When should surgeons retire?

Area of Science:

• Geriatric Medicine
• Surgical Science
• Neuroscience

Background:

• Global retirement policies for surgeons vary significantly.
• Ageing is associated with natural declines in human functional abilities.
• Increasing life expectancy raises concerns about the performance of ageing surgeons and patient safety.

Purpose of the Study:

• To investigate the impact of ageing on surgeon performance.
• To identify practical strategies for transitioning older surgeons out of practice.

Main Methods:

• A narrative review of MEDLINE-indexed articles using keywords 'ageing' and 'surgeon'.
• Article selection guided by Modified PRISMA guidelines.
• Inclusion criteria focused on studies exploring age-related brain changes and their effect on surgical performance.

Main Results:

• 36 articles were included from 1811 initial results.
• Significant individual variation exists in the functional abilities of ageing surgeons.
• Patient outcomes showed considerable variability linked to surgeon age, with a lack of specific neuroimaging research and performance markers.

Conclusions:

• Surgical competence assessment should prioritize individual functional ability over chronological age.
• Retirement policies for surgeons need to be informed by objective, individual-based functional assessments.
• Standardized, age-related surgical ability policies are currently lacking worldwide.