Anecdotes in support of this comment:
I lived with a orthopedic surgeon doing a specialization in pediatric orthopedia.
He was very very very good based on my understanding of the places he had worked, the offers he had to undertake his specialization, the change in operation waiting times and his model of how he worked within the hospital, and that immediately after returning to his home country he was head of the newly created orthopedic pediatrics ward.
His description of how he would approach a surgery was straight-forward:
- he would review the surgical referral, his notes from his patient intake
- he would review appropriate notes and documentation from the hospital on the allowed surgeries allowed, including reference texts on that particular surgery
- he would create a full plan for entering, performing, and exiting the operation
- (surgery)
- he would review the plan, add notes on how it actually went
So it's not like he woke up, walked into a surgical room, and ad-libbed it.
As an anecdote, he said he liked B-students for his surgical teams because they had to work hard to get there.
I also was good friends with a very nerdy emergency room doctor. He offered the anecdote that he was "called out" for using Google. His justification was that "once you throw in the appropriate medical terms, all you're getting is the latest research on treatments--and I was attempting to offer the best and latest in proven care". He also made the several changes to the shifts at the ER, including using time-sheet and patient data to show that patient outcomes suffered during longer doctor shift rotations. His anecdote on his schooling; "I was a bad student, and I'm a poor doctor, but my job is to get you stable until we can intervene properly". He funded a startup and wrote (in Java) a medical EMR system.
