Most surgeons think of teaching as something formal.
A lecture.
A ward round.
A demonstration at the operating table.
But in reality, teaching in surgery happens long before the first incision and long after the case is over.
Whether we realise it or not, every surgeon teaches.
Not occasionally.
Not intentionally.
But constantly.
Teaching Happens Even When You’re Not Teaching
Trainees do not learn only from what we explain.
They learn from what they observe.
They watch:
How we enter the operating room
How we speak under pressure
How we respond when something doesn’t go as planned
How we treat patients, nurses, anaesthetists, and colleagues
Silence teaches.
Behaviour teaches.
Attitude teaches.
You do not need a classroom to be an educator.
In surgery, the operating room itself is the classroom.
The Myth: “I Don’t Teach”
Many surgeons believe they are not teachers.
“I’m not in academics.”
“I don’t have trainees.”
“I’m too busy.”
But teaching is not defined by intention.
It is defined by influence.
Every interaction becomes a lesson whether you want it to or not.
And the more senior you become, the louder that lesson becomes.
You may not be teaching deliberately, but you are always teaching something.
What Trainees Learn When You Are Calm
Calm surgeons teach without saying a word.
They teach:
Judgement
Prioritisation
Emotional regulation
Confidence under pressure
A calm presence signals experience.
It tells the team that complexity is manageable and that uncertainty does not require panic.
Trainees remember how safe the operating room felt, not just what was done inside it.
Calmness teaches clarity.
What Trainees Learn When You Are Angry or Dismissive
Anger teaches fear.
Sarcasm teaches silence.
Public criticism teaches humiliation.
Dismissiveness teaches that questions are unwelcome, and that thinking independently is risky.
Often, unintentionally, we teach:
Avoidance instead of curiosity
Obedience instead of judgment
Silence instead of communication
What we tolerate, how we react, and what we ignore quietly become the curriculum.
Teaching Judgment, Not Just Technique
Technique can be learned from books, videos, and simulations.
Judgment cannot.
Judgment is taught through:
Patient selection
Timing of intervention
Restraint
Decision-making in uncertainty
How complications are handled
Trainees watch when you choose not to operate.
They watch how you explain risk.
They watch how you take responsibility when outcomes are imperfect.
The most valuable lessons are rarely written.
They are lived.
The Hidden Curriculum of Surgery
Beyond formal teaching lies the hidden curriculum.
It includes:
How seniors talk about patients
How colleagues are treated behind closed doors
How mistakes are discussed or avoided
How ego is expressed or restrained
These lessons shape:
Professional identity
Ethical boundaries
Leadership style
Trainees do not just learn how to operate.
They learn what kind of surgeon it is acceptable to become.
The Weight of Teaching Through Example
Senior surgeons are always being observed, even when they feel unnoticed.
Small actions are magnified:
How you scrub
How you speak during tension
How you leave the operating room
How you handle fatigue and frustration
Teaching is not optional in surgery.
It is inherent to position.
Influence grows with seniority, whether we acknowledge it or not.
What Legacy Are You Creating?
Years from now, trainees may forget:
Specific cases
Exact steps of a procedure
But they will remember:
How it felt to work with you
What you normalised
What you modelled
Legacy is not created in grand moments.
It is built quietly, case by case, day by day.
Every surgeon leaves a trace.
Teaching Is Not a Role - It Is a Presence
Not all surgeons are educators by title.
But all surgeons are educators by behaviour.
The question is not,
“Do I teach?”
The real question is:
“What am I teaching every day, without realising?”
Because long after the operation is over,
The lessons remain.
