From Volume to Mastery: Reimagining Orthopaedic Residency Training in India.

Area of Science:

• Medical Education
• Surgical Training
• Orthopaedics

Background:

• Current Indian orthopaedic residency training prioritizes procedure volume over skill mastery, inadequately preparing surgeons for complex modern practice.
• The traditional
• see one, do one, teach one
• model and compressed three-year structure lead to superficial learning.
• The growing orthopaedics market necessitates technically proficient surgeons.

Purpose of the Study:

• To critique existing orthopaedic residency models in India using K. Anders Ericsson's deliberate practice framework.
• To highlight the limitations of logbook-based assessments.
• To propose structured, feedback-driven training alternatives for enhanced surgical skill development.

Main Methods:

• Application of deliberate practice principles to analyze current residency training.
• Exploration of simulation technology, objective performance metrics, and formal coaching.
• Emphasis on faculty development in modern pedagogical methods for competency-based education.

Main Results:

• Current training fosters procedural volume but not skill mastery.
• Simulation-based training, objective assessments, and mentorship can improve resident proficiency and patient safety.
• Integrating deliberate practice into Competency-Based Medical Education (CBME) offers a path to measurable improvements.

Conclusions:

• India's orthopaedic residency must transition from quantity-based to quality-focused skill development.
• A National Medical Commission directive for deliberate practice by June 2027 is proposed.
• Embedding simulation, objective assessments, and mentorship into CBME will cultivate expert orthopaedic surgeons.