To continue your analogy. Your mate from the pub can also be a trained surgeon. Just because they are in a pub, drinking cheap beer, and don’t have a surgeon badge/uniform with them doesn’t mean that their answer is less valid.
Right, that would be a good argument IF we were talking about a bunch of random people whose rank is completely unknown, and in fact this sort of heuristic is the usual, common sense one that leads to the situation we're describing (and that can be exploited).
The KEY information here is that they're at the same rank. That means the slob has had to overcome people using the heuristic you've just described in order to reach the same rank, probably through being an objectively better surgeon.
The OP is talking about surgeons, not doctors. The two are entirely different professions; it's like conflating doctors with nurses, or doctors with medical researchers.
Probably an amateur learner cannot access cadavers or whatever they use to train on, and this field virtually demands hands-on experience to be considered knowledgeable. Which would mean yeah, good choice of response to the original OP.
I wouldn't care how my surgeon learned, so long as he was currently the best surgeon I could find.
Can you imagine asking the surgeon: “What is a scalpel? What kind of scalpels are there? Now, cut this cadaver as if you were to perform an appendectomy. Good. Now imagine that there were some complications–show how you’d cut in that case.” I hope you are having a good laugh, because such a situation is unimaginable.
Not unimaginable at all. In a world where surgery was run like software "engineering" [1], we would interview surgeons this way.
Why don't we interview surgeons this way?
(a) Because surgical training is via apprenticeship. For any given surgeon, you can ask "which group of other surgeons taught you everything you know? Which ones signed sworn statements that you are minimally competent?" Then you can find those senior surgeons and ask them candid questions about the candidate. This is always possible. If a surgeon turns up without such references they don't get as far as an interview. ("I taught myself surgery from blog posts, and I practiced on my cats?" Eeeek. NO HIRE.)
(b) Thanks to the long history of medicine and its very serious life-and-death implications, surgery is a very thoroughly attested event with a very definite chain of responsibility. Look at a hospital's records for a given surgery, and you will get a complete list of everyone in the room. If the surgeon was the only surgeon in the room, you can be fairly confident that they handled the operation themselves. And though I'm not sure there's an actual law that forbids a surgeon from handing the scalpel to a nurse, or an intern, and having them do everything, that would (a) not be something they could do in secret; everyone in the room would know and (b) the surgeon-of-record would still be the responsible party: If something went wrong in surgery guess who would be sued?
What I'm saying is: It is hard to bluff being a surgeon. Which is not to say it doesn't happen: For various all-too-human reasons, doctors and nurses do cover for each other, and scandals occur. But it's not like software, where the level of bluff is really, really large. Software "engineers" are often self-taught by necessity, especially in the tasks they actually do all day; their work has no legally defined standards or practices; there are so many ways to solve a given problem that two engineers with the same job title and official responsibility may have completely different skillsets; they work largely inside their own heads where nobody can see what is going on; they can very easily copy others' work, or sit in the corner while the rest of the team does the heavy lifting and then claim full credit.
---
[1] For this post, I'm going to use these scare quotes to distinguish "software engineers" like myself from actual Professional Engineers, who are like surgeons and are not, in fact, asked to build little bridges out of Lego bricks during their job interviews.
Ironically your argument fails as it depends entirely on skill level. A highly skilled surgeon could perform emergency surgery without standard resources, and you could run an emergency hospital without receptionists.
I didn't want to just guess this - there's enough misinformation driving this particular metaphor - but in fact I was pretty darned sure that, in addition to all the stuff I mentioned, every surgeon travels with the equivalent of a formal certification that he or she has passed the surgical equivalent of fizzbuzz.
>Do physicians have to perform surgery to demonstrate their knowledge when they change hospitals?
Not sure how serious you're being but the answer is yes, surgeons seeking to change from hospital A to hospital B have interviews where a surgeon from hospital B will visit hospital A to supervise a surgery or other operation. Depending on how critical the position it may even be a partner from one hospital doing the supervision. In fact nowadays the supervision can be done remotely.
Furthermore surgeons are required to maintain their accreditation by earning credits on a yearly basis through continuing education and/or training and they do so on their own time.
These guys don't mess around and if you think surgeons get hired because of their wonderful personality then you sorely underestimate the medical profession (and overestimate their personality ;P ). It's incredibly competitive, demanding, and prestigious in almost every sense imaginable.
There is also a big difference between a profession that respects the intelligence of their peers and one where people assume that their peers are ignorant and lack common sense.
Surgeons must act fast and be good at multitasking. I bet they are not in a forum discussing if those traits make them vulnerable to hasty decisions and to loss of concentration on the task at hand.
To paraphrase: Why can't we just let surgeons state the degree of medical training they have and explain how often they get training and who does the training etc? Then let people decide who they want to have surgery from. No gambling required. We can even expect surgeons to freely offer this information themselves, because it will make their services more attractive.
Remember we are talking about interactions between free individuals here. No one is forced after a critical, life-threatening accident to go to the nearest location such as Bob's Discount Surgery, "Where sterilization is for sissies. Check out our 50% off amputation special."
It sounds stupid because that analogy doesn’t work. A surgeon can’t properly do most kinds of surgery on themselves, some are down right impossible. There’s nothing a mechanic can’t do to their car that they can’t do for their costumers.
Yes. That's part of what makes that surgeon a professional - that they ignore their bias and do their job. If they cannot provide that standard of conduct they are unfit to be a surgeon.
reply