Saturday, September 25, 2010

Surgical Education

It is predicted that over the next ten years, as the baby boom generation ages, that there will be a shortage of available general surgeons to address the expected surgical needs of this aging population. Indeed, many general surgery residency programs have been finding it difficult to fill all their categorical positions, that is those positions that lead to a finished general surgeon. As more and more of the population reach retirement age, it is anticipated that the incidence of GI cancers, breast cancer, peripheral vascular disease and many other maladies prevalent among this age group will increase and there is a growing concern that the already overworked specialty of general surgery will be unable to adequately meet the challenge.

The recently passed Healthcare Reform act has squarely attacked this growing problem with several new and innovative pilot programs. The Simian Surgical project, previously reported on these pages is one such program. Another pilot program, to be headquartered in Phoenix, Arizona, is the ICS Surgical Education Program. This ground-breaking initiative, funded by an NIH grant through the recently passed healthcare bill, has as its goal to seek out highly skilled young persons and train them as surgeons. Currently, it takes many years to train a general surgeon. Four years of college, followed by four years of medical school and, then, five to six years of surgery residency is the current pathway to becoming a general surgeon. The new, innovative program will streamline this pathway considerably.

Dr. Albert Scheinbach elaborates, “Recent studies suggest that highly skilled technicians can adequately perform the necessary surgery to prevent the shortfall of qualified surgeons that this country may face in the coming years. Our aim is to find the future stars of surgery at a young age, perhaps as young as nine or ten, train them in the most modern techniques, utilizing the most modern equipment available and prevent what could be tragedy for so many of our elderly.”

Dr. Scheinbach explained that the initial phase will be one of recruitment. Carpet advertising in the most popular and widely read graphic journals*, as well as recruitment in various projection oriented arcades should allow the program to find young men and women with appropriate hand-eye coordination to perform the many surgical procedures at the highest possible level. It has been clearly demonstrated that surgical skills are directly correlated to scores achieved on “Donkey Kong”, Super Mario Brothers” and “Need for Speed”. However, besides demonstrating the necessary hand-eye coordination the recruitment process will also require the applicants to be able to fill out the application; the prospective surgeon will actually have to have the skill to legibly write their name and address, including postal code, on the form that will be available with the advertisement. Once accepted into the program, a vigorous, but compassionate educational and training regimen will commence.

From the comfort of their own home the student will be sent a weekly package containing the training materials, including educational manuals and anatomic parts. An instructional audio CD written by James Weldon Johnson**, famous spiritual composer, will accompany the material and will provide the student with detailed directions to allow him or her to complete the required tasks. At the end of the semester the student will be expected to return all the body parts properly assembled and fully functional. Those that pass this portion of the training will be allowed to progress to the final examination.

The final exam will be administered by the surgical staff of the University of Phoenix, International Correspondence Division, and will consist of a didactic portion as well as an actual operation. Dr. Scheinbach explains:

“The home centered education portion is not considered completely adequate training to allow our students to enter the operating theater unattended. The candidate for graduation must demonstrate the necessary dexterity to be a safe surgeon. The final exam will consist of a series of simulated procedures utilizing a standard model, Operation*** and then a computer graphics module****; successful completion of this phase is followed by an actual operation. The candidate will be assigned a random operation ranging from a simple appendectomy to a pancreatoduodenectomy. These highly skilled young people will be required to perform the assigned procedure assisted by standard operating room personnel. A grade of 70 % on this portion of the exam will be necessary to pass and be issued a diploma. The graduate will be bestowed with the degree ‘Doctor of Surgery’.”

A spokesman for the Obama administration stated that the supposed complexities of most operations are exaggerated and overstated. We believe that any properly trained person, with the necessary manual dexterity and assisted by the computer modules that our team has developed, can successfully perform most of the surgery necessary for the aging baby boomer population. He added that, initially, these newly trained surgeons will provide service limited to Medicare patients. It is anticipated that as the program becomes established and the significant cost savings are realized private insurers will jump on the bandwagon.

The initial pilot program will have 500 participants with initial training expected to be completed by January 2012.


* “Teen Titans”, “Astonishing X-Men”, “The Incredible Hulk”, “Spiderman”
** “Dem Bones, Dem Bones, Dem Dry Bones” Lyrics and music by James Weldon Johnson
** “Operation” Hasbro toys recommended for ages 6&up
**** “Virtual Surgery, For the Beginner”