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Invited Critique
October 2002

Complacency: The New Attitude of the Surgical Resident—Invited Critique

Arch Surg. 2002;137(10):1197. doi:10.1001/archsurg.137.10.1197

Surgeons and trainees often refer to the 1960s and 1970s as the "days of the giants." It was an era of extraordinary surgical progress, including the development of parenteral nutrition, transplantation, and cardiac surgery. Training programs were also in their heyday, and chief residents were looked on as gods by their juniors. I trained during this golden age, and I recognized that it was a real privilege. However, despite the remarkable talent of my attending physicians and the strength of the resident corps, many things were wrong with residency programs in that period. Salaries were at the poverty level, and we all had desperate financial problems; imagine supporting a wife and child on $100 a month. The pyramidal system kept residents on their toes, but we were afraid to err not because it might harm a patient but because we might not make the cut. The work hours were appalling, and call schedules generally ranged from every other day to 2 out of 3 days. There was certainly no time for family life or play. Although the conferences were great because the attending surgeons were brilliant, there was no structured educational program, and we had to learn everything on our own. Scut work was a constant source of harassment.

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