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Transition Planning for the Senior SurgeonGuidance and Recommendations From the Society of Surgical Chairs

Educational Objective To recognize and plan for end-of-career transitions for senior surgeons.
1 Credit CME

Importance  Aging is well documented to be associated with declines in cognitive function and psychomotor performance, but only limited guidance is currently available from medical professional societies or regulatory agencies on how to translate these observations into the appropriate monitoring of physician performance.

Observations  The Society of Surgical Chairs conducted a panel discussion at its 2017 annual meeting and a subsequent survey of its membership in 2018 to develop recommendations for the transitioning of the senior surgeon.

Conclusions and Relevance  Recommendations include mandatory cognitive and psychomotor testing of surgeons by at least age 65 years, potentially as a component of ongoing professional practice evaluation; career transition discussions with surgeons beginning early in their careers; respectful consideration of the potential financial needs, long-standing work commitments, and work-life concerns of retiring surgeons; and creation of teaching, mentoring or coaching, and/or administrative opportunities for senior surgeons in modified clinical or nonclinical roles. Ideally, these initiatives will catalyze a thoughtful and comprehensive new vista in supporting an aging workforce while ensuring the safety of patients, the efficient management of health care organizations, and the avoidance of unnecessary depletions to a sufficiently sized cadre of physicians with case-specific competencies.

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Article Information

Accepted for Publication: February 26, 2019.

Published Online: May 15, 2019. doi:10.1001/jamasurg.2019.1159

Correction: This article was corrected on June 12, 2019, to fix a sentence in the Results section. The sentence “Furthermore, 20 respondents (25%) identified a single policy in place at their institution to help resolve cognitive competency issues…” should have said “Furthermore, no more than 20 respondents (25%) were able to identify any one policy in place at their institution to help resolve cognitive competency issues….” The error has been corrected.

Corresponding Author: Todd K. Rosengart, MD, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 1 Baylor Plaza, MS 390, Houston, TX 77030 (

Conflict of Interest Disclosures: None reported.

Disclaimer: Dr Kibbe is the Editor of JAMA Surgery, but she was not involved in any of the decisions regarding review of the manuscript or its acceptance.

Additional Information: Representatives of the Society of Surgical Chairs reviewed and approved these recommendations.

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