From the moment you start cataract surgery training, you begin going down one of two paths, whether you realize it or not.
You either become an active surgeon or a passive surgeon.
This choice is not about skill, intelligence, or talent. It’s about mindset. And it determines not only how fast you gain independence but also the kind of surgeon you become years down the line.
The difference starts early, long before you even touch a phaco probe.
The First Few Weeks of Training: Who Takes Control?
Picture two new trainees entering cataract surgery training at the same time.
The passive surgeon waits to be taught. They stand back, observe, and follow instructions when given. They don’t ask to do more than what’s assigned. If a case gets difficult, they step aside and let the trainer handle it.
The active surgeon asks questions before even holding the instruments. They study surgical videos the night before and walk into the OR with a game plan. When they get a chance to operate, they take charge of every step they’re given—no matter how small.
The passive surgeon is waiting to be taught.
The active surgeon is teaching themselves.
Fast forward six months.
- The passive surgeon has assisted dozens of cases but still hesitates when asked to take the lead. They rely on their trainer to fix mistakes. They’re technically improving, but they don’t trust their own judgment yet.
- The active surgeon has performed fewer cases but already thinks like an independent surgeon. They anticipate problems, adjust without waiting for instructions, and constantly push for more responsibility.
Who do you think will be operating solo first?
How to Develop Clarity Faster as a Beginner
If you don’t know what went wrong, your only job is to FIND OUT. Here’s how:
1. Immediately Ask for Feedback
Right after your surgery (or the step you performed), ask your trainer:
“What was the biggest issue with my technique?”
“What should I do differently next time?”
Don’t just accept general feedback like “Be more careful.” Ask for specifics. Force your trainer to give you something actionable.
2. Rewatch Surgery Videos with Purpose
Instead of just watching random cataract surgery videos, watch them with a specific goal:
- If you’re struggling with wound construction, watch only videos on wound construction.
- If nucleus delivery feels hard, study only that step.
Targeted learning speeds up your problem-solving.
3. Write Down Every Mistake and Solution
Have a running log:
Problem: Rhexis ran out at 10 o’clock.
Suspected reason: Chamber was too shallow, I didn’t pivot enough.
Fix: Try better OVD fill, move wrist more, pull more centrally.
Mistakes disappear faster when you actively analyze and document them.
The Critical Difference: How They Handle Mistakes
Mistakes are inevitable in surgery. But how you react to mistakes determines whether you grow or stay stuck.
The passive surgeon fears mistakes. They get discouraged when they mess up, and instead of fixing the problem, they rely on their trainer to correct it. After a complication, they dwell on how “unlucky” or “not ready” they are.
The active surgeon owns their mistakes. When something goes wrong, they analyze why. They don’t look for excuses; they look for solutions.
- Passive surgeons repeat mistakes because they don’t take responsibility for them.
- Active surgeons fix mistakes fast because they force themselves to understand them.
One Year Later: The Gap Widens
After a year of training, the difference between the two is obvious.
- The passive surgeon still needs supervision. They can complete cases, but they lack speed and confidence. They second-guess themselves and avoid tougher cases. They’ve done the numbers, but they don’t own their surgeries.
- The active surgeon is operating solo. They have taken control of their training, made their own decisions, and forced themselves to grow. They aren’t perfect, but they trust themselves to handle complications.
Both surgeons started at the same place.
One became independent.
The other is still waiting to be “ready.”
The Passive Surgeon’s Future: A Career of Dependence
The danger of passive learning isn’t just slow training—it’s a lifetime of dependence.
- Passive surgeons end up working under someone else because they never built the confidence to start their own practice.
- They struggle in high-pressure settings because they never developed the ability to handle complications alone.
- They stay within their comfort zone, avoiding difficult cases, never truly mastering the art of surgery.
Years pass, and they wonder why they never became the surgeon they hoped to be.
The Active Surgeon’s Future: Total Surgical Freedom
Active surgeons, on the other hand, take charge of their careers the way they took charge of their training.
- They become independent fast and don’t rely on others to guide them through every case.
- They handle complications with confidence because they’ve trained themselves to think ahead and adjust in real-time.
- They open their own practice, train others, and become the kind of surgeon that juniors look up to.
While the passive surgeon is still waiting for the “right opportunity,” the active surgeon creates their own opportunities.
Which Surgeon Will You Be?
Every beginner makes mistakes. Every beginner struggles. Every beginner feels like they’re not ready.
The only question is: Will you wait for someone to make you a surgeon, or will you take control and become one yourself?
Start acting like an independent surgeon from day one, and you’ll become one much faster than you think.