Dr. John Burroughs has been in the operating room for 18 years. Early in his training, he was recognized as having excellent surgical skills and with each surgical rotation in medical school he was persuaded to enter the particular field that he was presently training in. These included over the course of his training: general surgery; urology; ENT; orthopedics; vascular surgery; ophthalmology; and lastly ophthalmic plastic surgery (oculofacial plastic surgery). As a resident in ophthalmology, he was asked to help in training the more junior residents and then encouraged to pursue subspecialty ophthalmic plastic surgery training.
Over the years since graduating medical school, Dr. Burroughs has trained medical students, residents, and even other specialty trained surgeons on techniques he has learned and mastered. With this experience he has pondered what makes a good surgeon. Some physicians seem to have a good “surgical” sense while others just don’t seem to be able apply anatomic understanding with the physical aspects of performing surgery. Some very safe and competent surgeons are otherwise quite slow, whereas there are some surgeons who are very quick but not necessarily very good. One of his mentors, taught him you can be a really bad fast surgeon, but who has ever heard of a really good slow surgeon? There is definitely some truth to this statement. Some of the problems with being slow during surgery include: higher infection risk for longer cases; potentially more bleeding; more anesthesia and local anesthetic needs; and operating room costs.
Dr. Burroughs has noted that the very best surgeons seem to be the most efficient with their surgical steps. These surgeons are also flexible to perform some steps or portions of a surgery out of order if a piece of equipment or suture is not readily available (e.g., dropped to floor or an unexpected issue delays a step). Dr. Burroughs has seen many very manually dexterous individuals are not necessarily “great” surgeons . Judgment is very crucial as well in terms of which patients to operate upon and what procedures would serve the patient best as well as making mid-surgical adjustments during a case as the need arises. Great surgeons are by nature very competent and self-assured individuals that sometime can come across as arrogance. This is because it takes a unique individual and personality profile to be willing to learn and master surgery.
The very best surgeons often despite their high level of confidence are also willing to analyze their own successes against their own failure or suboptimal results. In other words, they are life-long learners and continually strive to become better. Some have said surgeons learn in their training “how to operate,” and then learn during the rest of their careers when and how not to operate. In Dr. Burroughs’ experience, he has respected the so-called “master surgeons” the most that also are compassionate and humble. There is a saying in surgery that the only way you won’t see complications is if you don’t operate. Thus, even the very best surgeons experience complications from time to time. Even for a seeming great surgical case that goes well with no issues during surgery, there can be postoperative adverse reactions and healing issues (e.g., infection, delayed or slow healing).
Dr. John Burroughs has been involved in teaching and contributing to the field of medicine since even before entering medical school while he worked as a research assistant for a plastic surgeon during his undergraduate years. He has over 40 publications, his first before even graduating from medical school, and several surgical textbook chapters. During his own fellowship surgical training, he taught others and several have also gone into oculofacial plastic surgery. He has recently also restarted teaching medical students from the Denver area.
A recent study was published in the New England Journal of Medicine, and a summary article can be found at the following link.