The second assistant in cardiac surgery

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CTSNet classification: 2, 20

To the Editor:

I thank Dr Zamvar for his appreciative comments¹ on my editorial entitled “The second assistant in cardiac surgery: the challenges and answers.”² As Dr Zamvar rightly points out, the position of second assistant is to be seen as a great opportunity for surgical training and not a burden. As surgical trainees, we often have the mindset that surgical training is all about cutting and suturing, of doing rather than watching. The second assistant position in a way enforces a temporary pause in this “cutting and suturing” ritual, allowing the trainee to think and redefine his or her techniques. Indeed, it is very easy for the mind to drift, and the trainee has to make a conscious effort to stay focused. The ability to make sharp observations and stay focused for long durations is often not an innate skill and has to be developed over time. These mental faculties are as important as hand skills in the making of a good surgeon. The second assistant position offers a unique opportunity to develop these skills. I also agree with Dr Zamvar that the new laws enforcing limited hours of working on trainees³ will take away a great opportunity from the current generation of surgical trainees.

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References 

1. Zamvar V. They also serve who only stand and wait. J Thorac Cardiovac Surg. 2010;139:798
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2. Kumar TK. The second assistant in cardiac surgery: the challenges and answers. J Thorac Cardiovasc Surg. 2009;137:1311–1314
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3. Council of the European Union. The European working time directive. Council Directive. Brussels, Belgium: Council of the European Union; 1993. Publication no. 93/104/EC.1993.
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