[HSF] Current Requirements for the ABTS

[Michael Firstenberg]

Hal,
I agree with you 110%.  Unless you are in a system where you have no  
control of your patients post-op (which probably does not exist),  
these patients need to be led (not followed) thru their hospital  
stays and I think only a general surgery 5 year program allows for  
those skills.  Not just how to set-up and perform complex operations,  
but also how to manage a team - which no consists of RNs, NPs, PAs,  
Nutrition, PharmD, RTs, not to mention residents and house staff.   
Calling consults and dealing with problems is much easier if you know  
what you are talking about.  Unfortunately, most of us (at least I  
feel I do) often have more experience in neuro, renal, GI, and ID  
than many of fellows/residents (even at times Attendings?) is those  
areas.  It is a shame that probably the most important learning years  
in terms of becoming a leader and "doctor" and true patient advocate  
are getting lost.

But CT surgery is getting too complicated for 2-3 years of training -  
OPCAB, Maze, Valve repairs, VADs, transplant, aortic work, etc - not  
to mention congential and thoracic - I may be slow, but just learning  
the basics is a lifetime process and adding more and more years of  
training doesn't sound like the answer either.

I think part of the solution is for young trainees, such as myself,  
to find groups (as I have) of senior people who take pride in not  
just teaching fellows, but mentoring young surgeons.  Give them jobs,  
nurture their careers and professional development.  Guide them thru  
the early years of their careers as they mature.  Just dont dump on  
them and walk away.   No jobs?  Make them - hard to imagine that each  
major group/medical center cant find a role for a young hungry CT  
surgeon?  Case volume decreasing?  As Lytle says - "did you really  
think you would still be doing the same operation for 50 years?" -  
find new opportunities.  If there is so little work, then why is the  
training getting so long and why do we all spend so much time in the  
hospital?  IMHO, that is what leadership is.

Ok, rambling, but it is early Sunday....
Just my 2 cents on the problem.

Michael


On Oct 22, 2006, at 8:36 AM, Hgrmd at aol.com wrote:

> Prasanna,
>   Worse yet, how will a couple extra years less of cutting and  
> sewing  impact
> the CT surgery residents abilities?  As a 4th and 5th year general   
> surgery
> resident, I was the primary surgeon on a lot of huge cases.  Most   
> of these I
> don't currently do, but gaining the skills and maturity was   
> invaluable.  In
> addition, some of my current patients suffer postop GI   
> complications.  I can
> recognize a surgical abdomen, as well as make sure  that the  
> general surgeon
> handles it appropriately.  Alas, the U.S. CT  surgery programs have  
> multiple huge
> problems in even maintaining the quality of  trainee that we've become
> accustomed to them producing.
> Hal
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