Cold Steel: Canadian Journal of Surgery Podcast

Dr. Mark Campbell is a board certified general surgeon, a member of the Texas Surgical Society, and a Fellow of the American College of Surgery. He received a B.S. in Pre-Medical Biology at The University of Texas at Arlington in 1976 and received his M.D. from the University of Texas Medical School at Houston in 1979. He finished his surgical residency at St. Joseph’s Hospital in Houston in 1984. He has been practicing general surgery for 23 years and is currently in private practice in Paris, Texas. He has been a member of the Space Medicine Branch and The Aerospace Medical Association since 1989. He has authored or co-authored 25 published papers concerning surgical care during space flight and surgical techniques in weightlessness. Ten of these articles were published in Aviation Space and Environmental Medicine. He also was the author for the surgical section of “Medical Guidelines for Air Travel” published by the Aerospace Medical Association. Dr. Campbell has been a private pilot since 1984 (single and multi-engine ratings) and received his Air Force Flight Surgery wings in 1994. He began performing parabolic flight research with NASA Medical Operations at the Johnson Space Center in 1991 and was a NASA Flight Surgeon at the Johnson Space Center from 1994 to 1996 where he was deployed to Star City, Russia to support the Shuttle-Mir program.

In this episode we talk to him about prophylactic surgery for astronauts, developing remote surgical capacity, and telementored ultrasound. 

Links:

1. Nonoperative treatment of suspected appendicitis in remote medical care environments: implications for future spaceflight medical care. https://pubmed.ncbi.nlm.nih.gov/15110816/.

2. A review of surgical care in space. https://pubmed.ncbi.nlm.nih.gov/12081072/

3. Prophylactic surgery prior to extended-duration space flight: is the benefit worth the risk? https://pubmed.ncbi.nlm.nih.gov/22564516/

Dr. Melinda Davis (https://twitter.com/melindadavisyyc) is an anesthesiologist at the Foothills Medical Centre. She has a fellowship in neuroanesthesiology and clinical interest in perioperative medicine.

While she spends half her professional life putting people to sleep, Dr. Davis spends the other half attempting to inspire and energize them. She teaches at all levels of medical education from students in undergraduate medical education through to faculty development. She believes in finding the forest before the trees, and helping learners create strong cognitive scaffolds. She has been the recipient of numerous awards for education including the Jones Award for Teaching Excellence in Undergraduate Medical Education.

Dr. Davis holds a number of leadership positions in medical education. She is the Director of the Anesthesiology Clerkship, Associate Program Director of the Anesthesiology Residency Program, and the Director of the Master Teacher Program in Undergraduate Medical Education. Dr. Davis has a research interest in medical student career choice, shaped by the observation that medical students in Canada are making important, complex career decisions under considerable time pressure. She is the lead of the Career Exploration Program which aims to help students make informed, confident career choices in medicine.

An ectopic Australian, Dr. Davis has replaced oceans and beaches with time in the mountains at any opportunity.  She can be found there with her daughter, in a tent, on foot, on skis, or on a horse, but never with a bad cup of coffee.                  

In this episode with Dr. Davis, we put the surgery-anesthesia relationship on the table, dissect it out and try to think about ways we can make that relationship better. We also talk about career counseling for medical students and Dr. Davis’s role as the new program director for the Calgary anesthesia program. 

Links:
1. Career Counseling at UCalgary: https://cumming.ucalgary.ca/mdprogram/current-students/student-advising-wellness

2. Stats on CaRMS matching: https://pubmed.ncbi.nlm.nih.gov/32802225/

3. CFMS handbook on differential match rates in CaRMS: https://www.cfms.org/files/matchbook/MatchStats.pdf

4. Royal College CanMEDS framework: http://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e

5. Association of Coworker Reports About Unprofessional Behavior by Surgeons With Surgical Complications in Their Patients. https://jamanetwork.com/journals/jamasurgery/fullarticle/2736337

In this episode, we do a practice mock oral examination. We hope that this can help candidates to get a sense of the Royal College oral examinations. Although there are no oral exams this year, we hope to help next year's examinees get in the mindset for studying and practicing for the oral exam. 

Thanks again to our examiners Dr. Caitlin Cahill and Dr. Greg Knapp!
Dr. Cahill's slides: https://drive.google.com/file/d/1hSiLxlEEvqwC23Qbe4-8kU2ESoEabQN7/view?usp=sharing

Dr. Knapp's slides: https://drive.google.com/file/d/1XkjC1nlT-XvUqHjfQx_yxfLY1H6AuxGg/view?usp=sharing

Dr. Caitlin Cahill is a colorectal fellow at the University of Calgary. She did general surgery residency at the University of Ottawa. She has been instrumental in helping the Calgary chief residents prepare for their exams. 

Dr. Greg Knapp is a repeat guest on Cold Steel! He did residency at Dalhousie University, a year of community practice, a year as a Global Surgical Oncology Fellow at Memorial Sloan Kettering and is pursuing his surgical oncology fellowship at the University of Calgary.

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.
 
In this episode, we get Dr. Pasieka’s thoughts on conferences, gender equity and Dr. Pasieka’s approach to surgical education and training. 

Links:
1. American Association of Endocrine Surgeons (AAES): https://www.endocrinesurgery.org/
2. Chernobyl on Netflix: https://www.imdb.com/title/tt7366338/
3. Norm Thompson: https://americansurgical.org/transactions/Fellows/Memoirs/NormanWThompson.cgi
4. Kindred spirits of the endocrines: The training of the future endocrine surgeons. https://onlinelibrary.wiley.com/doi/abs/10.1002/jso.20176

Born and raised in Newfoundland and Labrador, Dr. Furey (https://twitter.com/FureyAndrew) is a passionate orthopaedic trauma surgeon and educator with Memorial University’s School of Medicine. He also holds a Diploma in Organizational Leadership from Oxford University. His strong work ethic has earned him many local, provincial, and national awards and honours. He was named Humanitarian of the Year by the Canadian Red Cross and earned the Governor General of Canada’s Meritorious Service Cross.

In 2010, he helped create Team Broken Earth to provide medical relief after the devastating earthquake in Haiti. This Newfoundland and Labrador-born charity has since expanded in size and scope. Today, over 1,500 volunteers from across Canada, the US, and UK have participated in medical missions to Haiti as well as Bangladesh, Ethiopia, Guatemala, and Nicaragua.

Dr. Furey is also the new premier-elect of the province of Newfoundland after winning the Liberal Party nomination on August 4, 2020. In this episode, we hear about how Dr. Furey started Team Broken Earth, a humanitarian organization, his work in Haiti and his thoughts on leadership and physician advocacy.

Links:

1. https://andrewfurey.ca/

2. Morbidity and mortality following pelvic ramus fractures in an older Atlantic Canadian cohort. http://canjsurg.ca/62-4-270/

3. The Orthopedic Trauma Symposium: improving care of orthopedic injuries in Haiti. http://canjsurg.ca/60-4-228/

4. Team Broken Earth: https://brokenearth.ca/

5. Courses from the Canadian Medical Association: https://www.cma.ca/advocacy-skills-coaching

Dr. Todd McMullen is a scientist and endocrine surgeon at the University of Alberta in Edmonton, Alberta. In this episode we talk to Dr. McMullen about a topic that is sometimes a pain in the neck for trainees: thyroid nodules. Dr. McMullen gives us his approach to nodules, how he works them up, a brief overview of how he does his thyroidectomies, and post op calcium management. We hope you enjoy!

Dr. Todd McMullen is a fellowship trained endocrine surgeon with specialized training in thyroid ultrasound techniques.He received his PhD in Biochemistry from the University of Alberta, then completed a Medical Research Council of Canada Post-Doctoral Fellowship in the Department of Physiology at the University of Virginia in Charlottesville, Virginia. Having received his PhD and additional training in Physiology, Dr. McMullen went on to complete medical school at the University of Toronto and a residency in General Surgery at the University of Alberta. He further specialized in Endocrine Surgery  at the Royal North Shore Hospital in Sydney, Australia, where he finished a TS Reeve Fellowship in Endocrine Surgery.

Since that time, Dr. McMullen has been an active member of the University of Alberta staff as part of the Faculty of Medicine and Dentistry, where he now holds positions in Surgery and Oncology (Division of General Surgery), an Adjunct appointment in the Division of Endocrinology (Department of Medicine) and also serves as the Director of the Division of Surgical Oncology (Department of Oncology) based at the Cross Cancer Institute.

In this episode we get Dr. McMullen's approach to thyroid nodules, thyroidectomies and post-op management.

Links:

1. TIRADS score: https://radiopaedia.org/articles/acr-thyroid-imaging-reporting-and-data-system-acr-ti-rads

2. South Korea's Thyroid-Cancer "Epidemic"--Turning the Tide. https://pubmed.ncbi.nlm.nih.gov/26650173/

3. The 2017 Bethesda System for Reporting Thyroid Cytopathology. https://pubmed.ncbi.nlm.nih.gov/29091573/

4. Minimally invasive thyroid surgery for single nodules: an evidence-based review of the lateral mini-incision technique.

Dr. Christian Finley trained in General Surgery in at UBC in Vancouver, BC and thereafter completed his training in Thoracic Surgery in Toronto at UofT. After completing advanced training in Leuven, Belgium and England, he started working at St. Joseph's Healthcare Hamilton in 2010. He completed his Masters of Public Health at Harvard University. Since joining the Division of Thoracic Surgery, Dr Finley has been awarded over $600 000 in research funding for his active research program in thoracic surgery quality improvement and has put considerable effort towards developing the collaborative clinical research program with his Thoracic Surgery colleagues. He is the proud father of three crazy girls.

In this episode, we talk with Dr. Finely about his work with the Canadian Partnership Against Cancer (CPAC) in demonstrating disparities in surgical cancer care across Canada.

1. The spatial epidemiology of trauma: the potential of geographic information science to organize data and reveal patterns of injury and services. http://canjsurg.ca/wp-content/uploads/2014/03/51-5-389.pdf

2. Julia Abelson. https://www.mcmasterforum.org/lets-collaborate/people/bio/julia-abelson

3. Understanding Failure to Rescue and Improving Safety Culture. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4385410/

4. Pan-Canadian standards for cancer surgery. Canadian Journal of Surgery. https://canjsurg.ca/wp-content/uploads/2019/07/62-4-S170.pdf

5. Surgical Skill and Complication Rates after Bariatric Surgery. https://www.nejm.org/doi/full/10.1056/NEJMsa1300625

6. "Personal Best" by Atul Gawande in the New Yorker about coaching in the operating room. https://www.newyorker.com/magazine/2011/10/03/personal-best

Dr. Prism Schneider is an orthopedic trauma surgeon and Assistant Professor at the University Calgary. Dr. Schneider is well known for her research on many topics, particularly on the use of thromboelastography in post operative and hospitalized patients. In this episode, we delve into Dr. Schneider’s research on intimate partner violence, and how surgeons might do a better job of recognizing it.

Links:
1. Health care practitioners’ responsibility to address intimate partner violence related to the COVID-19 pandemic. https://www.cmaj.ca/content/192/22/E609

2. Intimate Partner Violence and Orthopaedics: AOA Critical Issues. https://europepmc.org/article/med/31274727

3. Mohit Bhandari interview on Cold Steel: https://soundcloud.com/cjs-podcast/e20-mohit-bhandari-on-surgical-trials-productivity-and-presentations

4. Novel educational program improves readiness to manage intimate partner violence within the fracture clinic: a pretest–posttest study. http://cmajopen.ca/content/6/4/E628.full

Dr. Charles Vollmer is the Director of Pancreatic Surgery at the University of Pennsylvania where he holds the rank of Professor of Surgery. Dr. Vollmer began his career at the Beth Israel Deaconess Medical Center in Boston where he served as an Assistant Professor of Surgery at Harvard Medical School before moving to Penn in 2011. He specializes in Pancreaticobiliary and other complex gastrointestinal surgery with a clinical research focus in outcomes assessment of high-acuity surgery. He has authored over 100 manuscripts and numerous book chapters. He is active in multiple national and international surgical societies where he has served in various leadership positions, including being a past President of the AHPBA. He is the current Scientific Program Chair for the IHPBA, and sits on their Executive Committee and Council. He is currently a reviewer for over 20 medical specialty journals and is on the Editorial Boards of Annals of Surgery, Surgery, HPB, JOGS, and the Journal of Surgical Oncology.

In this episode, we delve into why Dr. Vollmer is so passionate about the pancreas and why he has done over a thousand peer reviews for surgical journals.

1. https://soundcloud.com/cjs-podcast/e07-paul-greig-on-transplantation-surgical-education-and-retiring-from-surgery

2. Clinical and Economic Validation of the International Study Group of Pancreatic Fistula (ISGPF) Classification Scheme. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1877022/

3. The Pancreas Club: https://www.pancreasclub.com/

4. Pancreatic Head Resection Following Roux-en-Y Gastric Bypass: Operative Considerations and Outcomes. https://pubmed.ncbi.nlm.nih.gov/31485901/

Dr. Omar Farooq is a general surgeon at Fort Saskatchewan Hospital in Fort Saskatchewan, Alberta. He did his MBBS in Punjab Medical College in Faisalabad, Pakistan. He then went on to do his internship at Case Western in Cleveland, general surgery resident at the University of Saskatchewan, and MIS fellowship at McMaster. 

In this episode, we hear his experiences as an International Medical Graduate (IMG). Dr. Farooq shares his advice for IMG's on navigating the system, as well as how we could potentially make the system better.

Links: 

1. Growth Mindset: https://hbr.org/2016/01/what-having-a-growth-mindset-actually-means

2. https://www.amazon.ca/Mans-Search-Meaning-Viktor-Frankl/dp/080701429X