"Back In My Day" - Why Today’s Residents Feel Less Prepared Than Ever | Cut & Tell

Attendings often tell stories about residency "back in the day" - more autonomy, more responsibility, more independence. But was training really better, or has the entire system changed?In this episode of Cut & Tell, plastic surgery resident Dr. Liz Malphrus explores why modern residents often report feeling less prepared for independent practice despite performing similar case volumes to previous generations. From duty-hour debates and supervision requirements to RVU-based compensation and the growing pressure for clinical productivity, she examines the structural forces reshaping surgical education.This isn't a conversation about whether residency is easier or harder. It's about understanding how the training environment has changed, and what that means for autonomy, burnout, and the future of medical education.Topics discussed:Why case numbers don't tell the whole storyResident autonomy and surgical confidenceThe impact of RVU-based compensation on teachingAcademic medicine's productivity pressuresWhy more residents pursue fellowship trainingThe relationship between autonomy and burnoutHow surgical education has evolved over the past two decadesWhat attendings and residents can learn from each otherCut & Tell is a podcast exploring the realities of surgical training, medicine, and life beyond the operating room.Subscribe for new episodes and visit the Hippocratic Collective for more conversations about the culture of medicine.