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From Volume to Mastery: Reimagining Orthopaedic Residency Training in India
Naveen Jeyaraman1,2,3, Madhan Jeyaraman1,2,3, Swaminathan Ramasubramanian1
1Department of Regenerative Medicine, Agathisha Institute of Stemcell and Regenerative Medicine (AISRM), Chennai, Tamil Nadu 600030 India.
Introduction:
India's orthopaedic residency training continues to rely on volume-based paradigms, emphasizing procedure counts over skill mastery. The traditional "see one, do one, teach one" model inadequately prepares residents for the complexities of modern surgical practice. With India's orthopaedics market projected to reach USD 1.69 billion by 2034, the demand for technically proficient surgeons is intensifying. The current three-year residency structure compresses learning, resulting in superficial exposure rather than deliberate skill refinement.
Methods:
Applying K. Anders Ericsson's framework of deliberate practice, the manuscript critiques existing residency models and highlights the limitations of logbook-based assessments. It explores structured, feedback-driven training approaches as alternatives, emphasizing the role of simulation technology, objective performance metrics, and formal coaching in skill development. Faculty development in modern pedagogical methods is underscored as a critical enabler for advancing competency-based education.
Results:
Analysis reveals that current residency structures foster procedural volume without ensuring skill mastery. Simulation-based training, objective skill assessments, and mentorship demonstrate potential to enhance resident proficiency and patient safety. Integration of deliberate practice into the Competency-Based Medical Education (CBME) framework offers a pathway to measurable improvements in surgical competence. The editorial outlines a phased implementation strategy, recommending simulation benchmarks, faculty training programs, and regional simulation hubs.
Conclusion:
India's orthopaedic residency must transition from quantity-driven training to quality-focused skill development. A National Medical Commission directive mandating deliberate practice components by June 2027 is proposed to institutionalize this shift. By embedding simulation hours, objective assessments, and structured mentorship into CBME, India can cultivate a generation of orthopaedic surgeons equipped for expert performance, patient safety, and global standards of care.
