This is an unfortunate situation where a resident surgeon in training is being forced to operate alone without supervision by a more experienced surgeon (a consultant, professor, or attending surgeon). I wish this would never happen, but the reality is that it does and it has been an issue for many decades, even back when I was a resident. If you are a patient reading this, it behooves you to read the fine print when you sign up for surgery at a university hospital.
It is unsafe and inappropriate for an ophthalmology resident to perform cataract surgery alone without supervision from an experienced attending. Cataract surgery, while common, is technically complex and carries serious risks. Residents are still developing their surgical skills, decision-making, and ability to manage complications in real time. Without direct supervision, they may not recognize early signs of trouble or know how to intervene effectively when complications arise.
An experienced attending provides critical guidance, ensuring patient safety and optimizing outcomes. Supervision allows for real-time teaching, reinforcement of proper technique, and intervention if the case becomes difficult. It also ensures that the resident works within their competency level. Performing unsupervised surgery may violate ethical and legal standards of care, may put patients at risk, and can undermine trust in the training institution, usually a university.
Furthermore, the goal of residency is to learn—not just to complete procedures. Structured supervision ensures that residents gain not only technical skills but also judgment, efficiency, and confidence under expert mentorship. Allowing a resident to operate independently before they are fully prepared compromises both patient safety and the integrity of surgical education.
What would you do in this situation? What advice do you have for our anonymous resident surgeon in training? Please comment below.
