In the demanding and intricate field of surgery, becoming a successful trainee requires more than just technical skills and knowledge. I currently straddle both roles: a trainee for more complex, super-specialized procedures, and a trainer for more junior trainees. This unique perspective has given me insights into how to maximize training experiences. Here are some key strategies and tips to enhance your training and become a trainable surgical trainee.

1. Defining Learning Objectives

One of the most crucial steps before any surgical procedure is defining your learning objectives. Spend at least five minutes before the operation to review scans and discuss the steps with your trainer. Clearly state what you hope to learn or which steps you want to perform or struggle with. This sets clear expectations and prevents any miscommunication during the procedure.

An inexperienced SHO once asked to place the first laparoscopic port during the operation. As I had never operated with him before and knew of his limited experience, this was not the right time to make such a request. Always ask for specific tasks before, not during the operation.

2. Knowing the Operation

Arriving unprepared for a procedure is not a good start. Even if it is not your specialty, you should have a basic understanding of the steps involved. If you are assisting or there to boost your numbers, inform your trainer if you haven’t had time to study the procedure. This transparency helps trainers understand your current knowledge level and provide appropriate guidance. Additionally, you can draft a case-based discussion for your logbook and get it signed off by your trainer immediately.

3. Knowing the Patient

This is a critical step that many trainees overlook. Always know your patient before the procedure. This means examining the patient, and reviewing their scans and bloodwork. If you do not do this, most trainers will not allow you to operate. Another pro tip, always follow up the patient you operated on. Belive me, your trainers will know and this will definitely put you in a positive light.

4. Knowing Your Limitations

It’s important to recognize your limitations and not feel pressured to know everything. The old adage “see one, do one, teach one” is not safe or realistic for most people. When using an unfamiliar instrument or device, I call out each step and proceed slowly. This not only ensures safety but also builds trust with your trainer.

When using a ligasure, I demonstrated its use several times before allowing the trainee to try. Even then, I could see his fingers going the wrong way. So, when know when to slow down.

5. Knowing When to Ask

Avoid asking to perform high-stakes tasks during critical moments of the surgery. Recognize the critical steps and, if you haven’t pre-agreed to perform them, do not ask at that point. Instead, request to perform less critical steps to showcase your skills and build up to more complex tasks gradually.

During a complex bowel resection, the trainee asked if he could ligate the thick mesentery. Given the complexity and risk, I declined. However, allowing him to ligate the mesentery of the resected bit, a less risky task, provided an opportunity to showcase his skills.

6. Becoming an Educated Assistant

Effective camera navigation and retraction are essential skills for laparoscopic surgery. Also, in major laparoscopic surgery, the camera holder is not only the eye and the third hand, but also need to know where excatly to show. If you struggle with these tasks, slow down and ask for guidance.

When my trainees struggle with the 30-degree camera. We slow down, and I provided guidance on camera navigation. Sometimes, i have to take the camera by myself, as he could not understand what I meant.

7. Supporting Your Trainer

During surgery, especially difficult cases, support your trainer without offering unsolicited advice unless patient safety is at risk. During a challenging operation, my consultant thanked me for my support, acknowledging that the procedure might not have been possible without it. Understand that surgery is a team effort, and showing emotional intelligence and timing in your suggestions can earn the gratitude and respect of your trainer.

8. Debriefing and Seeking Feedback

Always seek feedback immediately after the procedure. Reflect on the experience, write down key points, and incorporate them into your learning objectives for future operations. This continuous feedback loop is vital for growth and development as a surgical trainee.

After a procedure, my trainee left without debriefing. This missed opportunity for feedback could have been valuable for both of us. While i am reflecting, what i could have done better; I have no idea whether he even has that insight! Always seek feedback and reflect on it to maximize your training benefits.

By cultivating these qualities and strategies, you can significantly enhance your surgical training experience, ensuring you gain the most from each procedure and develop into a competent and confident surgeon.