Ethics in Surgery Training

Today, 80% of surveyed general surgery residency programs across the United States and Canada train residents without using animals.

Animals—typically pigs—used for surgery training suffer numerous invasive procedures and are killed during or at the end of the training sessions. Yet, the anatomical differences between animals and humans render this practice ineffective.

Surgery residency programs teach a range of procedures, including appendectomy (removal of the appendix), cholecystectomy (removal of the gallbladder), gastrectomy (removal of part of the stomach), and various techniques for dealing with trauma injuries.

These procedures can all be taught using human-relevant methods, including laparoscopic, virtual reality, and human-patient simulators; human cadavers; and partial task trainers. These devices replicate human anatomy, including blood, bones, muscle, and skin.

In December 2018, the Physicians Committee began a survey of surgery residency programs in the United States and Canada to determine training methodologies. Due to the large number of programs, the survey is ongoing, but results are showing a steady trend toward the replacement of animals.

Take Action

These are some of the surgery residency programs we are actively working to change. Please take a moment to urge these programs to replace animals with human-relevant methods.

Myths and Facts About the Issue

Myth: The use of live animals is necessary for training surgery residents.

Fact: Today, 80% of surveyed U.S. surgery programs use only nonanimal training methods, such as human-patient simulators, laparoscopic simulators, virtual reality simulators, human cadavers, and partial task trainers. Clearly, animals are unnecessary to produce expert surgeons.

Myth: Animals provide the gold standard for medical training.

Fact: Human-relevant methods are, in fact, the gold standard for medical training. The anatomical differences between pigs (the species commonly used in surgical training) and humans present numerous problems when teaching surgical skills. Compared with humans, pigs have smaller torsos, smaller and lighter limbs, and thicker skin, as well as important differences in the anatomy of the head and neck, internal organs, rib cage, and the airway. Applying the same pressure necessary for airway puncture in a pig could slice through a human airway. In addition, procedures learned on animals must later be re-learned on human anatomy.

Myth: The use of animals for medical training is humane and heavily regulated.

Fact: Under the federal Animal Welfare Act (AWA), no experiments are prohibited—including those that inflict pain or death. The AWA is primarily a husbandry statute that regulates the size of cages, cleanliness, food and water, etc. In addition, the U.S. Department of Agriculture, which is supposed to enforce the AWA, was cited by its own inspector general for closing investigations involving animal deaths and serious repeat violations and for unnecessarily reducing fines by an average of 86%. In February 2019, The Washington Post reported: “USDA inspectors documented 60 percent fewer violations at animal facilities in 2018 from the previous year…The drop in citations is one illustration of a shift—or what critics call a gutting—in USDA’s oversight of animal industries.” In addition, pigs are intelligent, emotionally complex animals. Even if the pigs remain under anesthesia during the emergency medicine course, they must endure the stress of transport, caging, and preparation for surgical procedures, and then they are killed—all just to provide substandard training.

Myth: Only live animals can prepare trainees for the real-world stress of the operating room.

Fact: Many scientific studies reveal that simulators modeled on human anatomy mimic real-world stress as well as or better than using animals. For example, the U.S. Army funded a study published in 2018 that compared goats to simulators. More than 200 Army medics performed several emergency procedures, including surgical airway. The authors concluded: “Synthetic models can produce a stress response equivalent to that of live tissue during simulation training.” Another study from 2017 compared the biomarkers of stress found in the saliva of medics while participating in a Tactical Medicine course using either live pigs or simulators, and found “that [simulators] and [live animals] do not exert varying effects on stress.”

Myth: The animals used for medical training would be slaughtered for food anyway.

Fact: This is simply false. Companies that sell animals for use in medical training or research increase breeding depending on anticipated sales.

News Coverage

Resource

Survey of Surgery Residencies

Support our work. Become a member.

Join Ways to Give