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November 5, 2014

The Evolution of SurgeryThe Story of “Two Poems”

Author Affiliations
  • 1Office of the Vice Chancellor, University of California Davis, Sacramento, California
  • 2Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
JAMA. 2014;312(17):1737-1738. doi:10.1001/jama.2014.14448

As the American College of Surgeons is about to convene for its 100th annual meeting in San Francisco, it is relevant to understand the evolution of surgery in modern times. Several decades ago, surgeons were portrayed as male type A personalities. Surgeons were revered and respected and had implicit autonomy and authority. Patients rarely questioned the recommended treatment. The training model was pyramidal, with strong dyadic mentor-mentee relationships. Education was of the “see one, do one, teach one” approach. Experience was gained by being present to directly manage cases, in the hospital, on call every other night. Operations were mostly open surgical procedures in the main operating room, with surgeons often staffing more than 1 room. Patients typically experienced extended lengths of stay in the hospital until full recovery. Inpatient services were large, often with 50 to 60 patients on each service.

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