[akor]

I work in Italy and a surgical resident doc had asked me this question. I used to work at a University hospital in the states a long time ago and don't remember. What year can they be the first operator? Do they have specific duties year by year? Thanks

[MsLeylaBar]

I'm not so sure what you mean by first operator. I have worked in many teaching hospitals and every surgery has an attending surgeon and an assistant could be anyone from an intern (R1) to a resident in their last year(R4-R5) or even a fellow. They tend to put R1s on simple surgeries first and the more senior you are, you get to assist on more complicated cases. Every program is different, I've worked in places where a resident is allowed to open and the attending comes by later in the middle of the case. (I hated it). Where I work now, the attending surgeon must always be present at the start, do the time out, and throughout the whole case, they just break scrub during skin closure. Not sure if I answered your question but feel free to elaborate.

[akor]

Thanks...you anwered my question. That's right,you call them R1 and so on( over here, we call them "specializzando"...I remember the attending surgeon always being there for the case except for the emergencies in the evening where the eldest residents would handle the case. We have two attending general surgeons here, each having their own equip of surgeons and residents. First year residents usually retract for a few months then start tying knots and so on...just like you said...the easy stuff first...Thanks again!

[core0]

Originally Posted by akor

I work in Italy and a surgical resident doc had asked me this question. I used to work at a University hospital in the states a long time ago and don't remember. What year can they be the first operator? Do they have specific duties year by year? Thanks

For the ACGME there is a requirement that a resident do a certain number of the cases as the primary surgeon. This usually starts in the 4th year and in the 5th year (chief resident year) a majority of the cases must be done as primary surgeon. There is also a requirement to do a certain amount of cases in the earlier years. In order to bill for the surgery the attending surgeon must be present for the critical portions of the case. A resident may do easier cases in their third or even second year but the bulk of the cases as primary surgeon come in the fourth and fifth year (at least around here).

David Carpenter, PA-C

[akor]

Thanks a million...