Lack of Attending Surgeon Scrubbed and Resident Autonomy Are Not Equivalent

In their article, “Association Between Operative Autonomy of Surgical Residents and Patient Outcomes,” Oliver and colleagues¹ analyzed records from the Veterans Affairs Surgical Quality Improvement Program database to assess the association between resident autonomy and surgical outcomes. The lack of an attending surgeon being scrubbed was used as a surrogate for resident autonomy. Using propensity score matching, the authors found no statistically significant differences in patient mortality, all-cause morbidity, or length of stay between surgical procedures performed by residents alone vs those performed by attending surgeons alone or by residents and attending surgeons together.