Abstract
Surgeons are committed to the principle of improving clinical practice through assessment of personal outcomes. Indeed, “practice-based learning and improvement” has been adopted as one of the 6 core competencies that are required areas of instruction and evaluation in surgical residency. Residents are encouraged to analyze their own experiences, ideally in a systematic fashion, in the hopes that this semi-objective process will lead to better patient care.
At what point does this reflective process begin, and how do we teach it? In our students, it is too early—there is an obvious need to experience surgical clerkships before it is possible to appraise their experience. For residents and fellows, it is worthwhile to hear about the process from those who have had the opportunity to reflect and are still close enough to training to speak the common tongue.
In this issue, Dr. Vadim Sherman examines some of the evolution of his thoughts on surgical training. As he has transitioned from medical student to resident, resident to fellow, fellow to attending, and attending to fellowship director, he has a unique vantage point to discuss training in minimally invasive surgery. I hope that you enjoy his commentary, and I look forward to your responses and reactions to this column.
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