In Reply to Soualhi et al: I thank Soualhi and colleagues for their comments and certainly agree that the involvement of medical students frequently results in valuable additions to both quality and safety in patient care. Indeed, the study undertaken by myself and my coauthors was in response to calls at our institution to limit the participation of surgery clerkship students in procedures, including urinary catheter placement. I believe our findings provide strong support for the concept that including medical students in these procedures can be safely accomplished without resulting in patient harm while providing a valuable educational experience.
For many students, the opportunity to develop procedural skills in the controlled environment of the operating room represents not only an important component of their broader medical education but also a potential catalyst for their interest in procedural disciplines, including surgery. Preserving these opportunities for experiential learning is increasingly important as curricula in medical schools evolve to limit clinical experiences, such as overnight call, where students might have greater opportunity for hands-on involvement.1
Preserving safe, yet meaningful, procedural exposure may have far-reaching implications for the wellness of the students themselves given recent data on burnout among resident physicians in a number of fields, including surgery.2 In a study of surgical residents, my coauthors and I found that exposure to call and procedural experiences in undergraduate medical clerkships can meaningfully improve preparation for surgical residency and is associated with decreased rates of burnout during graduate medical training.3 Taken together, these data represent a compelling argument for student involvement in procedural skills.
David D. Odell, MD, MMSc
Associate professor, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois; firstname.lastname@example.org.
1. Barzansky B, Etzel SI. Medical schools in the United States, 2018-2019. JAMA. 2019;322:986–995.
2. Hu YY, Ellis RJ, Hewitt DB, et al. Discrimination, abuse, harassment, and burnout in surgical residency training. N Engl J Med. 2019;381:1741–1752.
3. Engelhardt KE, Bilimoria KY, Johnson JK, et al. A national mixed-methods evaluation of preparedness for general surgery 1 residency and the association with resident burnout [published online ahead of print August 12, 2020]. JAMA Surg. doi: 10.1001/jamasurg.2020.2420.