Alan Zambeli-Ljepovic, MD, MHS, a surgery resident at UC San Francisco (UCSF), is among the trainees learning to operate advanced robotic surgical systems in the university’s Surgical Skills Lab. The lab provides hands-on experience with robotic technology that is increasingly used in surgeries such as urology, gynecology, and gastrointestinal procedures. In 2024, about 2.63 million robotic-assisted surgeries were performed in the United States, marking a nearly 20% increase from the previous year. This growth is attributed to benefits like less invasive procedures and quicker patient recovery.
Training for robotic surgery presents unique challenges compared to traditional methods. Surgeons now operate from a console away from the operating table, which can leave medical students physically separated from the action. Hueylan Chern, MD, director of the lab and a colorectal surgeon at UCSF, noted that students often felt disengaged during these procedures. “Learners are physically separated from the surgical team. We noticed that they weren’t really sure where they should be; sometimes we’d just see them sitting in the corner watching the video feed,” Chern explains. “They just didn’t feel engaged.”
To address this issue, Chern and UCSF medical students developed a certification program for final-year students to become robotic bedside assistants. These assistants play an active role by positioning the robot before and after surgery, switching out equipment on its arms, and ensuring safe movement of the device during operations. The program aims to give students direct exposure to new surgical technologies and enhance their residency applications.
The certification builds on UCSF’s broader robotic surgery training program established in 2018. The institution was one of the first in California to adopt robotic surgeries and remains among the busiest centers for such procedures statewide.
Surgical resident Anya Edwards, MD, MBA, who graduated from UCSF in 2023, recalled her earlier experiences observing robotic surgeries without participating directly: “Sometimes I wouldn’t even scrub in, I would just sit on the sidelines,” she said. “I never felt integrated because I didn’t have a role.” In response to this gap, Edwards worked with faculty including Chern and Patricia O’Sullivan, EdD, MS; Adnan Alseidi, MD, MEd, MBA; and Shareef Syed, MD to develop a simulation curriculum combining online modules with hands-on training using surgical robots.
This pilot effort became foundational for UCSF’s current bedside assistant certification program led by Chern and O’Sullivan along with residents Camilla Gomes, MD, MSc and Alyssa Murillo, MD, MSc. Students begin with an online introduction followed by small group tutorials focused on practical skills like manipulating robot arms and maintaining equipment hygiene. Certified students receive a sticker indicating their qualification as bedside assistants at UCSF facilities.
Medical student Jessica Santhakumar completed her bedside certification in April and has since assisted in more than twelve robotic surgeries at UCSF Helen Diller Medical Center at Parnassus Heights. She described her initial apprehension but credited supportive instructors for helping her succeed: “At first it was very intimidating… I just went up to our scrub nurse and let them know that it was my first or second time assisting and I’d love to learn from them. The whole team set me up for success.” Santhakumar now regularly participates in surgical cases as part of her training.
Chern emphasized that integrating students into these roles requires careful oversight to maintain patient safety while providing valuable educational opportunities: “The nurse managers, the attending physicians, the residents, the bedside staff — they all welcome the students and really enjoy providing a meaningful learning opportunity,” she says.
In July 2025 Chern received national recognition for UCSF’s work when admitted to the American College of Surgeons Academy of Master Surgeon Educators.
Reflecting on her involvement developing these programs alongside faculty members as a student herself Edwards stated: “What’s really beautiful about this work is the input that I as a student and other students had into this curriculum because it’s ultimately for students… It’s a beautiful example of designing a program with the people it’s intended for.”
