Cold Steel: Canadian Journal of Surgery Podcast

Podcast transcript: https://www.canjsurg.ca/content/e129-paul-mcbeth-engineering-and-surgery

This week we heard from Dr. Paul McBeth, intensivist and trauma surgeon at the University of Calgary. Dr. McBeth combines his unique engineering background with surgery, and shared his insights on how we all might use an engineering mindset to discover new ways of looking at old problems.

Links:

1. Robotics in neurosurgery. https://pubmed.ncbi.nlm.nih.gov/15476655/

2. Cost-effective remote iPhone-teathered telementored trauma telesonography. https://pubmed.ncbi.nlm.nih.gov/21150536/

Bio:

Dr. Paul McBeth is a Clinical Associate Professor in the Departments of Surgery and Critical Care Medicine at the University of Calgary. He began his career as an engineer with post graduate training in surgical robotics and human performance evaluation. He participated in the design and development of Project neuroArm: an image-guided neurosurgical robot system. During his medical training he continued to develop his research interests in robotics and remote ultrasound. Dr. McBeth completed post graduate training in General Surgery at the University of Calgary with sub-specialty training in Critical Care Medicine at the University of British Columbia and Trauma Surgery at the Elvis Presley Memorial Trauma Centre in Memphis, Tennessee. Dr. McBeth also holds an Adjunct position at the Schulich School of Engineering, University of Calgary where he is involved the a number of technology development projects. He has over 75 peer-reviewed publications and is currently leading a research program supporting intelligent systems monitoring for pre-hospital transport of critically ill patients.

Podcast transcript: https://www.canjsurg.ca/content/e128-helen-pham-australian-surgical-training-programs-and-advice-starting-residency

A big welcome to all the new resident starting this week on their journeys to become physicians and surgeons. To help you on the journey, we caught up with Dr. Helen Pham. Dr. Pham is a clinical associate lecturer at the University of Sydney and is the current HPB fellow at the University of Calgary. Dr. Pham shared with us some of the differences in training paradigms for surgical programs between Canada and Australia, and also gave us her invaluable advice for new trainees. We would love to hear your tips – what do you wish you knew when you were starting out as a PGY1? Email us at [email protected] or tweet at us @CanJSurg.

Links:

1. Dr. Pham's notes, textbook recommendations: https://drive.google.com/drive/folders/1x-QJxNi6T-p5EgNy4ChwImmn2KtzlSAN?usp=sharing

2. QxMD: https://read.qxmd.com/ 

3. 100 years of surgical education: the past, present, and future.  https://bulletin.facs.org/2013/07/100-years-of-surgical-education/ 

4. Five things they don’t teach you in medical school. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5042714/

Bio:

Dr. Helen Pham is an HPB fellow at the University of Calgary. She was previously the Clinical Superintendent of Surgery at Westmead Hospital. She has a number of publications in liver and pancreatic surgery.

Podcast transcript: https://www.canjsurg.ca/content/e127-rob-leeper-competitive-motivation-trauma-simulation-and-starting-out-practice

Dr. Rob Leeper is a trauma surgeon at Western University in London, Ontario. We spoke with Dr. Leeper about his work on trauma simulation and particularly on his work on data drive competitive motivation strategies. Finally, Dr. Leeper shared with us the tips that he wished he had when started out in practice. 

Links:

1. Data Driven Competitive Motivation Strategies in a Longitudinal Simulation Curriculum for Trauma Team Training. https://pubmed.ncbi.nlm.nih.gov/30833203/

2. Multidisciplinary Difficult Airway Course: An Essential Educational Component of a Hospital-Wide Difficult Airway Response Program. https://pubmed.ncbi.nlm.nih.gov/29628333/

3. The role of trauma team leaders in missed injuries: does specialty matter? https://pubmed.ncbi.nlm.nih.gov/24089109/

Bio: 

Dr. Rob Leeper is an Assistant Professor in the Department of Surgery at Western University. He is an acute care and trauma surgeon with an interest in resuscitation, both inside and outside the operating room. He did residency in Western and went on to do a prestigious trauma fellowship at Johns Hopkins University. He is the father of 3 and a former college football player.

Lauren Kirwan is the nurse clinician for general surgery at the Foothills Medical Centre. She is currently finishing up her nurse practitioner degree. 

We wanted to ask Lauren her thoughts about what it means to be an OR nurse and what she wishes surgeons would do to make the OR environment better. We also hear about the impact of COVID19 on our nursing colleagues. We’d love to hear from our nurse listeners – what are some things that make your day or make you mad in the operating room? Email us at [email protected] with your thoughts and comments. 

Links:

1. Melinda Davis on the Anesthetist - Surgeon relationship: https://soundcloud.com/cjs-podcast/e40-melinda-davis-on-career-counseling-and-the-anesthetist-surgeon-relationship

2.  Atul Gawande paper on Safe Surgery Checklist implementation in South Carolina. Perception of Safety of Surgical Practice Among Operating Room Personnel From Survey Data Is Associated With All-cause 30-day Postoperative Death Rate in South Carolina. https://journals.lww.com/annalsofsurgery/Abstract/2017/10000/Perception_of_Safety_of_Surgical_Practice_Among.14.aspx

We had the unique opportunity on this episode to speak with the Honourable Minister John Haggie. Dr. Haggie is a general surgeon who spent his career in Newfoundland and Labrador, and went on to become a Member of the House of Assembly in 2015. He was appointed to be the Minister of Health at that time and has continued to serve in that porfolio ever since. We spoke to him about his fascinating life story, his thoughts on leadership and the role of physicians in politics, and about his favourite book Shogun!

Bio (fromhttps://www.gov.nl.ca/hcs/department/minister/):

The Honourable John Haggie
Minister of Health and Community Services

Born in England, the Honourable John Haggie completed his medical studies at Victoria University in Manchester. He held several positions as physician, surgeon, tutor and registrar in the North West region of England and after a two-year fellowship, he received a doctorate in cancer research.

Since moving to Canada in the early nineties, Minister Haggie has had a long and distinguished career in medicine in Newfoundland and Labrador. He practiced initially as a general surgeon in St. Anthony with the Grenfell Region Health Services. In 1997, he was appointed attending surgeon of general and vascular surgery at James Paton Memorial Hospital in Gander. In 2008, he was appointed Chief of Staff at James Paton Memorial Hospital.

Dr. Haggie served as President of the Newfoundland and Labrador Medical Association and the Canadian Medical Association.

In Newfoundland and Labrador’s 2015 general election, he was elected MHA for the District of Gander and appointed to Cabinet to serve as the Minister of Health and Community Services, and continues to serve in that portfolio.

Dr. Haggie resides in Gander with his wife Jeanette and two Westies, Chloe and Gracie.

This week on the podcast we spoke with Dr. Paul Engels, a trauma surgeon from McMaster University in Hamilton, Ontario. We got into some pretty detailed discussions around trauma training specifically, but more broadly about how we define what a resident should be able to perform at the end of training. 

Links:

1. The current state of resident trauma training: Are we losing a generation? https://pubmed.ncbi.nlm.nih.gov/29806811/

2. Canadian Collaborative on Urgent Care Surgery (CANUCS): https://canucs.ca/

3. Cause for concern: Resident experience in operative trauma during general surgery residency at a Canadian centre. https://journalhosting.ucalgary.ca/index.php/cmej/article/view/69323/54233

4. Toward an all-inclusive trauma system in Central South Ontario: development of the Trauma-System Performance Improvement and Knowledge Exchange (T-SPIKE) project. https://pubmed.ncbi.nlm.nih.gov/33720676/

5. ASSET course: https://www.facs.org/quality-programs/trauma/education/asset/

6. Treatment of Ongoing Hemorrhage: The Art and Craft of Stopping Severe Bleeding. https://www.amazon.ca/Treatment-Ongoing-Hemorrhage-Stopping-Bleeding/dp/3319634941. 

7. Simulated Trauma and Resuscitation Team Training (S.T.A.R.T.T) course: https://caep.ca/cpd-courses/simulated-trauma-and-resuscitation-team-training-s-t-a-r-t-t/

8. Definitive Surgical Trauma Care (DSTC™) Courses.  https://iatsic.org/DSTC/

9. Advanced Trauma Operative Management (ATOM) course. https://atomcourse.com/#:~:text=The%20Advanced%20Trauma%20Operative%20Management,post%2Dcourse%20exams%20and%20evaluations.

10.  BEST - Basic Endovascular Skills for Trauma. https://medschool.ucsd.edu/som/surgery/divisions/trauma-burn/training/courses/Pages/REBOA-Course.aspx.

Bio:

Paul Engels is a Trauma/General Surgeon and Intensivist at McMaster University in Hamilton, Ontario. He completed his residency in General Surgery and fellowship in Critical Care at the University of Alberta. He completed a fellowship in Trauma & Acute Care Surgery at Sunnybrook Health Sciences Centre in Toronto. He is a Fellow of the Royal College of Surgeons of Canada and the American College of Surgeons, as well as a member of the Eastern Association for the Surgery of Trauma and the American Association for the Surgery of Trauma.

This week we were joined by Dr. Pasieka once again to talk about strategies to find stress and burnout as surgeons, especially in the context of COVID19. Check out her paper below!

Links:

1. Shinrin-yoku, yoga and other strategies in the fight against COVID-19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405594/

Bio:

Dr. Janice L Pasieka graduated from the University of Western Medical School and did her General Surgery Training at the University of Calgary. She then did two and a half years of Endocrine Surgical Training. The first year was spent in Dr David Hanley’s lab at the University of Calgary, then a year at the University of Michigan, under the mentorship of Dr. Norman Thompson followed by time at the Karolinska Institute in Stockholm, Sweden. She then returned to Calgary and has devoted her clinical practice solely to endocrine surgical diseases.

At the Tom Baker Clinic Center, Dr Pasieka was the driving force behind the development of a multidisciplinary clinic for Neuroendocrine Tumors as well as the Multidisciplinary Hereditary Endocrine Clinic. She is responsible for the development of the only Canadian AAES accredited fellowship program in Endocrine Surgery.
Dr Pasieka has been Secretary-Treasurer of the American Association of Endocrine Surgeons (AAES) and in 2010 she became the first Canadian and second woman to become President. She has served on the Council of the International Association of Endocrine Surgeons (IAES), and in 2016 became the Secretary-Treasurer - a position she holds at the present time. Dr Pasieka was the Canadian James IV Traveling Surgical Fellow 2006 and recently was appointed to the James VI Board of Directors. In 2007, the Women’s Executive Network named her as one of Canada’s 100 Most Powerful Women.
Dr Pasieka recently completed her six year term as a Governor of the American College of Surgeons. Her areas of interests (besides running, mountain biking, cycling and hiking & snowshoeing with her dog Kocher) evolve around neuroendocrine tumors, adrenal disease, thyroid cancer and the study of surgical outcomes in patients with hyperparathyroidism. To date she has over 140 peer-review publications, has edited 3 Endocrine Surgical textbooks and written over 24 book chapters.

Dr. Bill Wall is one of the pioneers of liver transplantation, especially in Canada. We spoke to him on this episode about his training, the early days of transplantation and about his new children's book!

Links:

1. Member of the Order of Canada: https://www.gg.ca/en/honours/recipients/146-9121

Bio (from https://www.gg.ca/en/honours/recipients/146-9121)

William Wall is a dedicated and compassionate physician whose surgical and clinical proficiency have benefited many Canadians with end-stage organ disease. Professor of surgery at the University of Western Ontario, he established Canada's first liver transplant program at the London Health Sciences Centre, where he is director of the Multi-Organ Transplant Program. In this role, he has promoted excellence in research and patient care, as well as public awareness and support for organ donation. Widely respected by his peers, he served as president of the International Liver Transplantation Society.

This week we had the pleasure of interviewing Dr. Peter Brennan (https://twitter.com/BrennanSurgeon?s=20&t=VZQWDi0op02x9_8qdn3Avg). Dr. Brennan is an oral maxillofacial surgeon in Portsmouth, England. A tremendously accomplished academic, Dr. Brennan has a keen interest in human factors in surgery. In addition, he is the co-editor of the Gray’s Surgical Anatomy. 

Links:

1. Dr. Brennan’s PhD on human factors: https://researchportal.port.ac.uk/portal/files/18357979/Peter_A_Brennan_PhD_thesis.pdf
2. We need to reduce hierarchy and empower junior doctors to speak up (BMJ): https://blogs.bmj.com/bmj/2019/05/03/improving-patient-safety-we-need-to-reduce-hierarchy-and-empower-junior-doctors-to-speak-up/
3. MDT meetings: https://onlinelibrary.wiley.com/doi/full/10.1111/jop.12853
4. Gray’s Surgical Anatomy: https://www.elsevier.com/books/grays-surgical-anatomy/brennan/978-0-7020-7386-1

Bio (from https://solentmaxillofacialclinic.com/professor-peter-brennan/)

Peter has been a consultant Oral and Maxillofacial Surgeon at Portsmouth Hospitals NHS Trust since 2002. He is also honorary Professor of Surgery and Head of the Academic Department of Surgery, at the University of Portsmouth. He qualified with honours in both medicine (1994) and dentistry (1987) gaining distinctions and winning many prizes in subjects including anatomy, pharmacology, anaesthetics, surgery, obstetrics and gynaecology and ophthalmology.

Last year, the Royal College of Physicians and Surgeons of Glasgow elected Peter as an Honorary Fellow, the first Maxillofacial Surgeon to receive this accolade.

Peter’s main clinical interests are head and neck malignancy, reconstructive free flap surgery and neck lumps. He is a research supervisor, an examiner for higher research degrees and has published over 500 papers to date covering many aspects of oral and maxillofacial surgery including cancer. Peter’s research has been awarded both National and International research prizes, and he has lectured extensively in the UK and abroad.

Peter has edited a number of books including the definitive 2 volume reference textbook of the speciality, Maxillofacial Surgery, which is used worldwide. He is the lead editor of the forthcoming Gray’s Surgical Anatomy, sister publication to the famous Gray’s Anatomy.

Welcome to all our Cold Steel listeners! We are excited to be collaborating with the Society of American Gastrointestinal and Endoscopic Surgeons or SAGES. SAGES produces an excellent podcast called the SAGES stories podcast, where they highlight some of the amazing work SAGES members have been doing. 

In this episode, SAGES stories hosts Shirin Towfigh and Kevin El Hayek interview one of our favourite former guests Dr. Liane Feldman, the outgoing presidents of SAGES.

Links:

1. SAGES Stories: https://www.sages.org/category/sages-stories/

2. Cold Steel interview  https://soundcloud.com/cjs-podcast/e89-liane-feldman-on-sages-presidency-future-of-mis-and-fuse-program?in_system_playlist=artist-stations%3A636175068