This is, in fact, happening when the stakes are much higher - in hospitals.<p>The UT Southwestern Medical Center is driven by residents' evaluations of their supervisors, and routinely operate on patients with absolutely no supervision present. The actual doctors are afraid of getting poor reviews and killing their chances for advancement, as has happened to their peers. So the residents do as they wish, often at great risk and harm to the patient.<p>I unfortunately have experience with this facility. My brother-in-law was operated on by their residents for a routine removal of a skin graft. Their supervisor (one of the faculty members mentioned in the article linked below) was not present. My brother-in-law received 5 holes in his intestines and was unable to eat for 12 months, surviving on TPN alone. The Mayo Clinic finally resected his bowels, leaving him questionably enough intestines for a normal life. Sadly, for state-affiliated medical facilities in Texas, there is little recourse after the fact. The state has limited damages in such a way that no attorney was interested in the case.<p>More details here: <a href="http://www.dallasnews.com/news/community-news/dallas/headlines/20100801-ut-southwestern-faculty-let-unsupervised-resident-doctors-operate-at-parkland-.ece" rel="nofollow">http://www.dallasnews.com/news/community-news/dallas/headlin...</a>