The Evolution of Surgical Training: Perspectives on Educational Models from the Past to the Future

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Surgical education and training have progressed through the centuries, with the most commonly used model being the apprentice model. With advances in medical knowledge and practice, the apprentice model has evolved and competing models have arisen. However, the apprentice model remains the gold standard today, but for future use, further evolutionary changes will need to be made to the apprentice model if it is to continue to remain an effective education paradigm.

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Brief history of surgical training

Attempts at improving surgical education began almost a millennium ago, the first tiny steps in a long process to advance training in the craft of surgery and transform it from trade to profession. As medicine became more defined as a field of its own, efforts were made to separate the academic surgeons from barber-surgeons with little or no training. The College deSaint Come, established in Paris in about 1210 ad, was the first to do this by identifying the academic surgeons, those who had

Modern models of residency training

The residency system of training did not eliminate the apprenticeship model for those who wished to learn the art of surgery; it was the catalyst of evolution. Residency gave the apprenticeship model the structure, standardization, and stability it needed to train modern surgical residents. In fact, the ideas introduced by Halstead still provide for the position of a master or mentor who supervises and instructs his or her apprentices. The position of mentor is so valuable and rewarding, not

Future evolution

Given the failure of the Mall model of residency training to fulfill the demands and requirements of graduate medical education, apprenticeship-style or Osler model residency training programs have quietly, without notice, become the dominant standard for surgical training once again. With the ongoing requirements and monitoring of programs provided by the ACGME, many of the flaws of the apprenticeship model, such as lack of standardization and the “cult of the individual,” are eliminated,

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