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?

There is aload of bollocks on this thread.

Students do not do operations or give anaesthetics.

Resident doctors can start using a Mr/Ms/Miss title very early on post graduation (around 18months) if they power through their exams. So don't base your assessment of expertise on that alone.

Some specialities do exams very late on during their training period e.g orthopaedics have an exit exam.

I'm a consultant we do graded exposure - at the weekend I did a few cases - a tiny baby which i completely took charge for, an older kid with additional needs where I supervised the resident doctor from the coffee room and a big teenager where I provided supervision from the end of my mobile phone.

Our hospital consent forms say that a member of the team rather than a specific staff member will operate. In certain circumstances making a request that only a consutant operate could be actively detrimental eg. if the consultant is at home but a suitably qualified resident doctor is on site and the condition is life threatening.

It's normal to be anxious but do be reassured that a surgeon in training isn't necessarily a bad thing. A family member had a bad outcome after bilateral knee surgery. The (experienced) consultant ruefully commented to me that of course it was the side they'd done that was the problem. Not the one the reg had done.

Also we tend to get help if we need it. I have a sub specialty interest and skills. It's not unusual for consultant colleagues to ask me to undertake niche procedures on their patients as they don't do them very often and I do several each month.

In my previous life, I was an opthamology nurse.

I would prefer the Resident to do a surgery for the sheer fact they are supervised and take their time.

I've witnessed fully qualified eye surgeons crow that they could do a cataract surgery in nine minutes and push through 35 patients in a day.

I've seen a surgeon pass out in the OR and the Resident had to finish the surgery. How would you like to witness the surgeon going down as he operated on your eye? That one took a lot of apologizing and smoozing to clear up.

But hey question a fully qualified doctor finishing up their specialty training.

I was using the language OP used, she’s a registrar but would be considered a student by OP’s post. It’s not hard to use comprehension skills.

True, but this is regarding a child.

If someone wants to take those risks on themselves, that is their decision, but I don't think a loving parent should be taking any kind of risk that's unnecessary if it's not themselves that are going to suffer dire consequences on their own bodies if something goes wrong.

It is, because this is a women's forum, and most of the responses or condoning this risk will be from women.

If there's a choice, the least risky choice is best because otherwise you're taking a gamble on someone else's body, more than is actually necessary.

Who d’you think’ll be doing the paediatric surgery in 10-15yrs time then when the current consultants retire and no one has been able to complete an adequate training programme? Gonna be a bit sad for all the kids that need operations then….they’ll just have to wait until they’re adults.

Probably would have been better to correct the OP to use the techically coreect terms, then people would know what you're talking about....

Especially given half the problem here is people are using the terms student, junior, registrar, resident and trainee interchangeably which alters perception of what each one actually is.

With a trainee doing the surgery, I guarantee that every bit of your child's op will be checked, double checked and triple checked by the consultant. It's their registration and reputation at risk of something goes wrong and it's because they've not supervised sufficiently.
In some ways, your child will be better cared for than if the consultant was just doing the op on their own.
I say this as a uni academic who has had the pleasure of the consultant bringing their juniors on the ward round and explaining things in great detail, and also the pleasure of the consultant on their own explaining to me in not as much detail. Still detailed, mind you! The joys of being a colleague...

As soon as anyone says this, they lose any of my sympathy.
As I said earlier in this thread, I work in the NHS and have the ‘I pay your wages’ thrown at me when people are trying to stamp their feet and get their own way - as I know most public facing public servants have.
Unless you’re top 1%, I doubt your tax contribution would come close to covering the cost of a highly complex eye operation plus the pre and post op care (I’d imagine your child has already had multiple appointments).
I do understand your worry, although I believe it’s needless as I explained earlier.
If you want to name your surgeon, you’ll need to go private.

Not wrong at all. I had cataract surgery at the London Eye hospital. First eye, senior surgeon. She then handed over to a junior who fiddled and farted with the other eye..the lense didn't go in properly and it was a faff .has never been quite right. Thens the breaks with free health treatment unfortunately

Are you paying?

Very few situations in the UK where the patient isn’t paying, though normally through taxation rather than directly.

But even if it was a charitable effort, do you think the OP shouldn’t consider whether the skill of the surgeon is sufficient given their DC, who is too young to evaluate the risk himself, has their eyesight at stake?

100%, I was one for a year before returned to training. Very much considering being one again too post-cct. (May as well get the cct now have a few months left but somewhat disillusioned with consultant life

you absolutely do have the right to not have a trainee do surgery on you/your child.

YANBU @RunningThroughMyHead if you’re not comfortable you should tell them.

This forum isn't exclusively for women or mums, despite the name and this post is about a little boy.

As many people have said, there won't usually be a choice if you choose to use the NHS. You also haven't thought about the consequences of not letting anyone else learn and develop their skills at all.

Hi op, I think its terminology used to those who don't understand medicine. I got asked if a student could operate for my jaw surgery but as these comments show, he'd have been well qualified. I said yes but as it turned out, the consultant did it in the end and he botched it right up! Nice bloke but unfortunately didn't go the best op so will be revising it. I'd have preferred someone to really take their time. Ask questions if you're unsure.

I think you have to make the best decision based on what is right for you. My answer would be dependent on what type surgery and the long term implication. I have had minor surgery and major surgery. I never met the surgeon prior to my surgery and I got a final report from the consultant. I never had any follow up. However, when I had eye surgery and another surgery I was very particular abut who did the surgery. I think it is important to know how many surgeries the person has completed. Being a consultant doesn't mean you are a good doctor or surgeon.

Also to add - you do have the right on whether a trainee does your surgery. - sometimes it advantageous to have done by trainee as you will be seen quicker.

I think it down the to the individual to decide whether they want a trainee. They will still learn irrespective as their always be patient that will be happy to proceed.

I think as well as the language very few people know what goes on in operating theatres. There is a team, it is not like on TV when big Mr surgeon is in charge and everyone else is beholden to him.

There is a team and each has their own role.

I was what was then known as a cardiac tech. In a cath lab you would have a Dr performing the catheterisation / stents. This could be a consultant or a registrar.

There would be a scrub nurse assisting, a radiographer 'steering' the table a circulating nurse and a tech.

My role was to monitor the ECGs and call out what was happening. If I said, "pull out" then the consultant would pull out the catheter.

In bypass surgery for decades the 'vein stripper' is a nurse. His or her job is to remove a vein from the patient's leg for the Surgeon to attach to the coronary arteries.

It isn't down to the individual in most circumstances, not unless you pay. It's also not reasonable to always say 'I don't really care what happens to others, someone else can be the guinea pig'.

Agree with this. If you refuse a resident doctor being involved in the surgery and insist on consultants only, then you are benefitting from every patient who agreed to be part of that consultant's training, while refusing those benefits to future patients. It's akin to being prepared to accept a transplanted organ whilst refusing to donate yourself IMHO.

I used to be more enthusiastic about the SAS roles, but honestly, if you’re cct’ing don’t go back to SAS’ing. It looked like a better option to me once upon a time but after 15yrs it’s just about worn me down.

I would contact the consultants secretary and ask for a further appt. If all your dh has took away from the appt is that a student surgeon will be performing part of the surgery, I don't think enough information has been provided.
The word 'student' makes it sound like an inexperienced learner will be performing the surgery. When it's probably a very experienced registrar, who is in the later stages of their path to consultant level.
Get more information. I don't think you have all the facts at the moment and that will understandably be making you anxious.

Well she’ll need to learn to deal with all sorts - rude ones, entitled ones, racist ones, smelly ones….. She won’t be successful if she only knows how to treat nice people. Don’t why you’re cross about this, it can’t come as a surprise?

Most jobs with any sort of customer-facing role have to deal with the full range of people.

PS she’ll also have to work alongside arrogant, entitled consultants too - there are plenty of those in the medical profession