Most beginner surgeons assume that ownership comes after mastery—that they’ll start ‘owning’ their surgeries only once they can complete a case from start to finish.
But this thinking is completely backward.
Taking ownership early is what accelerates technical readiness—not the other way around.
Surgical independence is not an all-or-nothing state. It’s a gradual process, and the mindset shift happens long before full technical mastery kicks in. The problem is that many trainees wait until they feel technically ready before stepping up. This keeps them stuck in a passive learning cycle, delaying their growth.
So, how can a beginner SICS surgeon start taking ownership before they know everything?
By shifting their mindset. Here’s how:
1. Own Every Step You Can (Even If It’s Just One Step at a Time)
Surgical ownership does not mean completing the entire surgery solo from day one. It means fully committing to whatever part of the surgery you are allowed to do.
- If all you’re given is the conjunctival peritomy, own it. Make it the cleanest, most efficient peritomy possible.
- If you get to do capsulorhexis today, own that step. Treat it as if the entire surgery depends on it—because in many ways, it does.
- If you’re struggling with nucleus delivery, take charge of that part. Even if you need help with wound construction or irrigation/aspiration later, own what you can.
Many trainees approach these steps like tasks— just things to get through before passing the case back to the trainer. That’s the wrong approach.
If you truly own each step, your learning curve will be dramatically faster than those who just “go through the motions.”
2. Stop Thinking Like an Assistant, Start Thinking Like a Surgeon
Even if you’re not yet performing the whole surgery, mentally act as if you are.
Before every case, ask yourself:
- “If I were the only surgeon here, what would I do next?”
- “What complications could happen right now, and how would I handle them?”
- “What is my plan for nucleus management in this specific eye?”
Most beginners rely on their trainer to think for them— they move when told, stop when told, and react rather than anticipate.
But anticipation is what makes a surgeon independent. If you start thinking ahead before you even touch the instruments, your reflexes and decision-making will develop much faster than those who just follow orders.
3. Take Full Responsibility for Your Mistakes
Many beginners operate with this mindset:
- “If I succeed, I’m skilled.”
- “If I fail, my trainer didn’t guide me properly.”
This is wrong thinking.
A surgeon with true ownership operates differently:
- “If I succeed, I was prepared.”
- “If I fail, I need to figure out why and fix it.”
For example, if your capsulorhexis keeps running out, don’t just brush it off as a tough case. Analyze the failure.
- Was my anterior chamber too shallow?
- Was I pulling too fast or using the wrong force vector?
- Was my cystitome technique poor?
Passive trainees wait for experience to fix their mistakes.
Active trainees force clarity and fix their mistakes faster.
The more responsibility you take for your failures, the less often you’ll repeat them.
4. Start Thinking About How to Fix Complications Before They Happen
Passive trainees react to complications when they occur.
Active trainees anticipate complications before they occur.
Ask yourself:
- If the rhexis starts to run out, do I know how to bring it back?
- If the nucleus gets stuck in the tunnel, do I know my backup maneuver?
- If the chamber collapses, do I already have a plan?
Even if you’re not yet the one managing complications, thinking through solutions in advance trains your mind to be faster, sharper, and more independent.
The best surgeons are not the ones who react quickly. They’re the ones who already saw the problem coming.
The Key Takeaway: Ownership Begins Before Mastery
You don’t have to be an independent surgeon to start thinking like one.
- You don’t have to complete an entire case to own the parts you’re given.
- You don’t have to know everything to start anticipating problems before they happen.
- You don’t have to be perfect to take responsibility for every mistake and fix it.
Many surgeons stay stuck for years because they wait until they’re ready before taking full ownership. But the truth is:
- You don’t become ready first and then take ownership.
- You take ownership first—and that’s what makes you ready.
If you shift your mindset today, your technical skills will catch up much faster than you think.