Different Career Paths for Surgical Learning

The path to learning surgery is a long and challenging one. True success requires years of dedication and the passion to consistently learn from every case and evolve your technique every year. We have previously discussed the learning curve and even given a sample learning grid of cataract surgery steps during residency.

In my quest to learn more about cataract surgery every week, I frequently follow the teaching of many international experts. I enjoy watching the live streaming done by Lukan Mishev MD and the pearls of wisdom from Professor Milton Yogi.

Recently, I saw this graph posted by Dr Yogi and since he is Brazilian, it is in Portugese.

I have used this as a basis for making a similar graph in English.

This graph shows three paths in becoming a surgeon:

  • The blue line is the young doctor who cannot find the drive to push past the frustration barrier to become an ophthalmic surgeon. As such, this doctor will drop out of medicine, switch to a different medical specialty, or choose to be a medical ophthalmologist who does not perform surgery. Fortunately, this is a rare occurrence.
  • The red line is the surgeon who is able to get past the frustration barrier and become a competent surgeon. But the passion and the drive to be better and better, simply is not there. This doctor will be stuck in this zone of mediocrity forever and will simply do the techniques that were learned back in residency training.
  • The green line is the expert surgeon who has the drive and determination to learn from every single case and consistently evolve surgical techniques over the years. This surgeon embraces the very difficult cases and prepares diligently for them. This surgeon has the passion to be the best and will maintain that passion for decades. This is the true expert.

When it comes time for me to have surgery, be it cataract surgery, orthopedic surgery, or cardiac surgery, I want a true expert who has the passion to be the best. I’m sure you feel the same.

Click below to learn more about this critically important topic from the video:


  1. Hi sir. Just a query. Why are some people fast learners surgically( have better tissue handling early on in curve) while some are slow though both are exposed to same setting? How to be a fast learner so that we will be given more cases by mentors? Well at least that’s how it works in India.This thought has intrigued me and I searched on net and I couldn’t find answers.

    1. There is a bell curve of hand-eye coordination and manual dexterity. Practice can make a big difference as well as developing the abilities of the left hand (or non-dominant hand). No one is born knowing how to suture with 10-0 nylon, so the new surgeon who spends a lot of time practicing in the wet lab will have an advantage over those who do not.

  2. sir, i thoroughly enjoy cataract surgeries especially the complicated ones requiring thinking. i enjoy learning from your videos than anything else. i watch videos of many other surgeons too. i am a regular student of cataract coach

    1. thank you — I am glad that you are enjoying and learning a lot from this website. please tell your colleagues too!

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