04/05/2025
A Surgeon of 1,000 Papers or a Surgeon of 1,000 Surgeries?
The landscape of modern medicine is marked by a striking paradox: scientific output has reached unprecedented levels, yet practical surgical experience appears increasingly marginalized.
While pursuing knowledge through research is undeniably fundamental to medical progress, an overemphasis on the sheer quantity of publications threatens to distort the true foundations of surgical excellence.
When publication metrics — citation counts, h-indices, and journal impact factors — become the primary measures of a surgeon's value, the original purpose of academic inquiry risks being lost.
In surgery, expertise is forged not solely through literature but through the unrelenting discipline of practice. It is cultivated in the operating room, through the mastery of technical nuances, the exercise of judgment under pressure, and the management of unforeseen complications — experiences that no manuscript can fully capture.
The contemporary academic environment, however, often prioritizes research productivity over clinical acumen. Aspiring surgeons are increasingly encouraged to author papers — sometimes even on procedures they have yet to perform — as a prerequisite for career advancement. This trend, if unchecked, may produce a generation of surgeons more proficient in manuscript submission than in the fundamental art of healing.
The emergence of artificial intelligence further accelerates this trajectory. Machine learning algorithms can now assist in data analysis, manuscript drafting, and hypothesis generation. While these tools offer remarkable opportunities for accelerating scientific discovery, they also pose the risk of diluting academic rigor and distancing practitioners from the experiences that define surgical mastery.
Thus, we are faced with a critical question: will the next generation of surgeons be recognized for their library of publications, or for the thousands of patients whose lives they have directly touched through surgical skill?
Science and surgical practice are not mutually exclusive; both are indispensable. However, in surgery, theoretical knowledge unaccompanied by technical proficiency does not simply result in academic shortcomings — it translates into clinical failures, with profound human consequences.
True surgical excellence demands balance. Scientific contributions must be encouraged and celebrated, but not at the expense of the time-honored apprenticeship that transforms physicians into surgeons.
Ultimately, when a patient lies on the operating table, it is not the surgeon's publication record that will dictate the outcome — it is the steadiness of their hands, the soundness of their judgment, and the depth of their experience.
Wilson Bothelho MD
CardioThoracic Surgeon
Sao Paulo Brazil
