Apprentice surgeons

The general public is often told that doctors want to be more open in explaining their decisions and recommendations—and in admitting their mistakes. My own experience as an adviser to consumer groups suggests that substantial problems need to be overcome if patients are to be fully convinced that paternalism is dead.

Medical training, especially in surgery, has always been an apprenticeship system, with trainees working under supervision until judged competent to operate on their own. In theory the supervision should ensure that the patient comes to no harm, but the few research studies that have been done have found that trainee surgeons do have a higher rate …