CHICAGO: The American College of Surgeons (ACS) released updated guidelines aimed at promoting surgeons' lifelong competency. The ACS statement focuses on enhancing patient safety and preserving physician dignity without imposing arbitrary age restrictions.
“There is no evidence to support excluding surgeons based on an arbitrary age. This work seeks to provide a data-driven framework supporting the entire surgical community,” said Patricia L. Turner, MD, MBA, FACS, Executive Director & CEO of the ACS. “This approach aligns with our commitment to patient safety, surgeon wellness, and the dignity of the profession.”
The ACS Board of Governors Physician Competency and Health Workgroup developed the updated statement, which builds upon an earlier ACS statement from 2015. A newly published paper in the Journal of the American College of Surgeons (JACS) informed some of the key guidelines featured in the updated ACS statement through a literature review of recent studies on the topic.
“We need to empower our surgeons to be involved in their assessments of competency throughout the entirety of their careers as opposed to focusing on the trigger of age,” said Adam M. Kopelan, MD, FACS, coauthor of the JACS article, Chair of the ACS Board of Governors Physician Competency and Health Workgroup, chair of surgery, Newark Beth Israel Medical Center, and chief of general surgical services, RWJBarnabas Health Northern Region. “By doing so, we can help destigmatize the concerns of aging on performance.”
Central to the guidelines is a suite of recommendations that advocate for surgeons' physical, mental, and emotional well-being throughout their careers. This includes rejecting mandatory retirement ages, instituting regular competency evaluations, and promoting transparent self-reporting of performance issues. The guidelines also recommend a series of career trajectory competency testing integrated with Ongoing Professional Practice Evaluations (OPPE), which are required for hospitals credentialed by a third party. The study suggests that validated neurocognitive assessments as part of these evaluations may be a proactive approach to identifying and addressing potential declines in performance.
“Importantly, maintaining this responsibility at the local, institutional level with guidance from national entities such as state medical boards, the American College of Surgeons, or the American Board of Surgery, could create universal recommendations that could be integrated into local assessments of relevant capabilities,” said Todd Rosengart, MD, FACS, lead author of the JACS paper and professor and chair of the department of surgery at Baylor College of Medicine.
Medical institutions, supported by overarching bodies, can tailor these guidelines to meet the unique needs of their surgical teams and ensure a cohesive approach to competency across the profession. Recognizing that smaller institutions may face challenges in implementation, the authors suggest that supplemental career transition education and training could be provided by professional societies, such as the ACS and other entities including state medical boards, with the guidance of clinical subject matter experts.
After retirement, if desired, “A senior surgeon can continue to contribute in many diverse ways,” said Dr. Rosengart. “An individual could serve as a wonderful first assistant to a more junior surgeon who could benefit from that surgeon’s skills and experience. Another surgeon, however, might decide they are ready to leave the operating room with the goal of helping the hospital institution in other ways. Think about all of the needs we have for talented and experienced physicians to support our institutions in quality improvement, research, education, or through mentoring, or coaching, or community outreach.”
To read the updated statement, visit the American College of Surgeons' website.
Study coauthors are Todd K Rosengart, MD, FACS; Jennifer H Chen, MD; Nancy L Gantt, MD, FACS; Peter Angelos, MD, FACS; Andrew L Warshaw, MD, FACS; Jennifer E Rosen, MD, FACS; Nancy D Perrier, MD, FACS; Krista L Kaups, MD, FACS; Gerard M Doherty, MD, FACS; Theofano Zoumpou, MD; Stanley W Ashley, MD, FACS; William Doscher, MD, FACS; David Welsh, MD, FACS; Mark Savarise, MD, MBA, FACS; Michael J Sutherland, MD, MBA, FACS; Anton N Sidawy, MD, MPH, FACS; Adam M Kopelan, MD, FACS
This study is published as an article in press on the JACS website.
Citation: Rosengart TK, Chen JH, Gantt NL, et al. Sustaining the Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy. Journal of the American College of Surgeons, 2024. DOI: 10.1097/XCS.0000000000000959
