(© Acronym - stock.adobe.com)
Researchers suggest regular and elaborate assessments to help doctors determine when it’s time for aging surgeons to put down the scalpel.
WACO, Texas — As the population of surgeons in the United States grows older, with over 40% projected to be 65 or older within the next decade, the medical community faces a critical challenge: how to ensure these skilled professionals maintain the sharp minds and steady hands needed to safely care for patients. A new paper published in the Journal of the American College of Surgeons offers a roadmap for navigating this complex issue, aiming to support surgeons throughout their careers while always keeping patient well-being front and center.
At the heart of the recommendations is a simple yet powerful idea – that assessing a surgeon’s abilities should be a career-long endeavor, not something reserved for their golden years. Just as commercial pilots undergo regular evaluations to confirm they still have the chops to fly, the authors argue, surgeons of all ages should receive periodic checkups on their cognitive and technical skills. This way, any hint of decline can be detected early, allowing ample time for additional support or, if needed, a gradual transition to less demanding roles.
Tests For Aging Surgeons
So what might these competency assessments look like? Currently, there are guidelines in place for mandatory cognitive evaluations beginning at age 65, and career transition planning at mid-career. Other countries like India and China have mandatory retirement ages in places. But no such policy exists in the U.S.
The authors suggest a wide range of tools, from computerized tests that gauge attributes like memory and reaction time to hands-on evaluations of a surgeon’s prowess in the operating room. The key is to use objective, validated measures whenever possible and to customize evaluations to each surgeon’s unique strengths and needs. By making assessments a routine part of a surgeon’s professional life, the goal is to normalize the process and avoid any perception of stigma or punishment.
Of course, identifying potential issues is only half the battle. That’s why the paper emphasizes the importance of pairing competency testing with proactive planning for how a surgeon’s career might evolve over time. Long before any sign of difficulty emerges, surgeons should be encouraged to contemplate their future and cultivate interests outside the OR. That could mean exploring administrative, teaching, or research roles within their institution or developing hobbies and relationships that will make an eventual move away from full-time surgery feel less jarring.
If and when assessments do suggest a surgeon’s skills are starting to slip, the response should be constructive and multifaceted. Additional training might shore up areas of weakness, while a modified schedule or narrowed scope of practice could play to a surgeon’s strengths. In some cases, shifting to a role like surgical assistant or consultant could allow a surgeon to contribute meaningfully without being the lead on high-stakes procedures. The authors stress that any such changes should be made collaboratively, with input from the surgeon, their colleagues, and their institution’s leadership.
How should hospitals and medical boards get involved?
Underpinning all of these recommendations is a fundamental belief that supporting surgeons throughout their careers is a shared responsibility. Hospitals and healthcare systems need to invest time and resources into competency testing and transition planning. Professional organizations like the American College of Surgeons (ACS) can provide education and advocate for policies that promote sustainable, fulfilling surgical careers.
And surgeons themselves must embrace a mindset of lifelong learning and adaptability.
“A significant number of physicians surveyed at the ACS annual meetings were not aware of their own cognitive decline, nor were many peers comfortable, understandably, calling them out and saying, ‘I’m concerned about my colleague,’” said lead author of the study Dr. Todd K. Rosengart, professor and DeBakey-Bard Chair of the Michael E. DeBakey Department of Surgery at Baylor College of Medicine, in a media release. “The ability to create a framework where we normalize taking care of ourselves and each other in a nonpejorative way is very important.
“Another important part of this study is that it addresses the question of who is going to lead this effort. Is it going to be the American College of Surgeons, the American Board of Surgery or other state or national entities?” Rosengart added. “If we abdicate this responsibility, is it going to be the federal government mandating what we do? Surgeons should take the leadership role in developing competency assessments and associated policy.”
A more thoughtful future for doctors and patients
The authors acknowledge that implementing their vision will take work. Busy surgeons may resist adding another obligation to their plates, while cash-strapped hospitals may balk at the upfront costs. But the potential benefits are enormous. By catching and addressing any competency issues early, before patients are harmed, these measures could prevent untold suffering. And by giving surgeons the tools and support to navigate career transitions gracefully, they could help preserve a wealth of accumulated wisdom and experience.
Ultimately, the paper argues, ensuring surgeons’ competency is about far more than evaluating individual practitioners. It’s about creating a culture of medicine that values lifelong growth, humility, and teamwork. In an era when burnout is rampant and public trust in institutions is fracturing, demonstrating a commitment to self-improvement and patient safety could be powerful indeed.
The challenges posed by an aging surgical workforce are not going away. As the number of older surgeons climbs in the coming years, a proactive, comprehensive approach will only become more crucial. By offering a blueprint for action, this new paper could help the surgical community get ahead of the curve and safeguard quality care for generations to come. The health of surgeons and their patients alike may depend on it.
“Too often surgeons think, ‘The day I leave the operating room is the day my life as I know it has ended,’” Rosengart said. “That can be frightening. We want to change that next chapter into something that physicians and surgeons will welcome as a new opportunity.”
