Yes, surgical residents perform surgery. This is standard practice in teaching hospitals and is fundamental to how surgeons are educated and trained. A surgical resident is a licensed physician who has completed medical school, not a student. Residency is a structured, multi-year training period, typically lasting at least five years. This training allows them to acquire the specialized knowledge and hands-on skills needed to become independent surgeons. All procedures performed by residents are conducted within a highly structured framework of supervision designed to ensure patient safety and quality of care.
Defining the Surgical Resident’s Role
Surgical residency is a supervised, on-the-job apprenticeship that is necessary to develop competence in the operating room. Residents are fully licensed physicians who are specializing in a surgical field, distinguishing them from medical students. This specialized training is guided by the principle of “graduated responsibility,” meaning the resident’s independence and complexity of tasks increase progressively throughout their training.
The residency is organized into Post-Graduate Years (PGY), starting with PGY-1, often referred to as the intern year. Early years involve foundational tasks, such as patient history taking, physical exams, and assisting in surgeries. As a resident advances to PGY-2 and PGY-3, they begin to take on more complex patient management roles and perform specific parts of surgical procedures.
By the later years, such as PGY-4 and PGY-5 (Chief Resident), the resident is expected to lead surgical teams and perform more advanced operations. The supervising attending surgeon determines which parts of the operation a resident can perform based on the resident’s demonstrated skill, the complexity of the case, and the patient’s specific condition. This system ensures the resident gains necessary experience while operating within their measured capabilities.
Levels of Supervision During Procedures
Patient safety remains the highest priority, and all surgical procedures involving a resident are overseen by a fully qualified attending surgeon. The attending physician is the “surgeon of record” and retains the ultimate responsibility for the patient’s care and the outcome of the surgery. The level of supervision is strictly defined by national guidelines and depends on the complexity of the procedure and the resident’s PGY level and demonstrated competence.
Supervision is categorized into two main levels: direct and indirect. Direct supervision requires the attending surgeon to be physically present with the resident and the patient. This is often mandated during the most complex portions of any surgical procedure. This level of oversight is common for junior residents (PGY-1) or for any resident performing a procedure in which they have not yet demonstrated proficiency.
Indirect supervision is utilized when the attending surgeon is not physically scrubbed in, but remains immediately available. “Immediately available” means the attending is physically within the hospital or surgical site and can quickly join the operating room if needed. For routine procedures or for senior residents who have proven their skill, the attending may be available by phone or electronic device, ready to return to the operating room at a moment’s notice.
The attending surgeon makes a case-by-case assessment, which can lead to a higher level of supervision than the resident’s training level might otherwise require. For instance, a PGY-2 resident performing a common procedure might work under indirect supervision. If the patient has significant complicating health factors, however, the attending may switch to direct supervision. This flexible system balances the need for resident training with the commitment to safe surgical care.
Patient Consent and Disclosure
Standard informed consent procedures require transparency regarding who will be involved in a patient’s care, including the participation of residents. Before a procedure, the patient must be informed that the hospital is a teaching institution and that residents or other trainees may be involved in performing tasks related to the surgery. This disclosure ensures the patient is making a well-informed decision about their treatment.
The consent process should explain the roles and qualifications of the surgical team, including the fact that a resident may perform part of the surgery under the guidance of the attending surgeon. Patients have the right to ask questions about the training level of the individuals who will be participating in their operation. Providing this information well in advance of the surgery gives patients time to process the information and ask any questions they may have.
The degree of resident involvement disclosed often depends on how active a role the resident will play. If a resident will be leading a significant part of the operation, this is ethically important information for the patient to know. Ultimately, the informed consent process affirms the patient’s right to understand and agree to the conditions under which their surgery will be performed.