How do surgeons practice their surgical skills

Leave the archive and display this page in the standard design: Suitability for the surgeon - self-doubt


stimulated by the many answers in the other thread (thanks for your contributions!), I would like to go into the surgical subjects that interest me the most at the moment and discuss the question of what prerequisites one should have for surgery. I kind of plague myself with self-doubt.

During the sewing and knotting course, someone demonstrated the stitching or knotting technique at the front - and there were many who were able to do it immediately. I was one of those people who had big problems, I just had difficulty following the explanations. During an apprenticeship in surgery, I learned how to sew properly in the operating room. It didn't work right away, but now I'm pretty good at it and I'm often praised for the beautiful seams.

It took me a long time to learn to take blood samples and to learn how to do it (in my opinion), but now I can do it well.

The lumbar puncture did not work the first time either, but only after the 4-5. Times.

In short: I am a person whose learning curve is obviously rather flat at the beginning. Now I'm just wondering whether I'm really suitable for a manual subject like surgery or whether I shouldn't leave it to the people who can do it all right away.
In addition, I am often told that I am too timid and not self-confident enough when dealing with patients. While my fellow students were often happy to "whack someone in", I was always overly cautious and rather insecure at the beginning. I just don't have that unshakable surgeon confidence.
All my life I've been more of a theoretical person, I always knew a little more than my fellow students, but when it comes to learning manual activities, I'm probably just not a natural, but one of the slow people.
Are my self-doubts now exaggerated or do you think I should bring an internal medicine subject with me.

If I were you, I would do what YOU imagine. If this is the surgery then do it! People are different and no one expects surgeons to be able to do everything right away. Everyone starts small and when I think about how difficult it was for some of my former colleagues to make usable sutures or the like at the beginning, then that is obviously not an obstacle to becoming a useful surgeon at some point. Even timidity is probably lost over time. For example, a former colleague was not very talented in manual work and was more of a calm, shy type. That subsided with increasing professional experience and today she is a specialist doctor.
And should you really and truly find that you are manually too clumsy or not configured appropriately for the surgery (in my opinion the bigger obstacle ...), you can always switch to the inside. :-opinion

Training is essential, but without interest it is worthless.
Even if you sew slowly, your learning curve is not quite as steep and your demeanor does not correspond 100% to a television doctor, you are no less worthy than someone else.

Surgery doesn't just consist of rinsing and suturing.
Diagnosis, indication and anamnesis are just as important!
Without clear indication and prior control that all risk factors and secondary diseases are secured, you are nothing more than a trained operating monkey who is amazed at the many complications, even though the skin seam is so beautiful.

Don't let it get you down, if you have a real interest in surgery, you will be able to master that too and then the manual skills follow through the practice that you get.

maybe have a look at the "hybrid subjects" where you can combine operative and clinical-intellectual activities: gyn, ent, eye, derma, uro (have I forgotten something !?).

* sigh *

clinical-intellectual activity

* sigh *

If you don't have a complete overview, please don't post such things. Just as internists work interventionally, real surgeons are also clinically and intellectually active.

And if you don't really trust yourself to do the "normal" surgical work, then microsurgical subjects should somehow not be the real thing ...
Apart from the fact that, contrary to all prejudices, surgeons don't just have their heads so that it doesn't rain down their throats. :- wow
By the way: As an ophthalmologic assistant doctor at university hospitals, the probability of being able to do surgery is very, very low ...

* sigh *

* sigh *

If you don't have a complete overview, please don't post such things. Just as internists are also active interventionally, real surgeons are also active clinically and intellectually.

sorry, was put stupidly and not meant at all as it sounded.

There is no one who can do something "immediately"; and those who learn manual skills quickly are by no means good surgeons.

Take an inguinal hernia, for example: a supposedly simple operation that is classified as an assistant operation in most clinics. If we take all the interns who have already operated on, say, 10 inguinal hernias according to, say, Lichtenstein, and check their understanding of what exactly they actually operated on, I bet a fool that at least half of these interns have not yet fully understood the operation. But they have already made 10. Comprende?

If you want to do surgery, you don't need to have any special skills - not talent, but practice makes perfect. A talent makes learning a little easier, nothing more. All you need is a clinic that trains you well, and luckily there are more and more of them.

So I agree with the previous speaker that your example does not show your ability to become a good surgeon. And surgeons who are clinically good in particular are good surgeons (i.e. those who think for themselves and also think outside the box).

If you want to do surgery, you don't need to have any special skills - not talent, but practice makes perfect. A talent makes learning a little easier, nothing more.
Exercise is certainly a very important factor in surgery, but I think talent is at least as important. I know some (even very advanced surgeons) who have no talent. During the operation you can clearly see that you had to practice the mechanical skills for a long time and now "master" them, but that is far from nice. I don't know if that won't be frustrating in the long run.

greetings, the kidney

This does not prevent an estimated 90% of all gynecologists from operating :-))

Seriously aside: a certain manual skill is certainly necessary, but practice is more important. I know an excellent surgeon who is otherwise about as skilled as a graduate of a girls' boarding school.

I know an excellent surgeon who is otherwise about as skilled as a graduate of a girls' boarding school.

Hey, don't underestimate the girls, they can't ask the big boys and have to do everything themselves ;-)
But I know what kidney means. Even if the result is often just as good, there are also people in my field who I damn well like to watch while they operate, because they display a lightness and skill that is simply great. Others simply rewind the program as if they had learned by heart. In my opinion, the most important thing is to be able to spontaneously go unusual ways if the conventional doesn't work. But first you have to get there so that you can see it, find a solution and then dare to implement it.

That's it. If things don't go according to scheme A, then the "technicians" can also do scheme B. But if that falls flat, they quickly become nervous and uncontrolled. The "gifted" stay calm and have at least Plan C and D in store and the really good ones can also improvise in really bad situations.

As I said ... I have no idea whether the "technicians" notice that they have no "real" talent and that they despair a little ...

greetings, the kidney

That is correct, but it has little to do with manual dexterity and more to do with the ability to act outside of the nucleus ruber. People who are quick to grasp and are able to provide creative solutions to a problem deal with situations that deviate from the standard much better than those who can only reel off the program they have learned. That has more to do with imagination and intelligence, and this separates the chaff, which can only be learned by heart well, from the wheat, which also understands what it is doing and is therefore capable of variations in action. This is a talent that is to be understood in a much more general way than just "the surgeon's talent". This not only distinguishes good surgeons from bad ones, but also fundamentally good specialists from the average crowd.

I've often doubted myself. However, at some point it occurred to me that being clumsy doesn't necessarily make me a good differential diagnostician. Both surgical and conservative therapy have their own specific requirement profile, with the latter you just don't notice it so directly if you don't meet it. Where success is less clearly measurable, there is also failure.

We're still at the beginning, we have to train everything. It is probably crucial that you want to train what you train. Talent is one thing, motivation is another. It is not for nothing that success is said to consist in going from one failure to the next without losing one's enthusiasm.

In any case, qualification and success are such a thing in medicine - always to be viewed in relation to the initial situation; mind you, both from the treating person and the treated person.

At this point I like to quote a surgery professor of mine: "If you don't break both arms when changing lightbulbs, you are in principle suitable as a surgeon!" ;): D

Your doubts so far all relate to the manual. But what about the physical requirements?

I always had the impression that far more people have problems with standing, bending, holding, etc. all the time than with the fine-tuning.

Are there any of the subject who would like to name a few "exclusion criteria"?

Well, that's part of it, but you can also train that, it's just sport ...: - oopss

Well ... with a chronic back problem it will be a very tough road. But I think it's all very, very individual. And as a rule it should be the case that the surgeons adjust to the tallest participant in the operation with the help of the height adjustability of the table and Böckli. Many other things can be trained ...

greetings, the kidney


You mean a kick
With us, that's called kick. Everyone gets one who is not big enough ...: - oopss

You can actually get used to standing; With a little practice, you can alternately lift your legs a little and circle, while still standing completely still. The back causes significantly fewer problems if you also pull yourself up to do a few exercises especially for it in your free time. The so-called "microsurgeons" often even operate while seated, so that with the appropriate dexterity the problem of standing should not come to the fore. It's all a matter of will.

But is that really sufficient in the microsurgical disciplines? Is there such a thing as a talented skill that you can no longer train at a certain point, but whose absence is a reason for exclusion for some subjects? Or is it also possible to compensate for this with a lot of training?

Nevertheless, I stick to it: Even the conservative subjects have a special requirement profile for which you need specific talents, which you cannot easily learn. Just because I think I lack manual dexterity doesn't mean I'm better suited for internal medicine than surgery.

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