Measuring Surgeon Competence: The Role of Age and Retirement — Steven Maurice Clark
In many professions, age often comes with a mandatory retirement, ensuring that individuals step away when their performance may begin to decline. Pilots, for example, undergo regular cognitive and physical testing and have set retirement ages to guarantee safety. But what about surgeons? Unlike many other professions, surgeons rarely face mandatory retirement or formal, periodic assessments of their ongoing competence.
Why does this matter?
Surgery is a field where skill, precision, and quick decision-making directly impact patient outcomes. Surgeons do not typically have a set retirement age, and many continue operating well into their later years. While experience is invaluable, aging can bring changes in cognitive ability, physical dexterity, and stamina that might affect performance.
Can we measure when a surgeon has passed their “due date”?
The challenge is developing objective measures to identify if a surgeon is past the peak of their competence. This is not about age discrimination but about patient safety and ensuring the highest quality of care. Cognitive and physical testing similar to what pilots undergo could be part of the solution. Such testing would provide an evidence-based way to monitor surgeons’ ability to perform safely and effectively.
Not just about older surgeons
It’s important to note that competence concerns apply to any surgeon regardless of age. Skills can decline or plateau for a variety of reasons — physical injury, burnout, or lack of practice on specific procedures. So, rather than focusing solely on age, the medical community needs a framework to measure ongoing performance objectively throughout a surgeon’s career.
Resistance and reality
Proposals to introduce such measures often face pushback. Professional organizations and surgeons themselves might resist mandatory evaluations or restrictions on practice based on performance data. Yet, from a patient perspective, transparency about surgeon competence and safety is crucial.
The bottom line
There is an urgent need to balance respect for surgeons’ careers with accountability and patient safety. Objective assessments tied to age or physical and cognitive testing could help identify when intervention — such as retraining, supervision, or even retirement — is appropriate.
In Part 2 of this series, we will explore the other important metrics that can be used to measure surgeon competence beyond age — including surgical time, procedure complexity, and outcome data — and how these metrics can help improve patient safety and surgical performance.
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