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Challenges for Practicing Surgeons

Challenges for Practicing Surgeons

Numbers vary between studies, but in general, a surgeon used to need to perform at least 25 cases to perform at a basic level of safety. Now, the number
is around 75-80 to achieve optimal proficiency.

Throughout a surgeon’s career, many new techniques and procedures will be introduced. Traditional training scenarios involve the surgeon traveling to a one-to-two day training workshop with the medical device company. This offsite training is time consuming and lacks opportunities for the surgeon to continue to practice. After training, it could be four to six months between the time the procedure is learned and the time the doctor gets to use the procedure on a patient.

The ability to continue to practice a new procedure is crucial. Increasingly complex technology means an increasing number of cases need to be practiced. Numbers vary between studies, but in general, a surgeon used to need to perform at least 25 cases to perform at a basic level of safety. Now, the number is around 75-80 to achieve optimal proficiency. New technology adds complexities for the entire surgical team as well. Surgical teams have limited team training opportunities so every member can understand the steps in a procedure.

One study shows training challenges extend well beyond residency and fellowship. This paper describes the learning curve for what would be considered a modern, more complex procedure called anterior total hip arthroplasty. It requires 50-100 patients to be operated on to be able to perform the surgery safely. When a surgeon is newer to the procedure, revision rates (meaning a second surgery is required) are 300 percent higher than normal. This shows how complex this surgery is to learn to do well for even fully trained surgeons. This phenomenon applies to most new modern medical technologies, including robotics, interventional technologies, patient specific implants, and navigation systems.

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