Can Live surgeries be conducted?

 The future of medical training is unfolding, and with it, the pressing question: How "live" can a surgery truly be shared?

Is it invaluable education or a high-stakes ethical dilemma?

Important salient points from the National Medical Commission (NMC) guidelines dated 26 July 2025 regarding the conduct and broadcast of live surgeries:

Key Salient Points

• Educational Value and Ethical Concerns
• Live surgeries may lack in-depth learning compared to recorded videos or hands-on training.
• There are ethical concerns about patient exposure and the risk versus benefit for educational purposes.
• Patient discomfort, anxiety, and risk may not be justified by educational benefit.
• Commercial Exploitation
• Criticism of the commercial misuse of live surgical broadcasts, including patient exploitation and prioritization of self-promotion and product advertising over patient safety.
• Comparison with Recorded Videos
• NMC advocates for recorded video, wet lab, cadaveric, and simulation-based surgeries/procedures for educational purposes. These are deemed safer for patients and allow for detailed, edited educational content.
• Who Can Organize and Perform
• Organizers must have indemnity insurance.
• Only qualified Registered Medical Practitioners (RMP) or Foreign Medical Practitioners (with NMC permission) with at least five years’ experience post-specialty certification can perform.
• Foreign doctors require prior permission from both the NMC and the State Medical Council.
• Venue and Facilities
• Must be held in accredited hospitals with full pre-op, operative, post-op, emergency, and ICU facilities.
• Setups are subject to inspection; inadequate setups result in broadcasts being deferred.
• Patient Protection
• Only low-risk, well-investigated patients who consent without inducement may participate.
• No patient should be financially incentivized; insurance coverage is recommended for unforeseen incidents.
• All complications arising during the procedure must be treated free of cost.
• Informed Consent
• Consent must be thorough, including educational purpose, risks/benefits, confidentiality, and the right to withdraw.
• Conduct During Surgery
• Surgeon should avoid interaction with the audience during the operation. If commentary is needed, use a separate moderator.
• High-risk procedures should be shown as edited recordings, not live.
• Ethical and Legal Responsibilities
• No charges to patients (including for devices, drugs, procedures).
• The operating team must provide post-op care for at least 24 hours.
• Strict confidentiality of patient identity is required.
• Standard operating procedures must be followed.
• Oversight and Permissions
• Prior written permission from the relevant regulatory/association/institution authority is mandatory.
• An apex committee should oversee compliance.
• Associations must prevent promotional/commercial activity during broadcasts.
• Other Recommendations
• Live surgery broadcasts are only for educational, not commercial, purposes.
• No glorification of individuals—emphasis on technique and care.
• Unedited recordings must be preserved for at least two years.
• Professional associations should self-regulate to uphold standards.

These guidelines collectively aim to protect patient welfare, ensure ethical standards, and refocus live surgery broadcasts on genuine educational value, strictly regulating organization, performance, consent, and commercial involvement.