Surgery Residency: Drop-Out Nation?

In the first decade of the 20th century, William Halsted---using principles he had learned from watching German surgeons---- implemented a new model of training general surgeons in America. Replacing the old journeyman/apprenticeship paradigm was an intensive, arduous, all-encompassing program that integrated basic science with bedside patient care, emphasized repetition and volume under the tutelage of master surgeons, and introduced responsibilities and skills in a gradual step wise manner. Resident surgeons basically spent 5 years of their lives living at hospitals, immersing themselves completely in the acquisition of essential skills and knowledge. The Halstedian paradigm quickly became the standard across the nation as its tenets were adopted by the newly formed American College of Surgeons in 1913.For most of the next 90 years, he basic training model remained constant. Of course it was brutal and inhumane. Young men (almost all men, during these years) literally never saw their families. Pyramidal structured programs meant that most interns would never make it through the training. Something had to give. Pyramid programs are no longer acceptable. Work hour reform has allowed most residents to maintain at least a tenuous grip on sanity. But there are no panaceas when you are talking about training future general surgeons. If anything, the demands on a surgical trainee are much greater than even what I faced 15 years ago...
Source: Buckeye Surgeon - Category: Surgery Authors: Source Type: blogs