"What the Operating Room Really Teaches Us: The Hidden Curriculum of Paediatric Surgery"

There is a moment every paediatric surgeon recognises—when the theatre lights dim just enough for the drapes to glow, the monitors settle into their quiet rhythm, and a child sleeps under anaesthesia with a trust so absolute it almost feels sacred. We enter the operating room to learn anatomy, technique, and judgement. But the lessons that stay with us—the ones that shape who we become—are rarely written in any curriculum.

They come from silent glances, unspoken expectations, and the culture we absorb long before we realise it.

1. The Theatre as a Classroom of Character

Long before trainees master sutures, they imitate tone.How a consultant speaks to a frightened parent, how they soften their eyes when a child is wheeled in—these gestures become templates for compassion.No textbook teaches a resident to pause, crouch beside a parent, and say, “We’re with you. Your child is safe.”But they learn it anyway, quietly, by watching us.

2. The Silence Around Error

Complications are inevitable; silence around them is not.Many trainees describe error as a space filled with whispers, not wisdom.A postoperative leak, a slipped knot, a moment of hesitation—discussed in corridors, never in conference rooms.This culture of muted shame stalls growth and isolates the very people we hope to protect.

Real maturity begins the day a trainee hears a senior say, without defensiveness:“This was my complication. This is what I learned.”That single sentence can reshape a young surgeon’s entire relationship with error.

3. Becoming Steel and Silk

Paediatric surgeons walk an emotional tightrope:steel for the catastrophe,silk for the family standing outside the theatre doors.Trainees learn to steady trembling hands while keeping their hearts open.Many speak of exhaustion after the first time a child they operated on does not survive. And yet, in these moments, peer empathy and mentorship often provide the protective scaffolding they didn’t know they needed.

Why This Matters

If we want resilient, compassionate surgeons, emotional literacy must sit beside anatomy and physiology.Debriefs. Safe conversations. Role-modelling humility.These are not additions to training—they are the oxygen that allows young surgeons to breathe inside the pressure chamber of paediatric surgery.

The hidden curriculum is always teaching.The question is: What do we want it to teach?