Surgeons' Level of Expertise
Toshiyasu Nakamura
Abstract
Professor Jing Bo Tang, editor-in-chief of the Journal of Hand Surgery European Volume, sent me an e-mail, informing me that the Journal of Hand Surgery European Volume has begun to ask authors to describe surgeons' level of expertise in the clinical study articles. The surgeons' level of expertise was defined in the editorial of the Journal of Hand Surgery European Volume in 2016.1 It is true that the surgeons' level of expertise may affect the clinical outcomes in the clinical studies; especially procedure papers, which advocate new techniques in the field, should indicate surgeons' level of expertise. They mentioned that the surgeons' level of expertise is divided into five categories: level 1 comprises nonspecialists who are undergoing training or are general practitioner; level 2 consists of specialists who have completed training but are less experienced, as they have not yet acquired in-depth knowledge or high-volume experience in the use of the technique(s); level 3 comprises experienced specialists who have obtained appreciable experience in use of the relevant technique(s), having practiced as a specialist over a longer period (typically > 5 years); level 4 consists of highly experienced specialists who possess in-depth knowledge and experience with use of the relevant technique(s), and this experience is indicated by having performed or been involved as a leading participant in scholastic studies relevant to the disorder(s) or technique(s); and level 5 comprises highly experienced specialists and experts who have made a recognized contribution to knowledge related to the disorder being investigated, or who have pioneered technique(s) in the report. At the end of Professor Tang's e-mail, he asked me to describe the surgeons' level of expertise in the Journal of Wrist Surgery. It is very important for readers to know the surgeons' level of expertise in the clinical study of the wrist, because the wrist is one of the most difficult joints to surgically treat. We recently published procedures and clinical research of new and highly demanding techniques including arthroscopic surgeries. I will ask all authors to mention the level of surgeons' expertise in the first paragraph of the method section of clinical research articles, special reviews, and procedure articles.