To reject trainee surgeon?

Relating a trainee hairdresser to this?

I mean, really? @allthegrass ?

We all know a trainee hairdresser hasn’t had 10 years of intensive study and experience though?

Interesting replies ! If you had come on and asked if you should let a trainee hairdresser do a complex cut and colour you would have got a resounding no.
I think attitudes around its free so suck it up are interesting too. Where does the notion that the nhs is free come from ? It isn’t you are all paying for it every month with your taxes, a working person will pay thousands and thousands towards it in their lifetime. You are also allowed to ask questions. That would be my advice really ask questions how many times have they carried out the operation before ?, how long have they been training for ? etc. Why is it the only profession where you are actively encouraged not to ask questions ? not to make a fuss ? Not to waste time ? Absolutely bonkers it’s his eyes. It’s not just mumsnet it’s the British society on a whole that has this attitude towards the nhs. Make a fuss op if you want to and ask questions if you want to. Wishing your son a fantastic outcome.

Im sorry you're getting a hard time. It's terrifying handing our children over to go into surgery and so I think it's natural to want the very best person for the job and assume it's the consultant. I think it sounds like you need more information to set your mind at rest, it's a shame you weren't there for the pre-brief.

It took me a full ten years post graduation to be fully qualified.

Surgical registrars towards the end of their training will be doing many operations more regularly and sometimes more recently than their consultant.

Occasionally patients do say they don’t want a registrar and at every hospital I’ve worked in this accepted, even on occasions when we’ve been aware that his means a less skilled doctor who would not be our choice is now the patient’s choice.

It can be hard with no background to understand how rigorous and lengthy specialist training actually is and for how long
you are competent before you actually get final sign off

The one that caused spinal injuries on me was allowed free rein to just stab multiple times in my spin trying to numb me up and it’s taken years for me to be able to walk again! I can’t feel anything from under my bra strap down at all and the student anaesthetist didn’t give a shit when he found out what he’d done to me. Told me that every doctor by the time they were fully qualified had killed at least 5 people and injured many more but that was ok because now they are qualified it shouldn’t happen again!

Yes, I agree @allergictoironing - experience and skill are two different things, and the one does not guarantee the other. But in the absence of more detailed information- e.g. success rates for each surgeon doing this particular op - I would be going for an experienced surgeon over an inexperienced one. And would have no qualms about doing so.

The surgeon will likely be an ST6 or 7, that’s a very experienced Registrar. It means they’ve had 2 years general surgery training and 5 years of ophthalmology specialist training under close supervision of Consultants.
I worked in Maxillofacial surgery for a year as an SHO helping in ops - always a Consultant and Reg in and only the very experienced registrars were allowed to take the lead.
They will be close to being a Consultant if the supervising Consultant is going to let them do the bulk of the procedure.
Your child will be in safe hands - honestly. If they had any concerns about the ability of the registrar, they would not allow them to operate on a paeds case with a critical outcome if it goes wrong.
Your child is precious and it’s normal to be worried but they will be in safe hands

I understand your apprehension but…The person operating will be very senior and not a student. They are all junior under the consultant but sometimes are more up to date. Haven’t formed bad habits. Sometimes consultants can be so confident they are lax and their registrars are the people you’d want to be operating. Your consultant will not let anyone touch your child who they don’t trust to do the best job possible. I hope things go smoothly for you all.

It’s shocking that there appears to be so many highly qualified posters on this thread who cannot help themselves but be rude to the OP. The OP is not medically qualified and is seeking reassurance. The amount of apparent medical professionals who are intentionally being rude to the OP, simply because their ego has been bruised is appalling. The OP hasn’t intentionally tried to insult anyone. She is a lay person with no understanding of how medical training works. Why can’t people just be kind and provide some reassurance to a concerned mother?!
OP, I have had many eye surgeries over the years since I was a child and I have been well looked after. Your child will be looked after well also. They will be in very good hands ❤️

As you seem to be very anxious, then say no. But in reality what you are asking is that you take the benefit of training doctors, but you want everyone else to accept the necessary processes involved in training very highly skilled personnel

Having only days ago watched a very young doctor (I’m old, so obviously he was 19 🤣) repair my sons face, I am in utter awe of the skill, professionalism and manner of the doctor. It was a masterclass in concentration, dedication and competence. The mess he started with, where you could see bone through many layers of tangled soft tissue injury, involved many stitches but only 3 visible, convinced a very worried mother who was devastated he’d be scarred for life. Scared DS, was utterly at ease, joking with the doctor from the corner of his mouth and is so relieved with the result.

I understand your worry OP, it’s your child! But regardless of the negative press, our doctors and surgeons are first class. Absolutely check back on the supervision angle; you’ll be reassured. It will be OK!!

It isn’t the op’s fault that you have just come off two night shifts. There is no need to be rude to her.

I'm sure it'll be absolutely fine. He'll probably read a book on eye surgery the night before 😉

With a patient or their parent fully informed and happy to consent. Not feeling bullied or pushed into it because the medical professionals career progression is put first.

OP's priority is always going to be her child, not someone's career.

We have pants drivers on the road because our driver training and testing isn’t particularly extensive (compared to training to be a surgeon) and drivers aren’t routinely monitored for the quality of their driving after they’ve passed their test. It is a completely inadequate analogy for surgery where there is a very high correlation between experience at a particular operation and outcomes for patients.

If it helps I had an experience with a 'trainee' surgeon who performed the procedure thoroughly and carefully under the constant supervision of the experienced consultant who was explaining different options and best practice the whole way. The trainees work received praise from everyone who checked on the healing.

Highly unusual for a senior surgeon training a junior colleague not to have extensive and up to date experience in the operation.

The whole point of training is to pass on up-to-date expertise because lack of experience and out of date techniques lead to worse outcomes.

And how does your experienced consultant start off their career?!

Experience and skill are often not the same thing! We all know people who have been driving for years and are still a bit pants, and others who seem to pick everything up in a few weeks. Keeping to the driving analogy, you get drivers who are very experienced and think because they've been doing it so long they can get away with bending or breaking the rules (drive too fast, cut the corners on bends etc).

@RunningThroughMyHead there's a fair chance that the letter is a bog standard stock letter for that clinic with just the patient details & dates etc changed. Your consultant will have a big list, probably even a few other patients on that day, and will decide which of the various operations can be done and to what degree by non-consultant surgeons, but the letter will read the same to all those patients. Yes he probably did say to your DH there would be a more junior (than consultant) surgeon assisting him who may well do some parts of the operation, and I'm sure there will be more routine operations being carried out on the same list that can be done perfectly competently by a resident.

If anything this thread shows that perhaps these things need to be explained more clearly, especially where there are children involved. That responsibility lies with the clinician who takes informed consent from
the caregiver. The fact that op is concerned and did not fully understand the language used (or at least what was relayed to her by her husband) shows that further explanation is required.

I would take a resident (what you describe as a "student surgeon") over a consultant any day of the week.

1. They're at the top of their game. Cramming for their v specialised postgraduate exams, practicing every chance they get.
2. They're not operating alone, and have a consultant with them overseeing
3. They're likely to be younger with the improved dexterity and eyesight that it comes with. Especially vs e.g. a consultant nearing retirement.

DoI - consultant medic, not a surgeon. Lots of experience with surgeons though.

This is not that. This is a situation where the OP was told that the trainee might well be doing ALL of the operation. FFS it's his eyesight!

Consultant doctor here (not an ophthalmologist).

As others have said, the language used can make things sound different. I was a junior doctor for 13 years. I was a junior doctor the day before I started my first consultant job, despite having all that experience and postgraduate exams passed years before.

When the junior doctors' strike in 2016 happened, my consultant colleague posted about how when she needed an emergency C section, the registrar (so the same level of doctor that is being talked about in the OP) made the correct decision that the C section was needed, and got her baby out and safe before the consultant could arrive and get changed/scrubbed for theatre - and he only came because the patient was another consultant!

Resident doctors (who used to be called junior doctors) are running hospitals overnight, dealing with cardiac arrests, operating on emergency cases, giving anaesthetics, doing invasive procedures such as lumbar punctures on tiny babies. They have been given gradual exposure to procedures/complex cases as they have become more senior. I'm not a surgeon, but when I was in my first year after qualification doing a surgical job, we sometimes assisted at operations - this meant that we might have started off holding a piece of equipment to keep the surgeon's view clear, but you might also be asked to put in stitches at the end. For a surgical trainee (meaning a fully qualified dr, in a training programme to become a consultant where their progress and experience is reviewed regularly by a body of other consultants) they would then progress to doing a more complex part of the procedure e.g. for keyhole surgery, the surgeon might let them operate/move the "port" (sorry surgeons, it's been decades since I knew the right terms!) and check their knowledge at that point - can you identify the gall bladder? what's that structure there? where are the blood vessels/nerves supplying it? ,moving onwards to doing a part of the operation, and finally a full operation under supervision. It's very carefully monitored, and I hope that if you speak to the consultant you might be reassured - it's ok to ask - what parts of the surgery will the consultant be doing, and what parts will someone else be doing, and I hope that will make you feel more confident.

It's completely possible that the anaesthetist may not be a consultant either , and you are trusting them with more than an eye.

My kids are grown up, but I would have no issues whatsoever in consenting for a "trainee" to do the operation on me or any of my family.

I hope all goes well for your child.

The very vast majority of operations done in all specialties have at least two surgeons scrubbed and it’s really not common for them both to be consultants - you cannot do a lot of operations without an assistant and declining to have a registrar/fellow assisting might just mean they can’t do the operation.

a resident/fellow/staff grade doing a paed eye list isn’t going to be someone on day 1 of their post-grad training. They will have demonstrated that they have the skillset to do at least defined parts of lots of operations. What the surgeon has done here is good practice and supposed to be reassuring - they will let their colleague do some parts because they are comfortable they’re experienced and skilled enough but they’re not just going to wander off and leave them to it in case things turn out more complex (and because most operations need 2 people anyway). It’s worth remembering that a non-consultant surgeon could still be someone who’s post-CCT and doing/done fellowships in sub-specialist bits of the specialty that may be exactly right for the operation in question. Or it could be someone more junior who’ll be holding retractors and cutting sutures and doing the very basic bits that most operations have. It isn’t in anyone’s interest just to let any old amateur that’s game have a bash at ‘complex eye surgery’….at the very least the paperwork it generates if there are problems mean that no one in their right mind would let it happen!

if you don’t trust the surgeon’s judgement enough to believe they’d only be working with a team who have the skillset to do the job safely they’re probably not the right surgeon for you.