What makes a great surgeon or doctor?

What makes a great surgeon or doctor? Or for that matter, a great violinist? As many psychologists suggest (regardless of whether one is talking about sports, music, painting, astronomy, physics, etc), it entails:

  • Focused practice (at least 10,000 hours according to many)
  • Good coaching
  • Great role model to provide motivation

Does this apply to surgeons or doctors? I believe it absolutely does.

Any person who puts in enough good training hours under the tutelage of a great teacher with a great role model to aspire to can become a more than competent physician. And as any highly trained professional can attest to, it requires continued training and practice to stay on top of one’s game. As Vladimir Horowitz, a premiere concert pianist, once said, “If I skip practice for one day, I notice. If I skip practice for two days, my wife notices. If I skip practice for three days, the world notices.”

How does this compare to a surgeon’s training and professional career?

To use myself as an example, while at Duke where I received 5 years of training to become a head and neck surgeon, I averaged about 110 hours of work training per week during my first 2 out of 5 years. In the last 3 years, I probably averaged around 90 hours a week for a grand total of 25,480 hours of training before I graduated and came to Northern Virginia to be in private practice. During that 5 years of training, I performed nearly 3,000 surgical cases under a master surgeon before graduating. Furthermore, I had plenty of role models at Duke for me to try to aspire towards. A “goal” so to speak, of the kind of surgeon I wanted to become.

A similar experience can be found for all physicians and doctors who go through the American medical training system.

Even after training, physician education is not complete.  In fact, it never ends. Indeed, physicians are required to continue to receive education from master instructors, journals, or other text every year (Continuing Medical Education or CME) as well as undergo regular testing to ensure their knowledge is current and comprehensive.

Christopher Chang is an otolaryngologist who blogs at Fauquier ENT Consultants blog.

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  • http://www.blog.greatzs.com ZMD

    I think it’s funny and ironic that Dr. Chang describes his 25,000+ hours of residency training as mandatory towards becoming a master surgeon, yet many are concerned about resident fatigue as suggested under “Similar Posts”.. So which is it? Do we want expert physicians or well rested residents?

    • http://fertilityfile.com IVF-MD

      Excellent point! The selfish answer is probably that we want the surgeon doing our operation to have exhausted himself in the past with 25,000+ grueling hours of practice practice practice, but be completely well-rested for the 48-hour-period before he operates on us. Overall, on the spectrum of residencies providing sufficient experience vs residences providing sufficient rest, I would focus on making sure they provide enough experience. The residents I oversee today definitely describe their lives as being more leisurely than what I was used to. However, they also complain of not having enough cases. I’m an “alumnus attending” in the same program at which I did my residency years ago. It appears that I was doing nearly twice as many deliveries, C-sections and hysterectomies as the current graduating residents are nowadays.

  • http://www.chestcracker.blogspot.com Norman Briffa

    Interesting quote from Horowitz. I am a cardiac surgeon and i remember one of my trainers telling me that when he was operating after a week off, he noticed a drop in ‘slickness’ in his operating, when he was off for 2 weeks his assistant noticed and when he was off for 3 or more weeks, the patient noticed!!

  • http://www.tvyourhealthcare.org Ellen Kagan

    Having long been active in health reform – I was the Host/Producer of the public access tv series, Your Health Care:Choice or Chance?, as well as the radio show of the same name, and now the writer of ELLEN IN MEDICALAND:TRUE STORIES OF HOW I FELL DOWN MEDICINE’S BLACK HOLE AND STILL LIVED AFTER ALL, which is on Kindle, I would say that humanity is missing from many doctors. Somehow kindness and empathy has been forgotten in the practice of medicine. My stories as a patient and a caregiver at a Harvard-teaching hospital are so Twilight Zonish and so unbelievably callous, that you would say that these Harvard-trained doctors and the administration were not brought up to be human beings. In my view, caring and humanity have been lost in the doctor-patient equation.

  • http://www.drmartinyoung.com Martin Young

    100 hour working weeks are just inhumane. Who would want to be a patient of an exhausted and overworked doctor?

    Is this the ‘old school’ mentality at work again?

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