Safest surgeons are aged 35 to 50

SURGEONS aged between 35 and 50 provide the safest care compared with their younger or older colleagues, according to a new study.

Research published on bmj.com looked at operative complications at five hospitals in France. It focused on patients undergoing a thyroidectomy and found complications were more likely amongst inexperienced surgeons and those who had been in the job for more than 20 years.

The results appear to support previous studies which have shown experts tend to reach their peak performance after about 10 years in their specialty.

Older doctors who have been practising for a long time may have less factual knowledge and be less likely to adhere to evidence-based medicine which risks safety of care, studies have also shown.

Data for the bmj.com study was collected from more than 3,500 operations carried out by 28 surgeons. Researchers chose to focus on thyroidectomy because the procedure is generally carried out in the same way by all surgeons and has not changed substantially over the past few decades.

The results found that surgeons with 20 years or more of experience had three times the risk of a patient suffering recurrent laryngeal nerve palsy (leading to severe hoarseness) and more than seven times the risk of hypoparathyroidism (damage to glands).

The researchers also found that younger surgeons performed less well.

The link between a surgeon’s age and complication rates was irrespective of how complex the surgical case list was, which suggests it wasn’t because the older, more experienced surgeons were seeing the “harder-to-treat” patients.

The findings raise concerns about ongoing training and motivation of surgeons throughout their careers, although experts stress they are not conclusive and further research is needed.

The researchers from the University of Lyon said: "Optimum individual performance in thyroid surgery cannot be passively achieved or maintained by accumulating experience.

"Factors contributing to poor performance in very experienced surgeons should be explored further."

Professor Mike Larvin, consultant general surgeon and director of education at the Royal College of Surgeons of England, said: "Given the pace of change in medical innovation it is certain that a surgeon at the end of his career will be undertaking a nearly completely different range of operations than at the outset."