Dr. Gustavo Stringel Discusses Surgical Expertise and the Efficient Use of Training Hours In recent years, surgical residents have faced limits of 80 hours per week on their hospital time, and practicing surgeons have seen their hours cut. While the limits were put in place to provide patients with better care, Dr. Gustavo Stringel hypothesizes that the resulting reduction in practice and diminished expertise may actually be harming patients. In an article entitled “How to Make the Most of the Hours We Have Left,” Dr. Stringel, a past President of the Society of Laparoendoscopic Surgeons, discussed ways in which residency programs can improve surgical expertise in their students. Dr. Gustavo Stringel did not argue for more time in the hospital. Instead, he outlined several ways in which residency programs could use time more efficiently in order to aid their students and better serve patients. He suggested that programs move away from a “years of residency” model to one in which students could leave the program once they demonstrated proficiency. This means that some students would finish the programs more quickly than they do under current policies, while others might spend a longer time in residency. This change would take into account that different students possess different levels of surgical ability. Dr. Stringel also suggested that programs use more simulations and encourage students to engage in visualization and mental practice to improve their motor skills, much as professional athletes do. Finally, Dr. Stringel explained that programs need to improve their feedback methods. Since only “perfect practice makes perfect,” students need accurate, specific feedback on their surgical work. He feels that these changes could improve the skill of new surgeons and prevent mistakes in the operating room.