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?

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.

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.

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

Because they have to get INFORMED consent!

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.

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.

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.

A doctor of opthalmology IS an eye surgeon.

Who do you think does cataract and retina surgeries?

Ignorance is bliss. You must be estatic.

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.

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

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

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

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

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

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

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.

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.

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.

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.

OP, it's a perfectly valid question you're asking. I also find the responses interesting to read through. This user is just trolling you. Please ignore them, they want you to feel bad. Eventually if enough people flag comments like this hopefully the users leaving deliberately unkind comments to upset others will be banned.

I’d be concerned too. But here’s the thing…. Your hubby probably didn’t take in or relay all the information. It’s not going to be an inexperienced student it will be someone experienced who is still working under supervision as the medical profession is highly regulated and cautious. There are always risks and it is scary but you can help allay your fears. So much can change between now and then. I would try and contact the consultants secretary and ask questions to allay fears .. you may get a return call if lucky. On the day they will go through everything and you will most likely meet the person doing the op. You can find out more then. If you have concerns you can refuse consent.

but be aware if you turn down the op on nhs you will go to the bottom of the pile and dads a long waiting list … when you get to the top of the list it will be the same again.

so I guess you either accept the offered option or go private. When going private it is often the same surgeons as on the nhs anyway.

beet of all is just go for it but find out more to allay your fears.

I had an nhs op just before Xmas last year during junior doctor strike and I was terrified. I need not have been … I was looked after sooo well and the op was a complete success.

Did you mean to type Mr or is that a typo? Did you mean MA? I think requesting the best qualified person for the job is okay but requesting that person to only be male is actually quite offensive. There are plenty of excellent female doctors.

Sorry if this isn’t the case OP, but I think you may have the same misconception I had about hospitals until more recently than I care to admit. I thought you had surgeons, who did surgery, and other doctors who did the ward rounds and the clinics and stuff. (Please don’t roast me, NHS people, I had had very little contact with the inner workings of hospitals or need to use the NHS much at all prior to having my son in my mid 30s.) The ophthalmology and the surgery are not a different skillset, they are the same. So it’s not just, like, someone who’s doing hip replacements up the corridor popping in to do the eye surgery. Sorry if you knew this already, it’s just a thing I didn’t know because I don’t have any doctors in my friendship group and had never been to hospital before.

It's the right approach, and is what a sensible person would do.

As a mum you are concerned for your child and rightly so, however the bottom line is you only want the surgeon with Mr in front of his name to do the surgery and that's fine as well. You are falling into the trap of arguing with everyone who disagrees with you or points out a wrong terminology that you have used. There comes a time when you need to stop arguing the toss and just ask for the less senior Dr to not operate and see what happens. Then you will have your answer.