The current state of surgeon credentialing in the robotic era
The unprecedented influx of technology into our operating rooms challenges surgical leaders and educators daily. Modern surgical training programs are under appropriate strict oversight to ensure rigorous, coordinated learning opportunities that provide the trainee supervision and graduated independence while maintaining the safest high-quality care possible for patients. Within this structure of residency there is a balance between training traditional techniques, exposure to new techniques and use of new technologies. Therefore, as surgical educators we must design pathways that ensure our learners are safely introduced to new tools and technologies. At the climax of this educational journey is the credentialing of newly minted surgeons to independently perform complex procedures within their various surgical practices. Specifically related to the credentialing of robotic surgeons, each institution has developed credentialing pathways. It is essential that a unified set of parameters to standardize the process of credentialing within robotic surgery is created and adopted. In this manuscript we explore the current process of surgical credentialing and privileging with robotic technology at academic institutions. We identified three distinct phases: initial credentialing, maintenance, and new device/technique adoption. Within each phase we describe a stepwise approach and highlight the variabilities within this immature process to prompt future investigation leading to a robust yet dynamic credentialing pathway that is transparent to patients, surgeons, and hospital administrators.