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?

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

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The whole point of training is to pass on up-to-date expertise because lack of experience and out of date techniques lead to worse outcomes.

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.

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.

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.

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

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.

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!!

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

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 ❤️

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.

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

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 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!

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

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.

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.

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

Relating a trainee hairdresser to this?

I mean, really? @allthegrass ?

I don’t know if you have misunderstood, OP but the consultant surgeon and resident doctor (who will be registrar level) will both be specialists in this field. So you want be having a resident doctor who does mainly thoracic surgery, for example, doing ophthalmic surgery on your child. The resident doctor would have many many hours of ophthalmic surgical experience under their belt, they won’t straight into complex surgery having not done so. Some or all of the operation may be done by the resident doctor, depending on their level of experience, under the supervision of the consultant. Who that resident doctor is, you won’t know because no-one knows yet - it will depend on the rota, leave, staff sickness, patient sickness (called to see an emergency) etc.

In the OP’s shoes, given her husband doesn’t seem at all clear what the surgeons actually said, I would have probably clarified the situation first before committing my entire afternoon to debating it on mumsnet.

Sorry op has been given so much grief. It's a completely understandable concern.

That's not our recent experience at all.

For DD surgery we were given a choice of surgeons and hospitals.

I had rare and critical surgery on my eye 5 years ago. It was an op always under GA but as it was during Covid I was sedated not fully unconscious as they weren’t taking overnight cases. I was assigned a “student” not the consultant I had been previously seen by (without notice, but that’s typical of that eye hospital & another story!) - said student was a fully-fledged surgeon. I could hear how well he was supervised by the consultant throughout the op. Optical surgery is micro & projected onto a huge screen and everyone in theatre can see it - in that sense far easier to supervise than nirmal body surgery.

The NHS gave you a list of surgeons and indeed hospitals and said “take your pick”? @Willyoujustbequiet