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    How to command patient trust while building experience

     

    Nonetheless, it is fair to say that in the limited 5 to 6 years allocated to residency (the days are long, but the years are short), maximizing exposure to the operating room is of paramount importance before beginning practice. One of the primary goals of training is to achieve autonomy in one’s own operative abilities and overcome self-doubt. There will inevitably be a challenging case, complication, or suboptimal outcome along the way that will keep us humble and curb overconfidence, but repetition and practice are the key ingredients to mitigate such surprises.

    That being said, it is plausible that the operations being learned by today’s residents may be very different from those they will perform in the future. With the constant emergence of new technologies and techniques, this is not an uncommon theme. Perhaps the most striking example is the evolution of the surgical management of prostate cancer. Whereas graduates from 15 to 20 years ago are well-versed in open radical prostatectomy, most residents today are performing this procedure robotically and have less familiarity with the open approach than their predecessors. Developing a solid fundamental surgical skill set and understanding of surgical anatomy enables one to adapt in a rapidly changing field, and also helps to convey a confidence that can help the patient feel safe and more comfortable.

    Have you read: Research success during residency: Seven useful strategies

    Lately, there has been growing concern over concurrent surgical cases booked under the same attending surgeon. In the academic world, this is often made possible by the assistance of residents and fellows, with the expectation that the attending surgeon be present during the “critical” portions of the case. Patient safety and outcomes are of course the primary goal of any intervention, but there must be some balance with training the next generation of surgeons under appropriate supervision.

    So how does one who is less experienced command trust from patients that would benefit from surgery? First, let patients take control of their own decisions. Be clear about the alternatives to surgery, but be forthright about the risks and benefits of each option so they understand the potential consequences of their decision. Patients generally appreciate transparency. Become knowledgeable about contemporary literature surrounding the relevant disease processes and be able to quote the evidence when counseling patients. Finally, for trainees especially, being honest about your role as an ancillary yet valuable member of the surgical team can go a long way.

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