In this episode of the Brown General Surgery Podcast, PGY-4 resident Evan Mitchell sits down with two Brown Surgery faculty—one of our senior Trauma surgeons, Dr. Andrew Stephen, MD and one of our newest Trauma faculty Dr. Holden Spivak, MD (fresh off fellowships in Trauma/Critical Care at Shock Trauma and MIS at Stony Brook)—to explore the evolving role of robotics in trauma and acute care surgery.

Key topics include:

• Why robotic surgery remains rare in acute trauma (hemodynamic instability, docking delays, and the risks of insufflation in unstable patients)
• Real-world exceptions: robotic splenectomy videos, liver laceration repairs, and selective use in stable obese patients with bowel injuries
• The nationwide decline in operative trauma since 1990 and the rebranding from “trauma surgeon” to “acute care surgeon”
• How emergency general surgery and elective MIS cases now sustain operative volume
• Training pathways: Is residency robotic experience now enough to skip a second fellowship year? Should future acute care surgeons pair a 1-year SCC fellowship with a dedicated MIS year?
• Will the classic 2-year AAST/ACS fellowship curriculum need to pivot toward more robotics and less ortho/neuro month-rotations?
• Job market realities: Being robotic-ready is nice, but sound decision-making (“when to operate and how”) remains the most valuable skill
• Why open surgery will never become obsolete in a field driven by source control and hemorrhage control
• Advice for trainees: seek broad exposure, lean on mentors, prioritize supportive groups, and don’t fear creative (even non-traditional) training routes

Whether you’re a med student eyeing surgical critical care, a resident deciding on fellowships, or a program director shaping tomorrow’s curriculum, this candid conversation offers an honest look at where the field stands today—and where it’s headed tomorrow.

Tune in for practical insights from surgeons who are living the transition.