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Is There a Proctor in the House?

By Lee C. Weatherly

A “proctor” is often described as a “supervisor” or “monitor” and, specifically, “one appointed to supervise students (as at an examination).” See Merriam-Websters Collegiate Dictionary, Eleventh Edition. Although one can easily understand the role of a proctor in a classroom setting, the role of a proctor in an operating room setting can be more complicated, especially when it comes to the ultimate responsibility for the care of a patient. Proctoring by experienced surgeons is a common and increasingly frequent method to credential surgeons for hospital privileges or those who are new to laproscopic or robotic procedures.

A surgical proctor can generally be described as a surgeon-observer who is responsible for the assessment of the skills and knowledge of the surgeon-learner during the initial phase of the learning curve. See Kevin C. Zorn, 182 J Urol 1126-32 (2009). The proctor reports his or her findings to the applicable governing body in charge of evaluating the subject surgeon, and provides recommendations based on his or her findings. Proctoring can also involve responding to questions about the surgical equipment being used without participating in the medical decision making involved in the procedure. Advanced technology has gone so far, through the use of teleproctoring, as to creating situations where the surgeon is not physically on site with the patient. Accordingly, a proctor is generally not involved in any medical decision-making or in the actual performance of the procedure being observed.

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