The Roots of Poor Surgical Care: Training

By | April 17, 2012

Training of surgical residents is a lot like training dogs. A good master is essential, but it really depends more on the talents and dedication of the dog.

While you might think that the type of training that a surgeon receives would be an important determinant of the quality of care that he delivers, in practice it turns out that his is rarely the case, because adequate training is a necessary, but not sufficient condition for excellent surgical care. Furthermore most surgical training programs have mechanisms to weed out weaker candidates. A related question that I am often asked by the patients at Schlesinger Pain Centers is whether or not neurosurgical training is better that orthopedic training with a spine fellowship. Again, this turns out not to be a very useful discriminant. I have seen good neurosurgeons and bad ones and I have seen good orthopedic spine surgeons and bad ones. What then can be said about training? Firstly the fine details are often hard for patients to interpret, but an area where the best pain clinic in Los Angeles would be able to provide useful guidance. Secondly, surgeons who have gone through larger and busier programs are more likely to be better trained and have more experience, but this is getting into the subject for the next blog.

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