Here is my concerns for having tos surgery done at a teaching hospital.
One of the goals of a teaching hospital is to teach residents students and fellows. TOs surgery is very complex and a mistake can have devastating consequences. I requested at the times of my surgery not to have residents or fellows "help" to do the surgery because I didnt go all the way there to have someone practice on me. I am curious some of the bad outcomes I read here is related to the fact we were used as teaching subjects. Clearly when some of these MLB players have TOS surgery they go to nonteaching hospitals.

I suppose it depends on how the teaching is set up.
Maybe the students only watch & listen while the teaching surgeon does the surgery.

I don't recall many of the poor outcomes of the past mentioning teaching hospitals. I think it was perhaps surgeries done by surgeons that were not fully skilled in the complexity of the area.

There seems to be many more qualified TOS surgeons now, but depending on locations and distance some many need to travel.

I believe that it is illegal to have a resident or something "help" when you have specifically stated you do not want them doing the surgery. I would agree completely, I would not allow someone to practice on me either. Talk to your doctor about your concerns. Usually the helping actually is just observing, holding a light, closing up, and using you to point out anatomical structures and abnormalities. I don't mind someone checking out what's going on but I'm not keen on being a test subject!

The reason I posted this is because I am a OR nurse, and works with surgeons and vascular surgeons in major teaching hospitals. Boston, saint louis etc. and witnessed these cases being done by trainees. sometimes with complications because the surgeons don't even come in to the or until the surgery is half way done. Yes, even for TOS surgery. In many teaching hospitals they would refuse to operate on you if you dont consent to have trainees "help". When I say Help I mean doing alot of the procedures.

leftTOSer

If "help" is done in OR by Residents or Fellows does that have to be documented on Operative or Medical reports? How would one know if you were not told that this was to occur and there was no documentation?

chloecasy

it has to be documentated in the operative report as assistant.
I don't know how each hospital is but most major teaching hospitals have heavy resident and fellow involvment in these case, how else would they learn.

I too worked in 2 major teaching hospitals. I never allow "residents or students" work on me. If the "short coats" (med students) that follow my surgeons around want to look at me or ask questions that's fine. But I double check my chart to be sure what they said and wrote is what I said.

For surgery I make it clear and add it to the OP consent that STAFF DOCTOR ONLY perform any & all procedures.