Episode 25: Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery
In this episode, Tom Varghese, MD, FACS, is joined by Calista M. Harbaugh, MD, MSc, from the University of Michigan. They discuss Dr. Harbaugh’s recent study, “Association of National Accreditation Program for Rectal Cancer Accreditation with Outcomes after Rectal Cancer Surgery,” in which the authors found that hospitals accredited by the National Accreditation Program for Rectal Cancer are associated with lower short- and long-term morbidity and mortality, but few programs achieve accreditation status.
Disclosure Information: Drs Varghese and Harbaugh have nothing to disclose.
Episode 24: Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy
In this episode, Lillian Erdahl, MD, FACS, is joined by Todd Rosengart, MD, FACS, from the Baylor College of Medicine. They discuss Dr. Rosengart’s recent article, “Sustaining Lifelong Competency of Surgeons: Multimodality Empowerment Personal and Institutional Strategy,” which focuses on maintaining and ensuring the competency of an aging surgeon workforce. The study provides evidence-based guiding principles as part of a comprehensive “whole of career” strategy that can be adopted at a personal, institutional, and national level.
Disclosure Information: Drs Erdahl and Rosengart have nothing to disclose.
Episode 23: Home Is Not Always Where the Sleep Is—The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being
In this episode, Tom Varghese, MD, FACS is joined by Jamie Coleman, MD, FACS, from the University of Louisville. They discuss Dr. Coleman’s recent article, “Home Is Not Always Where the Sleep Is: The Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being,” which quantifies sleep loss and burnout associated with home call in acute care surgeons, emphasizing that there are both physical and emotional contributors to burnout.
Disclosure Information: Drs Varghese and Coleman have nothing to disclose.
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Episode 22: Expeditionary Surgeons - Essential to Surgical Leadership in World War II and Today
In this episode, Tom Varghese, MD, FACS is joined by Jeremy Cannon, MD, SM, FACS, from the University of Pennsylvania. They discuss Dr. Cannon’s Excelsior Surgical Society Presidential Address, emphasizing the crucial contribution of expeditionary surgical leaders in World War II and how their legacy serves as an example for military and civilian surgeons seeking to lead in austere settings today.
Disclosure Information: Dr. Varghese has nothing to disclose. Dr. Cannon received royalties from UpToDate for authoring an article on an unrelated topic. Dr. Cannon's institute was supported by funding from CSL Behring.
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Episode 21: Social Determinants of Outcomes Disparity among Pediatric Solid Tumor Patients
In this episode, Lillian Erdahl, MD, FACS is joined by Dai Chung, MD, FACS, from the University of Texas Southwestern Medical Center. They discuss Dr. Chung’s recent study, which demonstrates that poor health outcomes among pediatric solid tumor patients are associated with minority race and residence in rural or border regions, and that the 5-year rate mortality rises with increasing area deprivation score.
Disclosure Information: Drs Erdahl and Chung have nothing to disclose.
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Episode 20: Anchors Aweigh! The History of Women Surgeons at Sea
In this episode, Lillian Erdahl, MD, FACS is joined by Amy Hernandez, MD, FACS, from the Department of Surgery, Naval Medical Center San Diego. They discuss Dr. Hernandez’s recent study, which uses literature review, personal interviews, and correspondence with Navy Medicine administrative leaders to describe the evolution of women providing surgical care at sea.
Disclosure Information: Drs Erdahl and Hernandez have nothing to disclose.
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Episode 19: Practical and Ethical Guidelines for the Involvement of Trainees in Global Surgery: Consensus Statement and Recommendations from the Resident and Associate Society of the American College of Surgeons Global Surgery Work Group
In this episode, Dr. Lillian Erdahl is joined by Erin M Scott, MD, MPH, from the University of Massachusetts Chan Medical School. They discuss Dr Scott’s recent study, which outlines the official recommendations of the American College of Surgeons Resident and Associate Society Global Surgery Work Group guidelines for involvement of trainees in global surgery, with an aim to support equitable, sustainable collaborations that center on improving access to safe, timely, and affordable surgical care for the global community.
Disclosure Information: Drs Erdahl and Scott have nothing to disclose.
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Episode 18: Diverticulitis Familiality: A Statewide Case-Control Study
In this episode, Dr Tom Varghese is joined by Jessica Cohan, MD, from the University of Utah. They discuss Dr Cohan’s recent study, which used statewide medical records linked with genealogy data to evaluate the familial contributions to diverticulitis. The results indicate that diverticulitis has a significant heritable component, which may inform surgeons as they counsel family members about diverticulitis risk and can be used to develop future risk-stratification tools.
Disclosure Information: Drs Varghese and Cohan have nothing to disclose.
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Episode 17: Novel Form of Breast Intraoperative Radiation Therapy with CT-Guided High-Dose-Rate Brachytherapy: Interim Results of a Prospective Phase II Clinical Trial
In this episode, Dr. Jamie Coleman is joined by Shayna Showalter, MD, from the University of Virginia School of Medicine, Charlottesville, VA. They discuss Dr. Showalter’s recent study evaluating precision breast intraoperative radiation therapy (PB-IORT), which uses customized CT-based treatment plans for high-dose-rate (HDR) brachytherapy. Interim results show that PB-IORT has an acceptable breast cancer recurrence rate, minimal side effects, and excellent cosmetic outcomes.
Disclosure Information: Drs. Coleman and Showalter have nothing to disclose.
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Episode 16: Comprehensive Cost Implications of Commercially Available Noninvasive Colorectal Cancer Screening Modalities
In this episode, Dr. Dante Yeh is joined by Casey Allen, MD, from the Institute of Surgery, Division of Surgical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania. They discuss Dr. Allen’s recent study, which found that widespread adoption of the fecal immunochemical test for noninvasive colorectal cancer screening could lead to substantial cost savings. This carries major value implications for a large population health system.
Episode 15: Operationalizing the Culture of Burnout and Well-Being: Multicenter Study of Value Congruence and Flourishing in General Surgery Residency
In this episode, Dr. Jamie Coleman is joined by Carter Lebares, MD, FACS, from the Department of Surgery, University of California San Francisco. They discuss Dr. Lebares’ recent study at 16 academic general surgery training programs, in which residents indicated a perceived lack of value congruence with leadership regarding occupational well-being. Program directors expressed variable alignment with these perceptions. Value congruence was significantly associated with individual resident global well-being.
Epiosde 14: Leadership and Impostor Syndrome in Surgery
In this episode, Dr. Dante Yeh is joined by Lola Fayanju, MD, MA, MPHS, FACS, from the University of Pennsylvania, Philadelphia, PA. They discuss Dr Fayanju’s recent study on impostor syndrome, an internalized sense of incompetence and not belonging. The study found that female physicians were more likely to experience impostor syndrome than male physicians, regardless of specialty or leadership role. While several identity-based gaps persist in leadership, impostor syndrome among racially minoritized groups may not be a significant contributor.
Episode 13: Quantifying the Prognostic Value of Preoperative Surgeon Intuition: Comparing Surgeon Intuition and Clinical Risk Prediction as Derived from the American College of Surgeons NSQIP Risk Calculator
In this episode, Dr. Dante Yeh is joined by Gabriel Brat, MD, FACS, MPH, and Jayson Marwaha, MD, MBI, from Beth Israel Deaconess Medical Center, Boston, MA. They discuss their recent study, which compared the predictive utility of preoperative surgeon intuition and surgical risk calculators and found that, while preoperative surgeon intuition alone is an independent predictor of patient outcomes, traditional risk calculators are more robust predictors of postoperative complication.
Episode 12: COVID Vaccination Status and Operative Outcomes after Kidney Transplantation
In this episode, Dr. Jamie Coleman is joined by Bradley Kushner, MD, from the Washington University School of Medicine, St Louis. They discuss Dr. Kushner’s study, which found that patients who are unvaccinated against COVID-19 have worse compliance and healthcare follow-up after a kidney transplant compared with those who were preoperatively vaccinated.
Episode 11: Severe Increase in Nursing Labor Cost and Effect on Surgical Department Financial Margins at an Academic, Tertiary Medical Center
In this episode, Dr. Jamie Coleman is joined by Clayton Brinster, MD, FACS, from Ochsner Health. They discuss his study, which demonstrates a significant increase in surgical nursing labor cost, with a resultant decrease in department of surgery financial margins. This nationwide, precarious trend is not sustainable, and fiscal recovery will require sustained, strategic workforce allocation.
Disclosure Information: Drs Brinster and Coleman have nothing to disclose.
Episode 10: Truth of Colorectal Enhanced Recovery Programs: Process Measure Compliance in 151 Hospitals
In this episode, Dr. Dante Yeh is joined by Tejen Shah, MD, from The Ohio State University Wexner Medical Center. They discuss his study, which shows that contrary to published enhanced recovery program (ERP) literature, most study hospitals had difficulty improving process compliance, with 80% not achieving substantial improvement. ERP bundles should be implemented in a more deliberate manner with better-planned, pragmatic, and informed strategies.
Disclosure Information: Dr. Shah has nothing to disclose. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.
Episode 9: Fluoroscopic Intraoperative Breast Neoplasm and Node Detection
In this episode, Dr. Jamie Coleman is joined by Roi Weiser, MD, from the University of Texas MD Anderson Cancer Center, and Suzanne Klimberg, MD, PhD, MSHCT, FACS, from the Division of Surgical Oncology at the University of Texas Medical Branch. They discuss their study, which shows that fluoroscopic intraoperative neoplasm and node detection (FIND) can be used to localize the biopsy clip marking a non-palpable breast or axillary lesion, obviating the need for an additional procedure to insert a localization device. Furthermore, FIND shows promising results, with decreased margin positivity and re-excision rate compared with wire localization.
Disclosure Information: Dr. Klimberg receives book royalties from Elsevier, Springer, and Saunders. Drs Coleman and Weiser have nothing to disclose.
Episode 8: Cost-Effectiveness of Universal Screening for Blunt Cerebrovascular Injury: A Markov Analysis
In this episode, Dr. Dante Yeh is joined by Sharven Taghavi, MD, MPH, MS, FACS, from the Tulane University School of Medicine. They discuss his study on blunt cerebrovascular injury (BCVI), which is a significant cause of morbidity and mortality in patients with blunt trauma. Using a Markov decision analysis, the authors found that universal screening for cerebrovascular injury using CT angiography in blunt trauma victims was the optimal strategy.
Disclosure Information: Nothing to disclose.
Disclosures outside the scope of this work: Dr. Taghavi receives funding from the CDC. Dr. Yeh receives author royalties from UpToDate, advisory panel/training honoraria from Takeda Pharmaceuticals, and advisory panel honoraria from Baxter, Eli Lilly, and Fresenius Kabi.
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Episode 7: Disparity-Sensitive Measures in Surgical Care: A Delphi Panel Consensus
In this episode, Dr. Jamie Coleman is joined by Elzerie de Jager, MBBS(Hons), PhD, from the University of Vermont and the Center for Surgery and Public Health, Department of Surgery, Brigham and Women’s Hospital, Harvard Medical School and Harvard TH Chan School of Public Health; and LD Britt MD, MPH, FACS, from the Department of Surgery, Eastern Virginia Medical School. They discuss their study, in which a Delphi panel identified 125 potential disparity-sensitive measures which could be used to track health disparity, evaluate the impact of focused interventions, and reduce healthcare inequity.
Episode 6: Permanent vs Absorbable Mesh for Ventral Hernia Repair in Contaminated Fields
In this episode, Dr. Dante Yeh is joined by Flavio Malcher, MD, MSc, from the Department of Surgery at New York University. They discuss his study, which validates the findings of recent randomized controlled trials in a larger multicenter cohort, suggesting that permanent mesh is the ideal prosthetic to enhance ventral hernia repair even in contaminated fields, which challenges a longstanding surgical dogma.
Episode 5: Core Entrustable Professional Activities for Entering Residency: A National Survey of Graduating Medical Student Self-Assessed Skills by Specialty
In this episode, Dr. Coleman is joined by Dorothy Andriole, MD, FACS, who is a surgeon and the Senior Director of Medical Education Research at the Association of American Medical Colleges, and Jonathan Amiel, MD, who is a professor of psychiatry and Senior Associate Dean for Innovation in Health Professions Education at Columbia University. They discuss their recent study, which found that many graduating students intending to enter surgery agreed they had skills to perform some, although not all, Core Entrustable Professional Activities for Entering Residency. Continued efforts to prepare graduates more optimally for the start of residency training are warranted.
Episode 4: Analyzing Impact of Multimorbidity on Long-Term Outcomes after Emergency General Surgery: A Retrospective Observational Cohort Study
In this episode, Dr. Yeh is joined by Claire Rosen, MD, from the Hospital of the University of Pennsylvania. They discuss her recent paper, which demonstrates that past medical history, specifically multimorbidity, influences the risk of adverse outcomes after emergency general surgery, from increased mortality to limited independence and function. When surgeons understand and communicate these risks, shared decision-making is improved.
Episode 3: Long-Term Outcomes after Adolescent Bariatric Surgery
In this episode, Dr. Coleman is joined by Nestor F. De la Cruz-Muñoz Jr, MD, Professor of Surgery and Section Chief of Bariatric Surgery at the University of Miami. They discuss his recent study, which demonstrates the lasting, positive impact of bariatric surgery even decades later, and confirms that bariatric surgery should not be denied to adolescents struggling with morbid obesity.
Episode 2: Use of Direct Oral Anticoagulant and Associated Bleeding and Thrombotic Complication after Lower Extremity Bypass
In this episode, Dr. Yeh is joined by lead author Danielle C. Sutzko, MD, MS, from the University of Alabama at Birmingham, and senior author Andrea T. Obi, MD, FACS, from the University of Michigan, both vascular surgeons. They discuss their recent work on outcomes associated with direct oral anticoagulant and vitamin K antagonist use after lower extremity bypass.
Episode 1: Mass Shootings in America: Consensus Recommendations for Healthcare Response
In the inaugural episode, Jamie Coleman, MD, FACS, and Dante Yeh, MD, FACS, speak with Craig Goolsby, MD, MEd, FACEP, Professor and Vice Chair of Emergency Medicine at the Uniformed Services University of the Health Sciences and Science Director at the National Center for Disaster Medicine and Public Health in Bethesda, MD about his group’s latest research, which was conducted using a Delphi process and resulted in 19 recommendations for training, public education, triage, communication, patient tracking, medical records, family reunification, and mental health. These consensus recommendations from the surgeons, physicians, and medics who cared for recent mass shooting patients will help everyone prepare for future incidents.
