Skill to do comes of doing.
-Ralph Waldo Emerson    

We are in the last steps of getting surgery arranged; the counseling is complete and the consent is on the clipboard. Just as the patient is putting pen to paper, she asks, “When I’m asleep, you’re not going to let some trainee practice on me, are you? I mean, I wouldn’t let the brand new stylist cut my hair, right? I don’t want any residents involved!” 

The patient sets down the pen and eyes me carefully. These can be uncomfortable conversations. I think back on the times my own family members have needed surgery. We all want “the best” for our loved ones. 

I begin. “The operation requires two people to perform. I am right there for every part of the surgery. The resident does nothing without my direct involvement.” These statements are true, but she is not satisfied. 

“Not good enough. How will I know for certain? I insist that there be no students or residents scrubbed in at all.” At this point, I need to decide if the proposed operation is one I can do by myself. If so, I might still proceed. The patient has put me in a box but she has the perfect right to make such a demand. 

I start again. “I can’t know for certain,” I say, “but changing my usual routine for a complex procedure like yours might place you at some unnecessary risk.” She looks at me skeptically. “In any case,” I add, “I am certain that having a resident involved in your surgery is safe.” Despite having made this claim many times over the years, I have never really known if it is true. 

Fortunately, a new research paper confirms that having residents participate in surgery is, indeed, safe.

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