Bridging generations: An interview with AO President Tim Pohlemann

AO President Tim Pohlemann with the group of young surgeons invited to the 2024 Trustees Meeting in Davos, Switzerland.

You have made generational change the focus of your presidency. Why is that?

Generational change is essential because an organization can only sustain itself with enough new blood. However, there are phases in which you must focus specifically on this when you notice that the age pyramid is still increasing slightly at the top. This is mainly the case in the AO because the idea is so inspiring that people want to be involved for the rest of their lives, give input, be inspired, and have so many friends after all these years that the social component also plays an important role. Despite all this, the AO must be just as attractive for our young people as it was for us back then. And you must bear in mind that we lived in a completely different social environment 30 or 40 years ago. The structures of hospitals were different; the structures of junior doctors, senior doctors, and chief physicians were different. That has all changed, and the economic pressure on hospitals has increased. We must adapt to these new requirements.


What are the differences that young surgeons experience in their day-to-day work today?

Back then, we had to be physically in the clinic to have social work contacts. Today, you have to be in the clinic to have contact with patients. It starts with the fact that, for example, the x-ray image that we used only to be able to see on the ward can now be shared digitally. A lot of decision-making work is now separate from physical presence. The recognition of problems and errors mustn't be lost. Everyone must be accessible and available, even under the new circumstances.

Even then none of us liked working 36 hours in a row, but we couldn't push through any changes in our time. Now, things have changed, and as long as patient care is guaranteed, that's okay. It is partly a problem in education because we need a certain density of experience. It's not enough to have done an operation once and then see it again nine months later. If you've done it four times in a week, it stays with you for life. It's like playing a musical instrument or doing gymnastics. However, the surgical results we have today are the best we have ever had. The standards have improved, although the attitude has changed.

Over the 42 years that I have been in surgery, I have always found it an extreme privilege to work across generational boundaries and to have contact with very young people, young professionals, and students. Continuous exposure to them makes it less difficult to understand what these young people need. And when you have children yourself, it's natural to shake your head at their ideas initially and then later say that they're not really that wrong.


How does this development affect the generational change in the AO?

We deliberately focused the Trustees Meeting 2024 on this question and brought in generational researcher Hartwin Maas, who explained to us what horizons of experience we still have that the younger generation no longer has, such as the rotary dial telephone. On the other hand, we "old people" had to learn in our lives that you can have a computer in your pocket.

What made me very happy is that the group of young surgeons we invited to the Trustees Meeting confirmed that our mission, values, and vision are just as attractive to the next generation—committing time and working together to identify problems we have in patient care and finding solutions to make life better for our patients, for the surgical team and thus also for society in general. To reach and retain this new generation, we must use different methods and adapt to new conditions permanently, but the basic principle of "improving patient care" will remain. And it will still be valid in ten or twenty years.


What concrete ideas do you have for retaining the next generation of surgeons in the AO?

We already know that the next generation very much appreciates our AO values. What we need to do is to convey these values. The channels are slightly different today. We are working on projects where we convey content in short videos, use social media to be present, and restructure our teaching activities. A lot of things are shifting more and more into the digital space. Our courses' practical, haptic side is hugely important and one of our unique selling points, but we can and will outsource a lot of the theoretical content to blended learning. Covid has shown us that the time we spend together is so valuable that we shouldn't waste it on lectures about preliminary knowledge.


At the AO Davos Courses 2024, several measures were taken to involve and motivate the next generation...

We have taken simple measures at the AO Davos Courses. For example, we published the programs much earlier, and we are seeing the first results. On average, we have more young participants. 33% of participants are under 35, 75% are under 45, and we have fully booked courses and a waiting list. That is very good.

We also have a Young Surgeons Advisory Group, which provides us with input for the courses. One of these inputs was that young surgeons would like uncomplicated access to the key opinion leaders to talk to them about topics outside the actual course curriculum. This gave rise to the "Meet and Eat" concept. The Young Surgeons Advisory Group implemented and moderated these events, and they were very successful. There were great interactions, a great topic—patient safety and error culture—and long discussions. It was a very valuable addition, and we want to continue working in this way. I have always said that the AO is unique, and I want to keep it that way. In my many trips for the AO, I have seen that our mission and values are global and cross-generational. It is an enduring movement in which people say: The AO as my lifelong professional family is attractive.