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Surgical education in the 21st century: implications for sexual medicine

International Journal of Impotence Research volume 32, pages 544–546 (2020)Cite this article

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A Correction to this article was published on 14 April 2020

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Surgical teaching is traditionally achieved by the “see one, do one, teach one” principle that was introduced by doctor William Halsted. This training principle in its essence is still being followed in residency programs, where residents under the “apprenticeship model” are trained by experienced surgeons. Legal issues caused by a growing number of lawsuits, increased emphasis on patient safety, escalating awareness and assertiveness of patient care, restriction in resident work hours and shorter training programs have put an increasing stress on this training strategy. Due to this training model, many surgeons nowadays start their active career at a stage where they have only limited or even no knowledge on how to perform technically demanding procedures proficiently with acceptable outcomes. This in part may explain the high complication rates, e.g., in colo-rectal surgery up to 36% [1] and in hernia repair up to 17% [2] resulting in increased health care costs to cover readmissions and additional procedures. As an example, it should be quoted that nearly 25% of the total budget of surgical cost in the United States goes toward the treatment of such complications. Improving surgical training is therefore of the utmost importance to provide the best care possible for our patients. To reach this goal we need a structured, standardized training program that is reproducible and applicable to all kinds of surgical procedures. The ideal pathway forward would be one combining theory-based with practice-based learning.

If we put this into the perspective of the 50,000 penile implant surgeries performed worldwide annually, where the majority of these cases are performed by low volume implant surgeons (<4 cases/year) with higher complication rates. To avoid these pitfalls a standardized, well-structured, and reproducible training curriculum is required for these surgeons to reach proficiency in specific surgical fields such as penile implant surgery [3, 4].

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Acknowledgements

This surgical education program is an ESSM (European Society for Sexual Medicin) initiative designed and developed within the scientific board of ESSM. The certicate that will follow after completing this Surgical Academy will be given by ESSM.

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Authors and Affiliations

  1. Department of Urology, Jessa Hospital Hasselt, Hasselt, Belgium

    Koenraad van Renterghem

  2. Faculty of Medicine, Hasselt University, Hasselt, Belgium

    Koenraad van Renterghem

  3. Department of Urology, University Hospitals Leuven, Leuven, Belgium

    Koenraad van Renterghem

  4. Department of Urology, University of Rochester, Rochester, New York, USA

    Ahmed Ghazi

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  1. Koenraad van Renterghem
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Correspondence to Koenraad van Renterghem.

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van Renterghem, K., Ghazi, A. Surgical education in the 21st century: implications for sexual medicine. Int J Impot Res 32, 544–546 (2020). https://doi.org/10.1038/s41443-019-0218-8

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