Preparing Surgical Residents for the Future of Surgery

July 8, 2026

The future of surgery is being shaped not only by breakthroughs in robotics, simulation and artificial intelligence, but also by a fundamental rethinking of how surgeons are trained. As program director of PCOM's general surgery residency, Lindsey Perea, DO '13, RES '18, is helping residents prepare for a profession that may look very different in the decades ahead.

For Perea, preparing future surgeons requires balancing tradition with innovation—from reexamining how competency is measured, to integrating new technologies into training, to creating opportunities for research and leadership development.

Training for a Changing Profession

One of the biggest conversations in surgical education is competency-based training. While general surgery residency traditionally follows a five-year structure, educators are increasingly exploring whether advancement should be based on demonstrated competency rather than time in training.

“The goal is to make sure that, at the end of training, regardless of how long that training takes, we're producing competent surgeons who are going to be caring for people's lives,” Perea said.

For Perea, adaptability is one of the most important skills a surgeon can develop. As a trauma surgeon, she regularly treats patients whose conditions can change within minutes, requiring rapid reassessment and decision-making.

“In a trauma case, a patient may have multiple injuries,” she said. “Residents have to learn how to determine which injuries are immediately life-threatening and need to be addressed first versus those that can wait until the patient is stabilized.”

That same adaptability is becoming increasingly important as new technologies reshape surgical practice. When Perea graduated from PCOM's general surgery residency program in 2018, robotic surgery represented a relatively small portion of her training experience. Today, residents graduate with robotics equivalency certificates that allow them to begin practicing on robotic platforms immediately after residency. Simulation has also become an important training tool, allowing residents to practice procedures, receive feedback and build confidence before treating patients.

“What I really like about our program is that we've maintained balance,” Perea said.

While some programs have become heavily focused on robotic surgery, Perea says residents benefit from training across robotic, laparoscopic and open surgical approaches. She also sees promise in emerging technologies such as artificial intelligence, particularly in areas like coding, billing and workflow optimization, while emphasizing the importance of thoughtful implementation. As surgery continues to evolve, the next generation of surgeons will need more than technical expertise alone.

Beyond Technical Skill

As research becomes increasingly important for residents pursuing competitive fellowships, Perea recognized the need to create new opportunities within the program.

“Research isn't traditionally built into our training experience in the same way it is at some larger academic centers,” she said. “When I became program director, I knew it was becoming more important, and I didn't want our residents to be behind the eight ball.”

Working with PCOM's department of Graduate Medical Education, Perea created an opportunity for one resident each year to dedicate a year to research. The program's first research resident, Rosmi P. Thomas, DO '22, is completing that year and will return to clinical training in July.

Through a leadership fellowship with the American Osteopathic Association, Thomas is developing a leadership training curriculum for the residency program—an initiative that has already attracted interest from another surgical residency program in the Northeast.

“The goal is to develop leadership competencies for residents. Surgeons are expected to be leaders, whether they're teaching trainees, leading a team in the operating room or guiding patient care decisions, yet there isn't a lot of formal leadership training built into residency,” Perea said. “I'm excited to see how this project develops because helping residents build leadership skills during training will benefit them throughout their careers. Whether they go into community practice or academic medicine, those skills will help them become more effective physicians and leaders.”

As surgical education continues to evolve, Perea is focused on ensuring residents are prepared for a rapidly changing profession—one shaped by new technologies, new approaches to training and expanding expectations for physician leadership. Yet amid those changes, she says patient care remains at the center of everything surgeons do.

“Of course, I want our residents to leave with exceptional technical skills in the operating room,” she said. “But what really stands out to me is the empathy and care they show toward patients and their families.”

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