'The Actualized Neurosurgeon': A proposed model of surgical resident development.

'The Actualized Neurosurgeon': A proposed model of surgical resident development.

World Neurosurg. 2016 Dec 21;:

Authors: Lipsman N, Khan O, Kulkarni AV

Abstract
Modern neurosurgical training is both physically and emotionally demanding, posing significant challenges, new and old, to residents, as well as programs attempting to train safe, competent surgeons. Models to describe resident development, such as the ACGME competencies and milestones, address the acquisition of specific skills, but largely ignore the stresses and pressures unique to each stage of resident training. We propose an alternative model of resident development adapted from the developmental psychology literature. Our model identifies the challenges that must be met at each stage of junior, intermediate, and senior/chief residency, leading ultimately to an "actualized" neurosurgeon, i.e., one who has maximized his/her potential. Failure to overcome any one of these challenges can lead to specific long-lasting consequences, including regret, identity crisis, incompetence, and bitterness. The actualized surgeon, in contrast, is one who has successfully acquired the virtues of hope, will, purpose, fidelity, productivity, leadership, competence and wisdom. They are clinicians who not only function safely, confidently, and professionally, but who have successfully navigated the challenges of residency and emerged from them having fulfilled their maximal potential. We believe this developmental perspective provides an individualized description of healthy surgical development. Our model allows programs to identify the basis for residents who fail to progress, counsel residents during their training, and, perhaps, help identify resident candidates who are better prepared to meet the developmental challenges of residency training.

PMID: 28012887 [PubMed - as supplied by publisher]

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