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June 22, 1963

Utilization of Private Patients in Surgical Education

JAMA. 1963;184(12):930-933. doi:10.1001/jama.1963.03700250066009

Surgical education faces a dilemma: More patients can afford private surgical care, and yet young surgeons must operate if they are to become competent. A program utilizing private patients for training of surgical residents is described. The program combines advantages of both the preceptorial and the residency systems of training: (1) personal relationship between surgeon and resident, (2) detailed supervision, (3) graded responsibility, and (4) opportunity for independent judgment. In the first three years, the resident's entire surgical experience is with private patients, under the supervision of the patient's surgeon. Ward patients are reserved for the senior resident. The program requires surgeons devoted to teaching, properly indoctrinated residents, and open communication with patients.