Challenges

Surgeons face numerous limitations in training procedures, and these challenges are evident across different continents, countries, and medical centers. Although the specifics may vary, several common issues hinder the development of surgical skills. Traditionally, surgical training is concentrated in high-volume university hospitals. However, the growing number of trainees and the specialized focus of these hospitals have disrupted the foundational training in essential surgical skills.

Differences in perspectives between trainees and mentors further complicate surgical training. The rapid advancement of techniques, such as laparoscopic and robotic surgery, demands a shift in traditional training methods. Additionally, the reduction in open and straightforward surgeries, coupled with an increase in complex procedures, limits trainees’ exposure to basic operations, emphasizing more challenging tasks instead.

Key Challenges for Trainees:

• Limited case availability for hands-on training.
• Concerns over the quality and quantity of operations performed during training.
• Insufficient time for attending conferences and specialized surgical courses.

Factors such as scheduling conflicts, insufficient patient cases, and restricted access to advanced medical equipment or technologies can create barriers to comprehensive learning experiences. Ensuring patient confidentiality is a critical component of medical education. Balancing the need for trainees to learn from real-life clinical cases with the obligation to protect patient privacy presents ongoing challenges. Ethical considerations limit trainees’ involvement in certain cases, which can restrict their exposure to diverse medical scenarios. Senior surgeons and educators also recognize these challenges, particularly the lack of cases for trainees to practice on. The time required to achieve advanced surgical skills is another significant obstacle.

Additional commonly reported challenges include:

• Restricted access to surgeries and procedures.
• Time constraints during training periods.
• Ethical concerns regarding practicing on live patients.
• Institutional Pressures Impacting Training

Hospitals are under pressure to meet predefined outcomes, such as faster diagnoses, shorter hospital stays, and increased efficiency in operating theatres (e.g., faster surgeries and shorter breaks). These priorities often shift the focus of senior surgeons toward achieving numerical targets rather than fostering the next generation of surgeons. Mistakes during live-patient training can result in severe consequences for everyone involved, including patients, trainees, educators, hospitals, and medical universities.