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We need a competency-based curriculum for a new generation of surgeons

In our first post we asked: “Is the certified clinician for surgery truly prepared for the multifaceted challenges of the broader professional landscape?”


Recently, a study published in BMC Medical Education by our esteemed partners at Kantonsspital St.Gallen and Centre Hospitalier Universitaire Vaudoise has shed light on a notable concern: “Department chairs stated that the existing curriculum in Switzerland does not meet the requirements of a modern training curriculum.” Why? Because the existing surgical catalog does not adequately reflect the high demand for manual skills of the residents. This is particularly true for the minimal invasive surgery (MIS), a technique increasingly integral to various surgical procedures.

Source: Wczysla et al. BMC Medical Education, (2024) 24:205.

What is the problem? The evolution of MIS in the last 25 years has been driven by its compelling patient-centered and consequential economic benefits. Great for the patients. But what about the surgeons? MIS demands surgeons to operate at the pinnacle of their perceptual, cognitive, and psychomotor abilities: Eye-hand coordination within a 3D-scene observed on a 2D-screen, attenuated haptic perception and feedback; fulcrum effect that leads to a scaling of the movement, limited freedom of manipulation and suboptimal ergonomics.

Attaining mastery in these skills requires repetitive training to enhance the performance. While major hospitals may offer ample patient volumes for such training, smaller hospitals where residents are also trained face significant limitations. This is where state-of-the-art training modalities such as simulator- and data-based surgical training come into play.

The advantage: This kind of training enables precise assessment and individualized feedback facilitating proficiency-based performance. Residents engage in repetitive practice, honing their skills on simulated procedures and grappling with potential complications until they achieve the necessary proficiency scores to operate on real patients. The duration of the residency depends on the invested training time outside the clinical setting as well as the individual talent.

We firmly believe that embracing these advanced training modalities will not only enhance surgical proficiency but also address socioeconomic challenges such as 48h working-hour limits, family commitments, and the pursuit of a work-life balance. Relating to this, also watch “Rundschau - Lieber Teilzeit statt Überzeit: Der Generationenkonflikt im Spital”, a production of the Swiss television SRF, broadcasted 28.02.2024.


This is why we work intensively on our Innosuisse Flagship project PROFICIENCY.


Stay curious - follow #atSurgicalProficiency 


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