhere to a certain set of guidelines/standards imposed by the RRC as well as the ACGME; in some cases. But I don't believe there are many, if any academic surgeons who lack knowledge in their respective fields, or are out there teaching residents wrong things... I think the ACS does a pretty good job at requiring CME as well as recertification...etc which basically forces them to incorporate the new findings into their didactic curriculums - now, do they ALL incorporate that into their practice? Perhaps not, but thats ok.
There is nothing wrong with learning how to take out an appendix or a gallbladder, or colon for that matter, in an open fashion. I do think it would be incorrect to deviate from the standard of care when it comes to patient management and not offering them the SAFEST approach, but I don't think you are in medicine to be spoon fed all your knowledge. You have clearly picked the wrong field if you are looking for ways to "make life easier" - This stuff is hard, at least surgery is, and there really is no way around, no shortcuts...etc.
I would also add that it is up to the residents in certain cases to challenge their attendings and their "old school" ways by presenting them with evidenced based science, cases, and ways to do things differently if it all falls within getting things done for the patient in a more efficient and safe manner.

 

[roinom]

True, there has been a paradigm shift over the years (or since the 80 hour work week), to try and get surgical residency programs to adhere to a certain set of guidelines/standards imposed by the RRC as well as the ACGME; in some cases. But I don't believe there are many, if any academic surgeons who lack knowledge in their respective fields, or are out there teaching residents wrong things... I think the ACS does a pretty good job at requiring CME as well as recertification...etc which basically forces them to incorporate the new findings into their didactic curriculums - now, do they ALL incorporate that into their practice? Perhaps not, but thats ok.
There is nothing wrong with learning how to take out an appendix or a gallbladder, or colon for that matter, in an open fashion. I do think it would be incorrect to deviate from the standard of care when it comes to patient management and not offering them the SAFEST approach, but I don't think you are in medicine to be spoon fed all your knowledge. You have clearly picked the wrong field if you are looking for ways to "make life easier" - This stuff is hard, at least surgery is, and there really is no way around, no shortcuts...etc.
I would also add that it is up to the residents in certain cases to challenge their attendings and their "old school" ways by presenting them with evidenced based science, cases, and ways to do things differently if it all falls within getting things done for the patient in a more efficient and safe manner.

Thanks for taking your time answering.

However, I think you misunderstood what I meant with "make life easier", I'm not looking for any shortcuts or so. It was more a question for attendings/late years residents that maybe retrospectively looked back at their residency and wished they had a more deep understanding in any subject before starting residency. Maybe someone who got the advice to just get out from medical school and then learn surgery.

 

[ajimd]

Yes, I do wish I knew more business -
In the end, surgery is a privilege, but medicine as a whole is a HUGE business. A lot of us are not business oriented and do not have any interest in the numbers or simply never had the time to learn about that stuff. I envy those with MPH's or other business backgrounds.
I do sympathize with you, medical school is full of esoteric information, a lot of which will be forgotten, but it is a necessary evil and a mental exercise to prepare you for the challenges of residency. My most sincere advice is to enjoy the time off you have doing what it is you like (with family, friends..etc). You can't get that time back and as you go up the ladder in this profession, you will have less of it with greater degrees of responsibility - all that being said, would never trade what I do for anything in the world. As an MS1, you have a long road ahead, but if you really like it, it is well worth it...

 

[roinom]

Yes, I do wish I knew more business -
In the end, surgery is a privilege, but medicine as a whole is a HUGE business. A lot of us are not business oriented and do not have any interest in the numbers or simply never had the time to learn about that stuff. I envy those with MPH's or other business backgrounds.
I do sympathize with you, medical school is full of esoteric information, a lot of which will be forgotten, but it is a necessary evil and a mental exercise to prepare you for the challenges of residency. My most sincere advice is to enjoy the time off you have doing what it is you like (with family, friends..etc). You can't get that time back and as you go up the ladder in this profession, you will have less of it with greater degrees of responsibility - all that being said, would never trade what I do for anything in the world. As an MS1, you have a long road ahead, but if you really like it, it is well worth it...

Thanks again for your comments. I've heard from several, especially people from the US, that they would like to have a better understanding of business. I actually tried to attend medical school and a school of economics, but after 6 month I decided to go all in to medicine and start research there, a decision I'm very happy with. The six months gave me an understanding of the general concepts of economics/business, and hopefully it will be helpful in the future.

I see your point in having a lot of information that shall be studied. Studies in medical school does not give you much intellectual stimulance, however, it takes skill to sort out the massive information and see the relevant parts, a skill that will be very useful in the future, I guess.

A bit off-topic now I guess. I welcome more comments on knowledge gaps among surgeons 🙂