To reject trainee surgeon?

So many crazy comments. If I was having a serious complicated surgery that isn't common and had serious risks I would ask my surgeon how many times they had done the op before - completely normal way of thinking. Of course I would do that for my child and presumably a trainee means they haven't done the op before, meaning I would probably say no and go private if I didn't have the option to change them.

I once agreed to let the trainee do the smear test (because we all use the NHS and it felt selfish to not do my bit to partake in the system I benefit from). She couldn't find the cervix, I have vaginismus and it was really embarrassing and awful. Resulted in not having the smear taken, left and didn't go back. No smear taken.

No way would I let a trainee do anything with my child's eyes. I know they've got to start somewhere but my job as a parent is to want the best for my child. It doesn't matter what people think of me for that.

YABU. You’re not going to be getting some teenager fresh out of year 11, you’re getting an already highly trained Opthalmic Surgeon who will have the added bonus of being even more careful than usual as they will be being both appraised and supervised. They’re not really in the habit of letting the newbies loose on people on day one, that tends to end up with awkward lawsuits.

It is scary, I understand because my son had eye surgery, obviously I don't know if it is exactly the same but his Consultant retired a few months before the scheduled surgery. The new Consultant was newly promoted/appointed and yes it did make me wonder how experienced he was. As it happened he was wonderful, my 4 year old took to him straight away when he had never been comfortable with the older doctor.

I hope everything goes well but if are worried I'd contact his secretary, say your husband was at the appointment and you aren't clear about who is doing the surgery and could you have some information. The surgeon might be doing the whole operation, the younger surgeon might be very minimally involved or he might be experienced and doing all or most of the op. I'm sure they can put your mind at rest.

I hope all goes well.

don't forget the SAS's...some of us are pretty useful too! (even if no one else has heard of us)😃

Depends on the situation. In many many cases most surgeons/anaesthetists would actually rather a very senior registrar at rhe end of their training for emergency situations if they were personally ill, than a very senior consultant as we do way more nights/put of hours emergencies/go to crash calls/resus etc as it isn't in their job plan and they have minimal exposure at any degree of frequency

Completely agree. Maybe I would allow a trainee to operate on myself, but never my child.

If you want to choose who does the surgery go private.

In the NHS you’re allocated to a consultant, but all the letters say ‘…or a member of their team’.

Anaesthetist. You can't insist unless you want to go private.

Trainers isn't a student. I'm technically a trainee for 3 more months... but I've been giving independent Anaesthetics for 9yrs. Our training scheme is 3-5yrs longer than europe/America/India etc (probs as we are cheaper labour). The consultant be in theatre unless very very senior reg and will take over if needed.

If you want to dictate your surgeon you need to pay, sorry

Absolutely right, @Nothernwannabe.

When I was a student nurse, back in the 80s, I had a friend who was a medical student, who told me about a gynae consultant who used to let all the students (actual medical students) who were in his theatre observing surgery do pelvic exams on the anaesthetised women on his operating table, before the surgery began.

Thankfully we have moved on since then.

A doctor of opthalmology IS an eye surgeon.

Who do you think does cataract and retina surgeries?

Ignorance is bliss. You must be estatic.

Considering a surgical registrars mistake is the reason why my son almost died, I didn't only wonder, I asked questions and only signed the consent form when I was happy to.

Despite the fact it happened before he was transferred to that hospital so didn't involve any of their registrars, they were incredibly patient and understanding and I'll never forget that. His first surgery which was the riskiest didn't even happen in theatre and was incredibly restricted with who was allowed in anyway which helped.

My son had a big eye op and I researched the surgeon to make sure they were very experienced. It might be a bit selfish, but I felt it was the best way to reduce the risk of complications.

He will have an op for strabismus later and I have been advised to find a surgeon who is very experienced, so that is what I plan to do. I am very fortunate that I have the option to go private for the second op (first was NHS).

I am not saying my approach is the right one, but I completely understand your feelings around this and you are not being unreasonable.

I’m not sure what you meant to say here, but OP wasn’t being contrite (remorseful). They also haven’t spoken disparagingly about the less senior surgeon as far as I can see.

I think we can assume a lack of detailed knowledge about the procedure and staffing of it by the fact the OP has asked for advice on here. If they were well-versed in different grades of surgeon, they likely wouldn’t be asking. That’s no reason to be abrasive with the OP.

Because they have to get INFORMED consent!

The are watched over by the surgeon who explains and examines every move and they have probably performed this procedure themselves before as far as eye surgeries go when your in any particular speciality you tend to see the same cases over and over again. They wouldn't be a student per say but an experienced doctor likely specializing. At least they told you surgeons always have junior staff assisting we just don't know about it. I wouldn't have an issue with this the surgeon would not be letting them do it if they thought it would cause significant risk or blindness to your child

In this specific context your son is likely to get the best care by allowing the medical team to do what they normally do in their usual way rather than trying to interrupt it.

In teaching hospitals, non consultants who are training are integrated into their departments doing more or less depending on experience. A list where a senior trainee is working with a consultant is likely be an established way these two people work together.

Imagine being a surgeon who had to live with knowing they've damaged somebody's eye? It's the kind of thing that might make someone feel unable to carry on as an eye surgeon, even if they've done nothing 'wrong'. Obviously the consequences to the person with a damaged eye are much more serious but there are pretty good incentives for the team to avoid making things worse. They will have equipment and procedures to reduce the chances of damage as much as possess.

I’m glad I’m not the only one who writes “trainee” in quotes for medics! The word winds me up because it’s very misleading.

I don’t necessarily think private is better. My friend paid privately to avoid waiting 4 weeks for NHS surgery and the surgeon operated on her non-cancerous breast.

The surgeon who did my emergency C-section was a registrar under the supervision of a consultant.

You can refuse surgery on your child’s behalf.

He/She will be a very capable and your child would be in good hands ..
and throughly capable of performing the procedure.
We need experienced surgeons and this is how we get them
He will be fine, and have two or three surgeons overseeing & looking after his sight.

No, your understanding is wrong.

First, all surgeons are medical doctors. Secondly, all surgeons specialise in a specific discipline.

Ophthalmology is a specialty that medical doctors go into and then they further specialise into medical or surgical ophthalmology. Then, there will be further specialisation and training into specific eye pathologies.

There are no student surgeons. There are surgeons still in training - who are fully qualified medical doctors who now focus on a particular area of surgery. A previous posted was right - the “student”/“trainee” surgeon could have 7-9 years of specialised surgical ophthalmology experience.

Secondly, how NHS operations work is that you will have a named consultant responsible for your child’s care. They will then need to have an assistant who will assist by doing parts of the operation or holding instruments or providing traction - this means that they will be scrubbed, standing be the bedside and be participating throughout the operation.

This assistant (or second operator) will almost always be a “junior doctor.” Sometimes the operation will need several assistants and some simple operations require none.

I cannot comment as to how much of the operation will be performed by the “junior doctor surgeon” but it depends on so many factors - including the difficulty of the operation, the rarity of the operation, patient, how many other cases are scheduled that day, bed pressures, level of junior, level of consultant and personalities of both.

While I understand your reluctance to not have students/juniors operate on your child - this demonstrates how the public perception of NHS doctors as “juniors” is really damaging to patients. There really won’t be a spotty teenager or 21 year old let loose to operate on your child.

This will most likely be a registrar and the consultant will assist. It's only in the private sector that a consultant always completes surgery, in the NHS it's often registrars operating under consultant supervision after years of already learning as their assistant. The consultant oversees a team of medics of different grades. If the consultant operates, the scrub nurse will be his/her assistant (all surgeons need an assistant), whereas in your scenario the consultant will be scrubbed up with the registrar, they won't just be in the theatre, they will be hands on and assisting. Its a bit like a pilot and co-pilot switching places on a flight, just one is more senior than the other. I fully understand your apprehension, but unfortunately, if you insist only the consultant operates, it may well be that you have to go Private. I hope the procedure goes well.

@hcee19 - it is my understanding that this ‘trainee’ is already a qualified surgeon - they will have completed their medical training and further training as a surgeon after that, but is now learning the specialist skills to be an ophthalmic surgeon. He or she could be near to becoming a fully fledged consultant.

Out of interest.... how many people on here have signed consent forms for themselves (form 1) or their child (form 2) for surgery without wondering what this statement (which is printed as standard on consent forms) might cover ... 'I understand that you cannot give me a guarantee that a particular person will perform the procedure. The person will, however, have appropriate experience.' All the OP's surgeon has done is really just explain one of the possibilities that statement might cover.