Surgical training programs such as at Northwestern University have the
responsibility of teaching resident surgeon how to do surgery, and surgery
is a "learn-by-doing" art. That urology resident will learn very little if
he just watches the operation.

The actual level of his participation will vary by training program policy,
his particular stage of training, the inclination of his supervising
physician. Depending on these and several other variables, the resident may
only watch the operation, assist the surgeon, do part of the operation, or
perhaps do all of the operation with the surgeon assisting and supervising.
It is the nature of medical education and has been since the time of Galen.

Resident physicians learn by taking increasing responsibility for patient
care with decreasing levels of supervision. High quality training programs
such as Northwestern take their responsibility to their patients very
seriously, just as they take their educational responsibilities very
seriously. Sometimes it's a difficult thing to balance. Patients at these
training insitutions have to trust their surgeon to balance these things and
assure that optimal quality is applied. In a responsible training program
quality of patient care does not suffer for their educational and training
obligations.

Residents are graduate MD's or DO's who have elected to specialize in a
particular area and spend 3-8 years training in that specialty after medical
school to learn all of the things they need to learn so that when they are
done, they will be competent to care for their own patients. They are
employees of the training program, not of any individual surgeon. All
residents are supervised by qualified doctors in that area who have been
through the same chain of training. In medicine, they say "see one, do one,
teach one". It would be unrealistic to think that such residents could
accomplish their training by simply watching prostatectomy after
prostatectomy for 5 years, then on the day they graduate go out and do one,
never having done one by themselves.

Northwestern's reputation as a high quality institution is generally
well-deserved. I'm sure you received excellent care. If a person is bothered
by the concept of having a surgical trainee participate in their care, and
cannot completely trust their surgeon to make sure that his/her operation
will be conducted according to the highest standards, then that person would
be better off seeking their care from a doctor in private practice not
affiliated with a training program and not supervising resident physicians.

HMc

At one point your doc was also a medical student and resident. He learn
sometime, too.

Most of the time, medical students help retract tissue so your surgeon can
see what he is doing. They also cut suture and stuff. As a medical student,
I only cut away tissue once. I did remove a lot of sutures and assist in
closing the incisions a lot. Residents did a lot more of the surgury, always
under the direct supervision of the attending, except that the surgeon often
left the resident and students to close while he talked to the family.

Nope.

No, doctors do not employ their own residents. If he was a resident, he was
employed by the hospital.

Yes. Only under the direct supervision of the attending.

Yes and medical students too.

No. You get a good result because the staff does interface with the surgeon
during surgery in a very appropriate and helpful way. For example, during
open heart surgery, it is vital that the techs who run the heart-lung
machine are competent and work well with the surgeon. Ditto for the
anesthesiology, nurses, etc.

Jeff

One of the great ironies is that for the best care, you go to a teaching
hospital where you will be looked after by interns and residents...

Did you ask him?

I'm not sure what the situation is here. Residents are not "employed"
by other doctors. The person employed by your urologist could be a
physicians' assistant or other paraprofessional. Again...did you ask
him who the other guy is?

Maybe. It depends on who he is. Some surgeons employ physicians
assistants who may assist during surgery (which may involve some of
"the cutting").

A good surgical outcome is rarely solely dependent upon the surgeon
doing "the cutting." It's a team effort. I recommend that all patients
ask basic questions prior to surgery, which should include how many
times the surgeon has performed that particular procedure at that
particular hospital, complication rates, and (if you're worried)
whether or not residents will be involved in your surgery. If you
prefer that they not be involved, you can always request it, although
frankly, I don't see any reason to be concerned as long as they're
supervised.