What makes surgeons “good”? It’s an important question: A 2015 review published in JAMA Surgery reveals that in roughly 1 out of every 100,000 U.S. surgeries, the wrong body part – and sometimes, the wrong person – was operated on. In approximately 1 out of every 10,000 operations, surgeons left a medical sponge (or some other surgical item) inside the patient. Admittedly, these are pretty low error rates – unless you happen to be one of the errors. Also, these mistakes tend to occur when there are multiple surgeons, the patient is having multiple procedures, or there are time constraints during either the verification process or the actual surgery. However, other issues, such as a surgical site infection or mistakenly cutting a blood vessel, could be directly related to surgical skills. A new study published in the Journal of Surgical Education set out to discover whether there are gender differences in basic surgical skills training. The subjects of the study, conducted by researchers in Shanghai, China, were 317 male medical students and 25 women students. They were rated on their ability to perform 10 surgical skills: preoperative preparation, sterile technique, knot tying, basic suture I, basic suture II, debridement, cecectomy, phlebotomy, laparotomy, and small bowel resection with hand-sewn anastomosis. Overall, women medical students scored higher – and they scored significantly higher in some areas. Other studies have shown that women may make better doctors. For example, a University of Montreal study of more than 870 physicians treating diabetic patients revealed that women performed better in three key areas: scheduling frequent check-ups, prescribing eye exams, and prescribing medications to treat cholesterol. However, the study (which had a relatively even mix of both genders) also revealed that the men physicians performed roughly 1,000 more procedures a year, so perhaps they’re less thorough because they have less time to spend with patients. DEFINING ‘GOOD’ SURGEONS But what accounts for the gender differences in surgical skills, and what, if anything, does this mean? According to Sally E. Carty, M.D., professor of surgery at the University of Pittsburgh School of Medicine, “In this unblinded study, the findings could be accounted for by unrelated factors like instructor bias or cultural bias.” Also, Carty tells GoodCall®, “Today we do not know if medical student aptitude predicts expertise as a surgeon; nevertheless, the findings are interesting and potentially valuable.” Before jumping to any type of conclusion, Dr. Heather J. Furnas warns that there are other factors that this type of test can’t control for. Furnas, a medical doctor and adjunct assistant professor in the Division of Plastic & Reconstructive Surgery at Stanford University, tells GoodCall®, “Basic surgical skills training and a theoretical examination wouldn’t be able to account for the skills involved in the vast array of surgical procedures, nor the judgment needed to know when to operate, when not to operate, what procedure to do, and how to handle unanticipated events.” And, she explains that’s why students have to spend several years in surgical training. “Nonetheless, surgery is a male-dominated field, and perhaps the favorable test results may encourage more women to choose a career as a surgeon,” Furnas concludes. A study by the AAMC reveals that medical school applicants are 54% men and 46% women. However, women comprise only 38% of surgical students and residents. The gender pay gap persists among physicians, dentists, and lawyers, partially because women are more likely to choose lower-paying specialties, such as OB-GYN, pediatrics, and family medicine. So what does it take to become a good surgeon? Chris Oliver, MD, is currently a consultant trauma orthopedic hand surgeon at the Royal Infirmary of Edinburgh. Oliver, who is also known as the Cycling Surgeon due to his love of physical activity and his many cycling expeditions, tells GoodCall® he believes there are several determining factors: You need to be innovative and have an open mind that is prepared to change. You need to “walk the walk” of a surgeon and be able to cope with chaos and adversity. You need a brain that can cope with complex decision-making in areas of extreme complexity. You don’t need to have particularly extraordinary motor skills, but being good at computer games is very helpful. You need to love all people and be empathic. Lastly, Oliver says perseverance is crucial. “Don’t ever give up if you choose to be a surgeon; it’s a long training period, but you’ll have a very interesting and fulfilling life.” Perhaps “thick skin” should also be a requirement – for all medical students. A recent report reveals that 86% of pre-med students think the academic pre-med culture is too competitive, sometimes resulting in sabotage and bullying. But even if students survive the gauntlet of pre-med, med school, and residencies, they may decide that they’re not cut out for this profession. “If you wish to be a surgeon, you have to be satisfied and motivated by the job itself,” says Lynn M. Gries, M.D., an assistant professor of surgery in the division of trauma, critical care, and emergency surgery at the University of Arizona. “You have to tolerate things that are difficult and physically challenging for your whole career, but so satisfying when you actually fix something right now.” Gries believes that technical skills and medical knowledge are only half of the equation. Good surgeons must also be passionate about what they do. “I’ve had a number of students who were actually quite good, technically, and understood the approach well, but were not tantalized intellectually and emotionally by the job, so they decided to practice medicine, anesthesia or emergency medicine.” Source
