One of the biggest frustrations for both trainers and trainees in cataract surgery training is this:
- Trainers struggle to figure out whether a trainee genuinely wants to learn or is just trying to rack up case numbers.
- Trainees feel stuck, wondering why their trainers won’t give them more surgical opportunities.
Many beginners believe: If I just do more cases, I’ll automatically get better.
But that’s the passive accumulation mindset, not an active learning mindset—and trainers can sense the difference.
If you’re a trainee who wants to gain more responsibility in surgery, it’s not enough to just keep asking.
You have to prove that you’re thinking, analyzing, and problem-solving like an independent surgeon.
Here’s how to do that.
1. Show Depth, Not Just Volume
Trainees who just want experience rush through cases without deeply engaging with their mistakes. They finish a step and immediately move on, assuming that experience alone will make them better.
- A passive trainee will complete a capsulorhexis and think, “Great, I did it.”
- An active trainee will complete a capsulorhexis and ask, “Was my size consistent? Were my centration and vector forces correct? What should I adjust?”
Instead of chasing numbers, focus on perfecting each step before moving forward.
What to Do:
- If you did a rhexis, ask your trainer for one key improvement before moving on.
- If your wound was slightly off, request feedback before your trainer has to mention it.
- Instead of just wanting “more cases,” show that you’re refining specific steps within those cases.
2. Ask for More Responsibility, Not Just More Cases
Many trainees say: “Can I do more cases?”
This signals passive accumulation—as if just doing more surgeries will magically improve skills.
Instead, you should be asking: “Can I handle nucleus delivery today instead of just capsulorhexis?”
This shows that you’re thinking in terms of skill progression, not just adding to your case count.
Start by owning smaller steps
Prove you’ve mastered them.
Then ask for the next level.
3. Take Initiative in Problem-Solving
Passive trainees ask for more cases but expect their trainer to rescue them whenever something goes wrong.
Trainers know that giving more cases to these trainees will just mean more interruptions and corrections.
Instead, be the trainee who anticipates problems and finds solutions independently.
Instead of waiting for your trainer to point out mistakes, say:
♠ “I noticed my rhexis was getting too large. I corrected my force vector—was that the right move?”
♠ “In the next dense cataract, how should I modify my tunnel construction?”
4. Accept Criticism Without Defensiveness
Trainees who only care about racking up cases often get defensive when corrected.
They see surgery as a performance, not a learning process.
A trainee with an ownership mindset actually seeks out corrections because they know that’s how they’ll improve.
If you made a mistake, acknowledge it before your trainer does:
♠ “My rhexis was too small today. I should have stretched it earlier—would that have been the right correction?”
♠ “I didn’t hydrodissect enough; I think that made nucleus delivery harder. Do you think that was the main issue?”
5. Reflect on Your Own Cases Without Being Asked
Most passive trainees only review cases when their trainer forces them to.
An active trainee self-analyzes their performance before being asked.
Instead of waiting for feedback, try to think through steps:
- “I felt like my wound was slightly anterior today. I’ll check tomorrow if I need to adjust my blade angle.”
- “I hesitated during nucleus delivery. Next time, I need to commit to the maneuver faster.”
This tells your trainer that you are already critiquing your own work- you are not blindly relying on them to tell you what went wrong.
Final Thought: Proving You’re Ready for More Responsibility
If you’re a trainee and want to gain more surgical opportunities, it’s not enough to just ask for more cases.
You have to prove that you are thinking, analyzing, and problem-solving like an independent surgeon.
- Focus on skill depth, not just case numbers.
- Ask for responsibility within a case, not just full cases.
- Anticipate problems and solutions before your trainer tells you.
- Seek out feedback and apply it.
- Show initiative by analyzing your own performance.
- Ask smart, targeted questions—not just for more cases.
Surgeons who do this gain independence faster because trainers trust them with more cases, more complex cases, and ultimately, full responsibility.