Profiles in ACS leadership: A few questions for Raphael Sun, MD

Editor’s note: The Bulletin of the American College of Surgeons is launching a new series of articles profiling leaders of the College. This feature will be published monthly. The questions are intended to give readers a look at the person behind the surgical mask and to inspire other members of the College to consider taking on leadership positions within the organization and the institutions where they practice.

For this third profile, we interviewed Raphael C. Sun, MD, Chair of the Executive Committee of the Resident and Associate Society of the American College of Surgeons (RAS-ACS). Dr. Sun recently completed his fellowship training in pediatric surgery at Texas Children’s Hospital-Baylor College of Medicine, Houston. He will be joining Oregon Health & Science University in Portland, starting in the fall as a pediatric and fetal surgeon.

Why did you choose to become a surgeon?

I decided very early in my medical career to become a surgeon. I came into medical school with plans to be a pediatrician or a critical care specialist. A trauma surgeon came to one of our first-year medical student interest group meetings and presented what he did as a trauma surgeon. I simply thought what he did was so cool—to be able to save lives by working with his hands. I also thought that the training involved to become a surgeon was not any longer than was needed to become a critical care specialist. So, I committed as a first-year medical student to becoming a surgeon.

My interest in treating the pediatric population helped me solidify my decision to become a pediatric surgeon. I never looked back and went on to graduate from medical school at Virginia Commonwealth University, Richmond, making decisions throughout my residency based on the end goal of becoming a pediatric surgeon.

Who are some of your mentors and role models, and how do you apply the lessons you have learned from them?

I have been fortunate to have had a lot of great mentors and role models at Washington University, St. Louis, MO, and Texas Children’s Hospital, where I did my residency and fellowship training, respectively.

However, the first person who comes to mind is Brad Warner, MD, FACS, professor and chief of pediatric surgery, St. Louis Children’s Hospital, Washington University (Wash U), MO. I contacted him when I was an intern at the University of Iowa, Iowa City, as I was interested in doing research in his lab. He said yes and said that he would even be able to provide funding, and that was huge because to get funding for two years requires a lot of commitment. Not only did I do my research at Wash U, but I ended up staying and finishing my residency training there.

I didn’t go to Wash U thinking I would stay there, but I had such a good experience with Dr. Warner and working with all the residents when I took call at St. Louis Children’s Hospital. Needless to say, that decision changed my entire life and career.

Dr. Warner exemplifies what an academic pediatric surgeon and leader should be. Every step along the way, in terms of research, he mentored and guided me—from how to set up my experiments, to how to write abstracts, to how to present my findings and eventually get my work published. All of those things are very important for someone to become an academic surgeon. He really guided me—taking someone who didn’t have any background in basic science research. He met with me often even though he was busy with other responsibilities. From day one, I told him I wanted to be an academic pediatric surgeon, and nine years later we got there.

After residency, I have continued to have a great relationship with him, and on the last day of my fellowship, after everything was said and done, the first person I called was Brad Warner. I said, ‘Hey, this is my last day of fellowship,’ and I just thanked him and expressed my gratitude for everything he had done for me. That was a really special moment that we shared. And that shows how important he was, and still is, as a mentor to me.

Now, I am mentoring a few residents in terms of research projects, and we are writing up some papers, and I plan to continue to do that. I’m actually starting a new job in September at Oregon Health & Science University, and already I’ve talked to some residents there who are eager to jump on some projects. I’m very excited about the prospects.

One of the biggest things I hope to share with the residents is to not focus so much on going through the ranks and being promoted. What is most important is that you love what you do. If your goal is to be an academic surgeon, you have to love the research, you have to love being in the operating room, and you have to love teaching. In time, recognition, the awards, and so on, will come, but you shouldn’t focus on those achievements. That’s a really important point that many of us lose sight of because so much of our goal is to become something—to be given a title, or an award, or some sort of recognition—but the most important thing is do what you love, do a good job, and really try to make a difference in the field of surgery. When you do that, all the other stuff will come naturally.

This was some of the best advice I got as I was getting ready to sign a contract. We all talk about the promotion and the position we held and what goals for the future we should have, but the most important thing is doing what you love, and the rest will follow.

How do you achieve work-life integration? What interests do you have outside of surgery?

To be honest, this has been really challenging. Residency was busy, but fellowship was even busier. My wife and I had two children during my fellowship, and I was hardly home. My wife and mother-in-law helped out so much and kept the family together.

Now that I have graduated, work-life integration is a lot easier. What I learned from Dr. Warner is that family comes first. I don’t do any work at home. This was not always the case, but now, I think it’s very important to put the family first when I am at home. I spend my free time playing with my children, ages two and one, and learning how to cook and bake for them. I take turns taking them to day care and picking them up from day care. On weekends, we go to the park. It’s just a lot of fun. When they were babies, they might not have remembered everything about what was going on around them, but now they are starting to be more aware of the situation, and so the timing in terms of moving into my new professional role was perfect.

My next interest is to get back into road biking. Of course, when I was growing up, that’s how we got around in Virginia and went from one neighborhood to the next. When I was a missionary in Taiwan, that’s how we got around as well—just bicycles. In Oregon, the scenery is beautiful and there are a lot of bike trails, and I’m looking forward to getting out there and starting that up. It’s fun. It’s good for my health. It’s good on the knees. I just really enjoy my time on the bicycle, so I’m excited to get back on it.

What do you consider the greatest challenges facing young surgeons today?

I think one of the greatest challenges that young surgeons will face is how to navigate through all the changes in health care policy. Over the last few decades, the number of surgeons has not drastically increased, but the number of patients and the health care administration has increased. There will be more hoops to jump through and more paperwork that we will have to deal with. The practice of surgery has changed, and young surgeons will have to learn how to adapt to those changes.

One of the hot topics we talk about is burnout and why physicians get burned out—especially electronic health record burnout. It’s important to document accurately and get all the diagnoses and all the charges down, but sometimes we spend more time in front of our computers than with our patients or in the operating room. I think that is just a challenge we are going to have to face. It does make X number of hours turn into double the number of hours we spend in the hospital. Back in the day, surgeons would go in, operate, dictate the operative note, and be done. Now there’s a lot more we have to do.

Even in my 10 years of residency and fellowship training, I think things have changed. We just have to learn and understand the changes and adapt. It’s going to be a challenge for a lot of the younger surgeons to learn to handle the fact that a lot of the hospital administration is going to be dictating how we do our job, regardless of whether you are in an academic or nonacademic practice. Unfortunately, medicine is a business, and I think we’re going to have to adapt to those business ideals that the institutional leadership has instilled.

What advice would you give to another Resident or Associate Fellow seeking to assume a leadership position within the ACS?

I would recommend just finding an interest and being involved to start. I reached out to Joseph Sakran, (MD, MPH, MPA, FACS, a trauma surgeon and assistant professor of surgery, Johns Hopkins University School of Medicine, Baltimore, MD), who was my chief resident when I was a medical student. I noticed that he was publishing quite a bit in the Bulletin, so I asked him about getting involved with the ACS, and he suggested that I come to one of the RAS meetings. I wanted to be involved but didn’t know how to start. Dr. Sakran took me under his wing and suggested that I help the RAS manage its Facebook page. He said the page was new and wasn’t getting a lot of traction and asked if I could help out. It was a small responsibility—I wasn’t given a formal title or anything—that eventually grew into a major role in social media. I spent the entire year trying to build the membership and get more people to follow the Facebook page. Now, it is one of the mainstream social media platforms we use on a regular basis.

This experience led to future opportunities to hold other leadership positions. The next year, I joined the RAS Communications Committee, and the following year, I was elected Secretary of the Communications Committee, and eventually I became Chair of the Communications Committee. Then I joined the RAS Membership Committee and rose through the ranks of that committee as Secretary, Vice-Chair, and then Chair. Then I became Secretary, Vice-Chair, and Chair of the RAS Executive Committee.

There are definitely many opportunities available, and you may not get your first choice, but try again and keep being involved. Be present and available. There is a role for everyone, and you can make it as big or small a role as you want, depending on how much time you can commit. I think the RAS-ACS is a great place to start. It’s a home for everyone and offers an opportunity for everyone.