Monday, April 15, 2013

Two new posts are out today

I posted two new entries today.

On Physician's Weekly, I comment about a new study from the British Journal of Surgery on trans-gastric (NOTES) appendectomy. The authors say the results are "promising." I don't think so. Here's a link:
On General Surgery News, a reader asks "Are program directors the reason that surgical residency training is a mess?" I explain here:


NeuroTrumpet said...

This, for me, was the money quote:

"In most cases, surgeons are not taught how to teach anything, let alone surgical skills. For many years, it has just been assumed that any surgeon (or any doctor in any specialty) is an excellent teacher. Of course, this is not so. However, teaching is not particularly valued or rewarded an academic medicine. On the other hand research is, especially research that brings in grant money."

Although I'm not entering a surgical residency, I think the teaching emphasis and capabilities should never be under appreciated. Many applicants are attracted to big-name training facilities busting at the seams with grant money and research opportunity (I am arguably entering one, myself). That's fine, but probably not ideal for residency, during which time the focus should really be on honing your skills as a surgeon or, in my case, clinician (especially in neurology where the neurological exam is paramount). Perhaps research power, money and esteem should be weightier considerations for fellowship or post-residency employment, and residency applicants should better sniff-out the pedagogical robustness of training institutions.

Skeptical Scalpel said...

I agree with you, but I doubt that medical teaching will ever be given the respect it deserves.

Anonymous said...

I think that many high-performing medical students will naturally gravitate to prestige institutions and programs. That is just human nature.

Many years later now, I think the clinical training is just as good or better in other settings. I've been in clinical settings where I was the only physician in the room without a Harvard degree/residency. I will say that the Harvard, etc. trainees are much better in committee work and interactions with colleagues and patients.

Skeptical Scalpel said...

I agree that clinical training is as good or better in non-academic settings. I have blogged about that before.

Here's a link to one post on the subject:

artiger said...

About those "promising" results from the NOTES study...I don't know what the authors were drinking, but they must have had a lot of it.

And, I'm not sure how program directors can change much of the mess that residency has become, as they have to spend more time on the wards than they used to.

Sorry, I'm in a bit of a sarcastic mood today.

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