Published in the British Medical Journal the study showed that those who have been carrying out the same operations for more than 20 years demonstrated a marked deterioration in their performance.
James McNally, a partner at Slee Blackwell and a member of the firm’s Clinical Negligence team said:
“It has been suggested for some time that surgeons reach their peak after about 10 years experience in their chosen field but until now no one has really known how long they remain at their best. Measuring surgical prowess is a very difficult thing to do as there are so many factors which can affect the outcome of an operation. What the study did was focus on one particular procedure, the removal of the thyroid gland, where the treatment has remained the same for decades and the complications are well known. They then made adjustments for the age and general health of the patients.”
The study looked at 28 surgeons in 5 French hospitals carrying out 3,574 thyroidectomies a year. It looked for two main major complications caused by surgery, severe hoarseness and damage to the parathyroid glands which can lead to low calcium levels, cramping and twitching. The results showed that complications were least likely to occur in those operated on by surgeons with more than 5 years experience but less than 20. These were the surgeons in the 35 to 50 year old age bracket.
The results are surprising because it dismisses the view that a surgeon can achieve and maintain a top performance just by accumulating experience. It is thought that maybe the older surgeons may be loaded down with responsibility or be too easily distracted if they’ve been performing the same operation day in day out and that they would benefit not just from ongoing training but also better motivation.
James says: “The authors of the study were quick to point out that their findings may not be applicable to all surgeons carrying out all types of operations but they do suggest that surgeons may require more help and support in the early stages of their career and possibly as they get older as well. This could be difficult for many surgeons to accept but if it is the difference between a successful outcome and one where a patient is left with complications which will cause problems then perhaps they do need to swallow their pride and know when it is time to ask for assistance or to hang up their scalpel. Modern medicine moves so fast nowadays that it really isn’t unusual for a surgeon nearing the end of his career to be carrying out a very different procedure to that he was taught at the outset.”
Although not as a result of the study the Royal College of Surgeons have recently announced that from the end of this year they will introduce continuing professional development for medical revalidation as well as a system of regular five year doctor competence check ups.
James McNally is a partner in Slee Blackwell and a member of the Clinical Negligence team. If you are looking for a medical negligence solicitor he can be contacted on 01392 423000 or via email at [email protected]
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