Training with the aging urologist

"Aging faculty can bring out techniques not seen except in the depths of an old surgical atlas," the urologist writes.

Training with the aging urologist comes with both a multitude of positives and the occasional negative. There is a degree of understanding the past that comes with more senior faculty. Whether it’s stories from a time gone by, or the history of a particular procedure, aging faculty help a young resident understand more than what is put on the table in front of them. I have had many an opportunity, consensual or not, to hear stories from the glory days. The amalgamation of these stories throughout the many years of the training process molds a trainee into the professional they will eventually become.

Occasionally, aging faculty seem stuck in their ways. A newer or more technological procedure may be appropriate for a patient’s needs, but a more senior faculty may choose an older "gold standard." To the trainee, this can seem outdated. But many of these procedures remain efficacious in well-trained hands. Aging faculty can bring out techniques not seen except in the depths of an old surgical atlas. Not all of these old techniques or skills are worthwhile to master in today's setting, but understanding them can be an imperative to understanding an historical perspective.

Is there a possibility of harm to patients while training with aging faculty? Many of us have seen the attending who is present in name only, the attending who “supervises” at the VA while residents run the show. Is there someone in today’s system to tell these people that their time is up?

The biggest conundrum in training with more senior faculty is existential in nature. The young trainee is always looking in front of them for the life they may lead. They have chosen hard work, constant struggle, but a fulfilling career. However, when a trainee looks at an aging faculty, he or she cannot help but wonder if that is the future in-store for them. Because in training, life tends to shrink around us. We want to believe that when retirement comes around, we will be ready to turn off the expressway. We sometimes struggle with the urologist that works deep into their 70s or 80s. We ask ourselves, is this the future in store for us? Are we preparing for a life where work leads to death? We must try not to project this thought process onto them and remember that for many, working into a senior role is a choice, one that when it comes time, we will all have to make. Ultimately, we should all hope to have careers that we can choose to end if we desire. Training with aging faculty teaches important lessons. And it is the right balance of the lessons with a young ambitious trainee that has molded me into the product I have become.