This happens in the US, too. (my daughter just had open heart surgery at a top tier research hospital.) It's very common for a resident surgeon to open the pa

This happens in the US, too. (my daughter just had open heart surgery at a top tier research hospital.) It's very common for a resident surgeon to open the patient and prep the detailed surgical site as part of their practical work (residency, fellowship). This usually happens under direct supervision of the attending, but not always. But, in the case of cardiac surgery, "getting to the heart" is a very quick process -- a couple of incisions, some clamps & drainage, and there's a heart right in front of you. The time-consuming early part is getting the anesthesia work done (not just sedation, but installing all the necessary ports, tubes and catheters) and hooking them up on a heart/lung bypass. I can't comment on your second point.