{"id":24355,"date":"2013-02-08T15:43:39","date_gmt":"2013-02-08T14:43:39","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=24355"},"modified":"2013-02-08T15:43:39","modified_gmt":"2013-02-08T14:43:39","slug":"domhnall-macauley-the-surgeons-who-are-not-doctors","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/","title":{"rendered":"Domhnall MacAuley: The surgeons who are not doctors"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"Domhnall Macauley\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg\" width=\"162\" height=\"110\" align=\"left\" \/>\u201c<a href=\"http:\/\/www.bbc.co.uk\/news\/health-20629396\">The surgeons who are not doctors.<\/a>\u201d<\/p>\n<p>Reading this headline, I expected a story on training healthcare workers as surgical technicians in some under doctored developing country. But no, it was in the UK. I was intrigued.<\/p>\n<p>Medicine is introspective, protective, and doctor centric; self regulating and self directing. Places at medical school are highly prized, access is increasingly competitive and based on academic achievement. We have created a professional fiefdom. But, could others do the job better?<!--more--><\/p>\n<p>Watching skilled craftsmen is a pleasure. I marvel at cabinet makers, boatbuilders, plasterers, tilers, and plumbers. A job well done looks easy and, if I need a hip placement or knee surgery, I hope that my surgeon has the skills and finesse of the master craftsmen. But, where will my surgeon have learned these skills and were they always \u201cgood with their hands?\u201d Unlikely. Being bright at school, they were probably diverted down an academic stream at school\u2014the bookworms and academic nerds separated from those more vocationally skilled. Surgeons will have spent their most formative years with their heads in a book leaving little time left to develop fine movement skills, hand eye coordination and train a plastic brain in neuromuscular coordination. At school and university they had to read, write and recite and progressed by examination rather than apprenticeship. Where was the skills training at a time when skills are learned best?<\/p>\n<p>Working backwards\u2014if you could identify the skills needed for surgery and choose those teenagers with most talent for technical skills, you wouldn\u2019t choose the academics. You would train those with the best manual dexterity; the skilled mechanics, woodworkers, electricians and metal workers. These are the craftsmen (and women) I would like to do my operation.<\/p>\n<p><strong>Domhnall MacAuley<\/strong> is primary care editor,<em> BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cThe surgeons who are not doctors.\u201d Reading this headline, I expected a story on training healthcare workers as surgical technicians in some under doctored developing country. But no, it was [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1287],"tags":[],"class_list":["post-24355","post","type-post","status-publish","format-standard","hentry","category-domhnall-macauley"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Domhnall MacAuley: The surgeons who are not doctors - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Domhnall MacAuley: The surgeons who are not doctors - The BMJ\" \/>\n<meta property=\"og:description\" content=\"\u201cThe surgeons who are not doctors.\u201d Reading this headline, I expected a story on training healthcare workers as surgical technicians in some under doctored developing country. But no, it was [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2013-02-08T14:43:39+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Domhnall MacAuley: The surgeons who are not doctors\",\"datePublished\":\"2013-02-08T14:43:39+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/\"},\"wordCount\":303,\"commentCount\":6,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#primaryimage\"},\"thumbnailUrl\":\"http:\\\/\\\/www.bmj.com\\\/site\\\/blog\\\/icons\\\/domhnall.jpg\",\"articleSection\":[\"Domhnall MacAuley\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/\",\"name\":\"Domhnall MacAuley: The surgeons who are not doctors - The BMJ\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#primaryimage\"},\"thumbnailUrl\":\"http:\\\/\\\/www.bmj.com\\\/site\\\/blog\\\/icons\\\/domhnall.jpg\",\"datePublished\":\"2013-02-08T14:43:39+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#primaryimage\",\"url\":\"http:\\\/\\\/www.bmj.com\\\/site\\\/blog\\\/icons\\\/domhnall.jpg\",\"contentUrl\":\"http:\\\/\\\/www.bmj.com\\\/site\\\/blog\\\/icons\\\/domhnall.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2013\\\/02\\\/08\\\/domhnall-macauley-the-surgeons-who-are-not-doctors\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Domhnall MacAuley: The surgeons who are not doctors\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"name\":\"The BMJ\",\"description\":\"Helping doctors make better decisions.\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\",\"name\":\"The BMJ\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/files\\\/2018\\\/05\\\/The-BMJ-logo.jpg\",\"width\":852,\"height\":568,\"caption\":\"The BMJ\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/logo\\\/image\\\/\"},\"sameAs\":[\"https:\\\/\\\/www.facebook.com\\\/bmjdotcom\\\/\",\"https:\\\/\\\/x.com\\\/bmj_latest\"]},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Domhnall MacAuley: The surgeons who are not doctors - The BMJ","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/","og_locale":"en_US","og_type":"article","og_title":"Domhnall MacAuley: The surgeons who are not doctors - The BMJ","og_description":"\u201cThe surgeons who are not doctors.\u201d Reading this headline, I expected a story on training healthcare workers as surgical technicians in some under doctored developing country. But no, it was [...]More...","og_url":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/","og_site_name":"The BMJ","article_publisher":"https:\/\/www.facebook.com\/bmjdotcom\/","article_published_time":"2013-02-08T14:43:39+00:00","og_image":[{"url":"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg","type":"","width":"","height":""}],"author":"BMJ","twitter_card":"summary_large_image","twitter_creator":"@bmj_latest","twitter_site":"@bmj_latest","twitter_misc":{"Written by":"BMJ","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Domhnall MacAuley: The surgeons who are not doctors","datePublished":"2013-02-08T14:43:39+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/"},"wordCount":303,"commentCount":6,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#primaryimage"},"thumbnailUrl":"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg","articleSection":["Domhnall MacAuley"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/","url":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/","name":"Domhnall MacAuley: The surgeons who are not doctors - The BMJ","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#website"},"primaryImageOfPage":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#primaryimage"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#primaryimage"},"thumbnailUrl":"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg","datePublished":"2013-02-08T14:43:39+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#primaryimage","url":"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg","contentUrl":"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/bmj\/2013\/02\/08\/domhnall-macauley-the-surgeons-who-are-not-doctors\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/bmj\/"},{"@type":"ListItem","position":2,"name":"Domhnall MacAuley: The surgeons who are not doctors"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/bmj\/#website","url":"https:\/\/blogs.bmj.com\/bmj\/","name":"The BMJ","description":"Helping doctors make better decisions.","publisher":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/bmj\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/bmj\/#organization","name":"The BMJ","url":"https:\/\/blogs.bmj.com\/bmj\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","contentUrl":"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/05\/The-BMJ-logo.jpg","width":852,"height":568,"caption":"The BMJ"},"image":{"@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/bmjdotcom\/","https:\/\/x.com\/bmj_latest"]},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/bmj\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/bmj\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/24355","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=24355"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/24355\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=24355"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=24355"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=24355"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}