When Experience Retires, What Remains
The surgical suite has long been a space of precision, pressure, and human mastery. Here, the steady hands of seasoned surgeons have repaired hearts, removed tumors, and stitched together lives. But as many of these experts prepare to hang up their scrubs, a quiet tension is emerging: who will replace them—and what role will artificial intelligence and robotic systems play in the operating room of the future?
We are entering a new era of surgical care. Not just because of technology, but because of timing. Around the world, a large percentage of senior surgeons are approaching retirement, taking with them decades of skill, instinct, and procedural wisdom. At the same time, robot-assisted surgery and AI-guided systems are becoming standard in many hospitals. Tools like the Da Vinci Surgical System, Medtronic’s Hugo, and AI platforms for intraoperative decision support are reshaping what surgery looks and feels like for both patient and provider.
But as the tools evolve, so must the training. And with fewer experienced surgeons available to mentor and model, we must ask: Can AI help teach the next generation—or will it hinder the passing of essential human knowledge?
A Shrinking Talent Pipeline
Surgery is not a skill one simply reads about or learns from video. It’s a deeply embodied practice—a blend of science, artistry, spatial reasoning, and tactile precision honed through repetition and mentorship. Traditionally, surgical expertise has been passed down through apprenticeship models, with trainees observing, assisting, and eventually performing under the guidance of senior surgeons.
But that model is now under strain. In countries like the U.S., Canada, the UK, and Japan, retirement among senior surgeons is outpacing the entry of new ones. General surgery and specialized fields like cardiothoracic, orthopedic, and neurosurgery are experiencing significant shortages. Meanwhile, surgical residency programs are under pressure to train faster and with fewer available mentors.
In this context, AI is being welcomed not just as a tool for precision—but as a training partner.
How AI and Robotics Are Changing Surgical Education
AI in surgical training is showing up in several key ways:
- Virtual Reality (VR) and Simulation: Platforms like Osso VR and Touch Surgery allow trainees to practice procedures in immersive environments that replicate the OR.
- Haptic Feedback Systems: Simulators that offer tactile responses help young surgeons develop “feel”—a critical sense usually built through years of practice.
- Real-Time Guidance: Some AI systems now assist during surgery by identifying anatomical structures, flagging potential risks, and even suggesting next steps.
- Performance Tracking: Machine learning can analyze hand movements, tool trajectories, and decision-making patterns to provide feedback on technical skill.
These tools offer incredible promise—especially in a world where access to human mentorship is narrowing. Trainees can practice procedures repeatedly in safe environments, receive immediate feedback, and build muscle memory with fewer risks to real patients.
But there are limits.
The Intangibles of Surgical Wisdom
Senior surgeons bring more than technique. They bring judgment—the ability to pivot mid-procedure, make fast decisions under pressure, or recognize subtle signs of trouble. They know when to push forward and when to stop. They often teach not just with their words, but with a raised eyebrow, a controlled breath, a pause in motion.
These are the intangibles that don’t yet exist in AI systems or simulators. They are passed on in late-night debriefings, quiet moments between cases, and the countless hours trainees spend simply watching their mentors work. When those mentors retire, the question becomes: who (or what) fills the silence?
There’s also the question of emotional presence. Surgeons are increasingly expected to balance technical brilliance with patient-centered care. Empathy, communication, ethical reflection—none of these are easily modeled by machines.
Are We Training Technicians or Surgeons?
This tension leads to a critical question: are we at risk of training technicians instead of surgeons?
As AI systems become more embedded in the OR, there’s a temptation to rely on them—not just for assistance, but for direction. A trainee might learn to follow a robotic workflow, but struggle when something unexpected happens. Over-reliance on automation can erode the development of clinical intuition.
A 2023 study in Annals of Surgery warned that “proficiency in robot-assisted procedures is not a substitute for foundational surgical skill.” In other words: AI can’t teach what it doesn’t know.
The future must include both.
Designing a Better Surgical Future
To navigate this transition wisely, we must:
- Retain retiring surgeons as mentors, proctors, and contributors to simulation design.
- Embed AI literacy into surgical training programs so young doctors understand the tools they’re using.
- Blend hands-on learning with tech-enhanced methods, ensuring trainees get both repetition and real-world exposure.
- Preserve the art of surgery, not just the science of it.
Some programs are already experimenting with this hybrid model. At Stanford and Johns Hopkins, simulation labs are paired with mentorship tracks where retiring surgeons spend their final years teaching full-time. In Japan, master surgeons are being recorded in high-fidelity VR to preserve their techniques for future generations.
It’s not about nostalgia—it’s about ensuring the next wave of surgeons doesn’t just operate—they lead, adapt, and care.
The Scalpel and the Circuit
AI will make surgery safer, faster, and more consistent. But it will never hold a patient’s hand before anesthesia or sense hesitation in a junior assistant’s posture. It won’t know when to teach with a story instead of a statistic.
As senior surgeons retire, their legacy must be more than logged cases—it must be woven into the systems we build. The scalpel and the circuit can work together. But only if we honor both the wisdom of experience and the promise of innovation.
Next up in the series: No One Left to Teach – The Risk of Losing Mentorship and Informal Knowledge.
