Cold Steel: Canadian Journal of Surgery Podcast

Paul Fedak is a cardiac surgeon and translational scientist at the University of Calgary. He has written and spoken about what it means to pursue excellence and what it might cost us. Dr. Fedak unexpectedly had to cut short his clinical career as a surgeon due to spinal cord issues. The result has been a powerful exploration about identity, meaning, burnout and the pursuit of excellence. This is a conversation about that pursuit.

Bio: https://profiles.ucalgary.ca/paul-fedak 

Links:

1. https://www.theglobeandmail.com/opinion/article-as-a-heart-surgeon-i-chased-excellence-it-cost-me-my-body-and-my-mind/
2. http://paulfedak.com/
3. https://www.ted.com/talks/paul_fedak_beyond_mastery_how_a_heart_surgeon_found_his_own_heart
4. https://calgaryherald.com/opinion/columnists/opinion-the-mountain-decides-who-goes-and-who-stays 

It's that time of year again. Can you sense it? The anticipation, the anxiety, the dread, the wracking of heart and head? Yes, it's almost time for final year Canadian medical students across the country to submit their rank lists to CaRMS.

On this episode we explore the history of CaRMS and the underlying matching algorithms.

We then talk about some of our top tips when building your CaRMS rank list.

What do you think? How did you make your rank list? Send us an email at [email protected].

Links:

1. Young TA. Teaching medical students to lie. The disturbing contradiction: medical ideals and the resident-selection process. CMAJ. 1997 Jan 15;156(2):219-22. PMID: 9012725; PMCID: PMC1226912. https://pmc-ncbi-nlm-nih-gov.proxy.queensu.ca/articles/PMC1226912/ 
2. https://pmc-ncbi-nlm-nih-gov.proxy.queensu.ca/articles/PMC1226912/
3. Roth AE. The origins, history, and design of the resident match. JAMA. 2003 Feb 19;289(7):909-12. doi: 10.1001/jama.289.7.909. PMID: 12588278.
4. https://impact.stanford.edu/article/how-does-applied-economics-maximize-kidney-transplants
5. Cal Newport’s books: https://calnewport.com/writing/
   
   

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed November 2025. This webinar was moderated by Dr. Alison Laws and Dr. Ameer Farooq, and featured panelists Dr. Nicole Culos-Reed, Dr. Christopher Booth and Dr. Bishal Gyawali.

In this EBRS webinar, we discussed Structured Exercise after Adjuvant Chemotherapy for Colon Cancer (Courneya et al., 2025).

Links:

1. Courneya KS, Vardy JL, O’Callaghan CJ, et al. Structured Exercise after Adjuvant Chemotherapy for Colon Cancer. N Engl J Med. 2025;393(1):13-25. doi:10.1056/NEJMoa2502760

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed July 2025. This webinar was moderated by Dr. Kelly Vogt and Dr. Chad Ball, and featured panelists Dr. Bourke Tillmann and Dr. Emilie Joos.

In this EBRS webinar, we discussed Getting out of the bay faster: Assessing trauma team performance using trauma video review" (Maiga et al., 2024).

Links:

1. Maiga AW, Vella MA, Appelbaum RD, et al. Getting out of the bay faster: Assessing trauma team performance using trauma video review. J Trauma Acute Care Surg. 2024;96(1):76-84. doi:10.1097/TA.0000000000004168

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed May 2025. This webinar was moderated by Dr. Alison Laws and Dr. Kerollos Wanis, and featured panelists Dr. Stephanie Wong, Dr. Sarah Knowles and Dr. Rebecca Warburton.

In this EBRS webinar, we discussed Axillary Surgery in Breast Cancer--Primary Results of the INSEMA Trial (Reimer et al., 2024) & Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes (Gentilini et al., 2023).

Links:

1. Gentilini, O. D., Botteri, E., Sangalli, C., Galimberti, V., Porpiglia, M., Agresti, R., Luini, A., Viale, G., Cassano, E., Peradze, N., Toesca, A., Massari, G., Sacchini, V., Munzone, E., Leonardi, M. C., Cattadori, F., Di Micco, R., Esposito, E., Sgarella, A., Cattaneo, S., … SOUND Trial Group (2023). Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial. JAMA oncology, 9(11), 1557–1564. https://doi.org/10.1001/jamaoncol.2023.3759
2. Reimer, T., Stachs, A., Veselinovic, K., Kühn, T., Heil, J., Polata, S., Marmé, F., Müller, T., Hildebrandt, G., Krug, D., Ataseven, B., Reitsamer, R., Ruth, S., Denkert, C., Bekes, I., Zahm, D. M., Thill, M., Golatta, M., Holtschmidt, J., Knauer, M., … Gerber, B. (2025). Axillary Surgery in Breast Cancer – Primary Results of the INSEMA Trial. The New England journal of medicine, 392(11), 1051–1064. https://doi.org/10.1056/NEJMoa2412063

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed January 2022, in collaboration with UNITAR. This webinar was moderated by Dr. Chad Ball and Dr. Neel Detta, and featured panelists Dr. Keith Lillemoe, Dr. Majella Doyle and Dr. Jeff Barkun.

In this EBRS webinar, we discussed Safe Cholecystectomy Multi-society Practice Guideline and State of the Art Consensus Conference on Prevention of Bile Duct Injury During Cholecystectomy (Brunt et al., 2020).

Links:

1. Brunt LM, Deziel DJ, Telem DA, et al. Safe Cholecystectomy Multi-society Practice Guideline and State of the Art Consensus Conference on Prevention of Bile Duct Injury During Cholecystectomy. Ann Surg. 2020;272(1):3-23. doi:10.1097/SLA.0000000000003791

This Evidence Based Reviews in Surgery (EBRS) webinar was filmed February 2025. This webinar was moderated by Dr. Kelly Vogt and Dr. Chad Ball, and featured panelists Dr. James Byrne, Dr. Kimberly Bertens and Dr. Sean Gregg.

In this EBRS webinar, we discussed Restrictive Strategy vs Usual Care for Cholecystectomy in Patients with Abdominal Pain and Gallstones: 5-Year Follow-Up of the SECURE Randomized Clinical Trial (Comes et al., 2024).

Links:

1. Comes DJ, Wennmacker SZ, Latenstein CSS, et al. Restrictive Strategy vs Usual Care for Cholecystectomy in Patients With Abdominal Pain and Gallstones: 5-Year Follow-Up of the SECURE Randomized Clinical Trial. JAMA Surg. 2024;159(11):1235-1243. doi:10.1001/jamasurg.2024.3080

The William Ersil Research day invited guest and moderator for 2025 was Dr. Krista Goulding. 

Dr. Goulding is an Orthopedic Surgeon at Mayo Clinic Arizona, where she specializes in caring for patients with sarcomas and other cancerous and non-cancerous tumors of the musculoskeletal system.

 Dr. Goulding’s expertise is in limb preservation surgery using innovative techniques (synthetic and bone transplants, 3D printed and patient-specific implants, joint replacement). Her goal is to cure cancer while preserving function and quality of life. She is involved in research on a national and international scale, and is currently researching ways to improving surgical, oncologic and health-related quality of life outcomes for patients with malignant bone and soft tissue cancers.

In this “How I Built This” segment of the research day, we explored Dr. Goulding’s career.

Links:

1. What are the 2-year survivorship outcomes of custom hemipelvis reconstruction after hemipelvectomy and revision arthroplasty? The evolution of a custom ilium "monoflange". https://pubmed-ncbi-nlm-nih-gov.proxy.queensu.ca/36255157/
2. Košir U, Denis-Larocque G, Tsimicalis A, Freeman C, Turcotte RE, Cury F, Alcindor T, Goulding K. Psychological functioning, coping styles and their relationship to appraisal of physical limitations following invasive surgical procedures for soft-tissue sarcoma: A qualitative study. J Surg Oncol. 2020 Jun;121(8):1266-1275. doi: 10.1002/jso.25915. Epub 2020 Mar 27. PMID: 32221986.

Surgery has never been more complicated. The variety of surgical approaches and the complexity of treatment continue to grow exponentially, yet in many institutions, surgical training has not really changed. Dr. Adnan Alseidi, our guest for this episode, is trying to change that. 

Dr. Adnan Alseidi is a liver and pancreas surgeon at UCSF and is the associate dean of assessment, improvement, and accreditation. He recently gave the Langer lecture at the Canadian Surgical Forum in Montreal this year about surgical education and the path from novice to master. This episode was really a moment for us to ask all our burning questions about surgical education. What are the phases of mastery? Should we really be aiming for mastery? And how do we create trust between attending and trainees?

We’d love to hear your thoughts and comments, so email us at [email protected].

Links:

1. Medical school accreditation is outdated. WSJ. https://www.wsj.com/opinion/medical-school-accreditation-is-outdated-holds-back-innovation-nyu-98fe80bd
2. https://www.canadiansurgeryforum.com/biographies
3. An Integrative Model of Organizational Trust. Roger C. Mayer, James H. Davis, F. David Schoorman. The Academy of Management Review, Vol. 20, No. 3 (Jul., 1995), pp. 709-734 (26 pages). https://www.jstor.org/stable/258792
4. Ericsson. https://share.google/bRhcSSC7sKKp9bX9b
5. The Five-Stage Model of Adult Skill Acquisition. Dreyfus model. https://share.google/2GSuypiGKExQMeMPX
6. Wicked problems! Horst W. J. Rittel & Melvin M. Webber . Dilemmas in a general theory of planning
7. The Book Of Joy: Lasting Happiness In A Changing World. Dalai Lama,Desmond Tutu,Douglas Carlton Abrams
   
   

Dr. Teresa Purzner MD PhD FRCSC is a clinician scientist neurosurgeon with a special interest in neuroncology and general neurosurgery.  She completed her residency training at the University of Toronto, and her PhD training at Stanford University.  Her lab, run jointly with her husband Dr. James Purzner, is focused on interdisciplinary approaches to identifying novel drug targets for brain cancer as well as the translation of promising new drug targets into human-ready therapeutics.  Her work has led to the identification of a critical new drug target in the brain tumor medulloblastoma – a discovery that she has since translated into a novel drug for both brain cancer and skin cancer, currently being tested in phase 1 and phase 2 clinical trials.  This work has resulted in her being named a Stanford Interdisciplinary Graduate fellow, Biox fellow and SPARK fellow, and has earned her both national and international recognition including the Annual Award of the American Academy of Neurological Surgery, the K.G. McKenzie prize for Basic Science Research, AANS Louise Eisenhardt Award and the Neurosurgery Research and Education Fellowship.

She is a mom, an entrepreneur, and design-thinker, having created her own baby food company as well as redesigned the Integrated Brain Tumor Program. 

Links:

1. Integrated Brain Tumor Program: https://surgery.queensu.ca/administration/announcements/integrative-brain-tumor-program-achieving-best-class-patient-outcomes
2. https://www.ibtp.ca/purzner-lab
3. https://www.theglobeandmail.com/business/economy/article-how-a-neurosurgeon-used-her-entrepreneurial-background-to-revamp-a/