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@NEJM Ask the Author and Experts: Breaking the Silence of the Switch — Increasing Transparency about Trainee Participation in Surgery

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Breaking the Silence of the Switch — Increasing Transparency about Trainee Participation in Surgery

Not all attending eye surgeons expect trainees to operate in silence, but many ophthalmology residents experience some variation on this scenario. Some surgeons speak openly as residents operate, and others even berate trainees for their technique, with little regard for patients’ perceptions. I never minded such tongue lashings; rather, I always dreaded the silent switch. The miming, soundless communication over the top of a fully alert patient is clearly deceptive and seems directly at odds with the trust required in a good physician–patient relationship.



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