Doctor K: Surgeons must learn physical, mental skills

DEAR DOCTOR K: You often mention your colleagues at Harvard Medical School. I’m curious, what does it take to become a doctor at Harvard?

DEAR READER: We have several hundred medical students. They spend four to five years learning to become doctors.

The next step is residency and fellowship. This is a multiyear process when a newly minted M.D. gets additional training and certification in one of the medical specialties, such as internal medicine or surgery. Then, for many, comes further training in narrower subspecialties within each specialty. For example, internal medicine is divided into subspecialties such as cardiology, endocrinology or general internal medicine (primary care). The process of going through residency and fellowship can take three to eight years.

For a surgical trainee, the process of becoming an independent surgeon is a gradual one. At first, the trainee is just watching and learning. There’s always lots of book learning – textbooks and surgical research journals. And there are computerized simulations to help learn manual skills.

At Harvard, surgical residents must learn 139 essential surgical procedures by the time they’ve completed their training.

As soon as they’re ready, the residents enter the operating room. There, they work next to attending surgeons on appropriate cases for every level of their training.

There are lots of skills taught during medical school and residency. For surgeons, the manual procedures of doing surgery obviously must be mastered. But that’s not enough: The trainees need to learn coolness under fire and how to think clearly when things are not going “by the book.” Above all, they need to learn how to be members of a team – because surgery requires a team – and how to listen to, comfort and explain things to patients.