To reject trainee surgeon?

[RunningThroughMyHead]

My young child is on the wait list for eye surgery. It’s a complex surgery with risks of blindness or other permanent eye issues if not done correctly. These risks have been explained to us but the benefits outweigh the risks.

My husband took him to the last appointment and the surgeon explained that a student surgeon may undertake all or part of the surgery under his supervision. My husband nodded along as far as I can tell.

Whilst I fully understand that healthcare professionals need to practice, perhaps selfishly, I don’t want my son practiced on. I wouldn’t forgive myself if something happened and I want someone well experienced to do the full surgery.

AIBU to request/insist on this?

@snappyshopperThey will be specialists! Ophthalmology specialists. Just not at full surgical level for every operation. They will definitely be working alongside, not alone.

I honestly think that OP and others don't, in fact, understand this at all and think that a bunch of 19 year old first years at uni are being let loose performing surgery.

I don't think she does think that.

But for people who are not au fait with medical training, they can quite easily use the word 'student' for someone not fully qualified as a consultant and working towards that.

I literally acknowledged that it my OP. But I’m also a mum who wants the best for my child. I care about them much more than anyone else, obviously.

I had a student midwife deliver my third child, she did well and I had a great experience. But she posed my less risk to me as she was mainly just encouraging me and passing me the gas and air. It was low intervention and my third birth.

My son’s eye is small and the operation for his condition is very complex; long term problems from the surgery aren’t rare. A millimetre inaccuracy could render him blind in that eye, forever.

Yes, they need experience. Am I loving the fact it could be on my son who I love more than anyone? No. Although I’m starting to see the benefit of having two doctors present, as other posters have helped me see.

I understand your concern, ideally we'd all like to be operated on by the most experienced person around. However if we do that there will be no experienced people to operate on anybody in a few years time. There is incredible competition for a training post in ophthalmology as its a specialty with a lot of private practice since many people are prepared to pay. So the person who gets a training post will have had not just the standard training but will have been putting a lot of effort into building their portfolio.

I dont know about ophthalmology training specifically but these days medical training often includes time to practice on quite advanced dummies and virtual reality training as well as the practise on dead bodies. It's likely that the resident doctor will have put many hours into practising their skills before they got too close to a real patient.

And there are plenty of resident doctors practising to be anaesthetists. But they are not "students" they are qualified doctors receiving specialist training under supervision.

Also, qualified doctors who want to be surgeons don’t train in a range of specialties. They choose. If you want to check anything, check who they are and what level of training they have had to date. Or refuse.

OP this is your call, but my feeling is that continuing to talk to posters who are not helping you, is not helpful and just stressful.

I think you need an appt with the consultant, go in with questions, and be reassured or not.

If you're not happy then the option is to seek another consultant either within the NHS or privately.

My mum had an operation last year where a "trainee" was supervised by the specialist. It was very close supervision.

The main issue was that it took much longer and was done under local, so it wasn't a great experience for my mum and she said she would have refused the trainee if she'd known how long it would take. However, it was done as well as it would have been done by the experienced consultant.

I think if it was my child I'd want the specialist doing it. But maybe have a chat. If it's just sewing up at the end, it's fine!

Wow I wonder how you would feel if you’d spent years learning your job and every time someone was told you were going to look after them, they asked for someone else because they didn’t think you knew what you were doing!
in a lot of cases you wouldn’t have even known about this, but go ahead and refuse and go back on a waiting list, all the while your child could be getting worse!
no one is going to put your child’s sight at risk, in fact the person performing the op will probably do a better job because they’ll be fully invested in the procedure, and it won’t just be run if the mill!
I once had a mouth operation, the very experienced surgeon, actually ended up seeing my gum to the inside of my cheek, making it impossible to open my mouth. Why? Because she was rushing and distracted by her partner waiting for some exam results and wanted to hear how he’d done!

I’m glad he’s home - hopefully being crabby is a good sign (better that than unusually quiet I guess!).

Thanks, on the back of some of the suggestions, I’m going to ask about their experience in hopes this reassures me. I’m sure it’ll be fine regardless, but I kind of think it’s my job to do what I can to make sure he gets the best care.

Wishing your son a speedy recovery!

That thread was removed for being a possible troll.

no one is saying dont ask question. But you've asked a question on this forum so you will get a variety of answers, not all helpful. You are your child’s advocate at the end of the day. I would say its more beneficial to have 2 doctors in the room and the registrar performing will be meticulous as will be being watched.

a lot of surgeries within the NHS will be partly or wholly completed by very experienced registrars - fully qualified doctors who have years of experience and definitely if you go into hospital unexpectedly they will be the people you see. They may also have SHOs/interns doing part of the procedure. They aren’t students and using that term is quite disparaging of you. But if you want a consultant, arrange to go privately and choose the specific person you want. Or ask some further questions at the current hospital because you don’t understand it fully. You need to feel comfortable with your child’s care so it’s good to explore what exactly will happen, who will be in the room, what happens if you refuse care etc. FWIW I’ve had surgery with a registrar and consultant and I can’t tell which opening was completed by who. My kids have been seen very competently by registrars at various points in time.

Patient choice. I work in healthcare & was gobsmacked to find myself doing something similar. Surgery is very slow and meticulous- your child would be safe but I get it.

Yes you’re right. I’m just saddened that there are so many people who want to kick me whilst I’m down. It’s so unnecessary. There’s been lots of great advice that I’ve taken on board but also so many unkind posts. Why do people think that’s ok? I’m sure they don’t talk to people like that in real life.

There's nothing at all wrong with asking questions.

A surgical registrar made a huge mistake with my son (though not during surgery, he said that my son didn't need surgery when he desperately did and ignored nurses concerns).

You are right to decline.

One of the biggest indicators of surgical success is experience in the particular operation, especially if it is complex.

It is perfectly reasonable to ask a surgeon how often they have carried out an operation (and the outcomes) and choose on the basis of experience.

I know there has to be a first time for everyone but few would choose that to be on them or their children!

I did see that it was a troll this morning, but regardless, that poster was given support to challenge medical advice. Yet I’m given vitriol but so many other parents?

Anyway, I’ve had the advice, so I’m off now. Thanks to those who responded with helpful advice and information.

That's not the OP's fault, is it? Maybe don't come onto a public forum if you can't respond politely. The OP is obviously worried, you're not helping matters by being so rude.

Blimey, some people.

Of course more junior doctors have to learn. But if it were me, I wouldn't really want them to learn on my child, where if it went wrong there would be no coming back from it.

She's having to consent on her son's behalf - that adds a LOT of weight to the decision.

I might consent to it being done on me. You might consent to it being done on you, or one of your loved ones.

The OP wants proper assurance that if she gives this consent, it is fully informed and is genuinely in the best interests OF HER CHILD. Not in the best interests of a registrar's career.

Let's just be glad that not everyone thinks like you or else in around 10/15 years there will be no medical professionals left to treat people.

Exactly.

I'm sure the surgical registrar involved with my son learned a lot and will never make the same mistake again but it was almost at the expense of my child's life.

If you want to look at it that way, ALL doctors are "students", as they have to undergo CPD which usually has some form of test or exam at the end to ensure it was done properly. Plus as new techniques and instruments are developed, they need to train on those so are still "trainees" using your thinking.

From an academic point of view, is someone who has their degree and masters and is working towards a doctorate at the same level of "student" as someone who is working towards their degree?

I think that's really mean. The language in health care is really confusing. 'Junior', 'Trainee', 'Student' all sound like they have very little experience. Would you trust your finances to a 'trainee advisor'? The fact that these surgeons are actually very experienced isn't obvious.

@RunningThroughMyHead I used to work in a specialist theatres recovery, so spent a lot of time in theatre, and I also did my return to practice placement in general theatres.

Firstly, know that the theatres team is a lot bigger than the surgical team. You'll have an anaesthetist and an OPD who are caring for your DS's physical state during the operation. Before surgery starts, the whole team will have a 'Time Out' where they agree who the patient is, what operation is planned, any complications to be aware of, and who everyone in the team is.

You'll have a scrub nurse who is handing the surgeon everything they need and supporting them as they operate. A circulating nurse makes sure that if anything extra is needed, or equipment is needed, it's available.

Surgical trainees start by observing surgery. Then they may be invited to do a layer of stitching, or a defined part of a surgery. They never just dive in and operate.

The fact that you've been told this surgery is tricky and delicate, means that the surgeon who operates will be experienced. They may be a 'trainee', but all that means is that they have a formal contract with the hospital to give them the training they need to qualify in their speciality. Specialist training contracts are competitive and they will have done huge amounts of study and gained lots of experience to even qualify as a candidate.

Ask the questions - the Consultant's secretary would be a good place to start. They'll be able to give you the information and reassurance you need.

What is the operation that it is so complex? It could be something that the suitably trained and experienced registrar carries out multiple times a day. They could have even carried out more of that procedure recently than the Consultant.

I would consent if it were a minor operation with limited risks, but not a major operation on my child.

And again, I maybe would if they had completed multiple similar operations on adults but this was their first paediatric case.

But first operation, high risk factors, no way. I would be looking for a very experienced consultant. As would most on here were push to come to shove and they really had to face their child potentially losing their sight.