2017 Charles G. Drake History of Surgery Lecture

John R. Potts, III, MD, FACS, MAMSE

It came as a complete and very pleasant surprise to be asked by the Advisory Council for Neurological Surgery to give the Charles G. Drake History of Surgery Lecture at the 2017 Clinical Congress. The specific topic that I was asked to address was the future of surgical education. I did address that topic. But, because this was a name history lecture, because one cannot address the future without understanding the past, and probably in some part because I was a history major in college, I did so only after a review of the history of surgical education in the United States. This included a 30,000-foot view of the initial implementation of surgical residency programs, the evolution of subspecialization, the formation of the certifying boards, and the accreditation of surgical training programs. This was followed by a much more detailed review of trends in surgical education including changes in the length of training, changes in the demographical composition of surgical residents, and changes in the numbers of programs and residents. Other trends that were addressed included the use of simulation, increasing subspecialization, alternative formats for specialty training, and the promise of competency-based residency education. Only then was the requested topic of the future of surgical training addressed. In doing so, I used as a categorization vehicle, “The Good, the Bad, and the Ugly” to express my feelings about the already occurring, the probable, and the possible developments in the future of surgical education.