A Thoughtful December


Welcome to our December Online issue. I hope you all have a happy holiday season and as prosperous a new year as Congress will allow.

Dr. Andros

We have some very interesting articles this month. In particular, I call your attention to the article on the American College of Surgeons’ response to new changes in resident work hours, and its very apt commentary by Dr. Cynthia Shortell.

Those of us who are not directly involved in the post-graduate education of residents and fellows are nevertheless affected by the flux in work hours that Dr. Shortell has commented upon. These matters are important to us all, as these are the future vascular surgeons who will be taking care of our patients and ourselves. They are our future partners and leaders of our specialty.

In his typically thought-provoking book “The Outliers,” author Malcolm Gladwell reminds us what it takes to excel, maybe not how to be the absolute best, but how to be the best that your talent will allow.

Besides luck it takes being around at the right time, and for young vascular surgeons the time has never been better. The vascular surgical tent is big and diverse. No one can perform our specialty as well as we can. But will the next generation of trainees be up to the opportunity offered to them because it also takes time on the job? As Gladwell tells us it takes 10,000 hours to be really good at something. Will the current work hours allow for the development of this kind of excellence? Can we afford to allow some of that time to be misdirected away from training to moonlighting? Dr. Shortell finds the issue to be astonishing and I cannot disagree.

If you have any opinions that you would like to express on this subject, I invite you to weigh in by writing me care of [email protected]

Also, be sure to note our other stories, especially the one on the potential dangers of an office visit by a recovery audit contractor and Dr. Russell Samson’s insightful comments on its direct relevance to vascular surgeons. Opinions on this and other stories are also welcome.


George Andros, M.D.

Medical Editor


Please enter your comment!
Please enter your name here