American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

July 2013

Message from the Chair
Join us at the ACS Clinical Congress
Newly Appointed RAS-ACS Liaisons
Volunteers Needed for ACS Committees and Advisory Councils
2013 Leadership Scholarships for Residents and Associate Fellows
Register Now for Simulation Course
RAS-ACS Committee Reports
          Communications Committee
          Membership Committee
          Education Committee
          Issues Committee
ACS Committee Reports
          ACS Health Policy and Advocacy Group
          Commission on Cancer
          Committee on Ethics
          Comprehensive Communications Committee
          International Relations Committee
          Medical Student Education Committee
          Young Fellows Association
Advisory Council Reports
          Advisory Council for Colon and Rectal Surgery
          Advisory Council for Neurological Surgery
          Advisory Council for Orthopaedic Surgery
          Advisory Council for Otolaryngology—Head and Neck Surgery
          Advisory Council for Plastic and Maxillofacial Surgery
          Advisory Council for Vascular Surgery

Message from the Chair

Welcome to the July issue of the Resident and Associate Society of the American College of Surgeons (RAS-ACS) News. This stands to be a larger issue than normal because we have received a number of updates from the RAS-ACS Advisory Council and Committee Liaisons—thank you to each of you for your continued dedication and hard work on behalf of all Residents, Associate Fellows, and trainees across the country!

My congratulations and warm welcome to the seven new RAS-ACS Liaisons. Terms are three years—beginning October 11, 2013, and ending October 16, 2016. The submissions for these positions were fantastic, and we really had a difficult time making the final selections. For those of you who were not selected or those who were not able to make the deadline for application, don't fret. We are going to place a call for even more positions now that the ACS Board of Governors has reorganized the committee and work group structure. Keep in mind that these are some of the most highly sought after RAS-ACS positions because they allow RAS-ACS members to interact with ACS leaders on a more personal level for three years. The positions do involve some travel for Committee meetings, Clinical Congress, and the Leadership Conference and Advocacy Summit in the spring. Fortunately, RAS-ACS is able to help defer most, if not all, of the costs associated with these trips. We encourage RAS-ACS members at all levels of training to apply, and good luck!

Planning is in full swing for the Focus on RAS—Resident Leadership Session at the Clinical Congress on Sunday, October 6 beginning at 11:30 am. Watch for a mailer to arrive within the next month. Plan to arrive in Washington, DC, before 11:30 am on Sunday to ensure that you will be able to attend the full day of activities. This is a unique opportunity that RAS-ACS is sponsoring, and we believe it will be a huge success! Don't miss it!

If I may be of any help or answer any of your questions, please do not hesitate to contact me.

Brian J. Santin, MD
Chair, RAS-ACS
Vascular Surgery Fellow
Good Samaritan Hospital, Cincinnati, OH

Monthly Conference Call Schedule

Issues: first Wednesday
Communications: second Wednesday
Membership: third Wednesday
Education: fourth Wednesday
Call-in: 866-434-7675 | Access: 7287911
All calls will take place at 9:00 pm (Eastern time)

Join us at the ACS Clinical Congress

The RAS-ACS and the ACS Division of Education would appreciate your participation at the 2013 ACS Clinical Congress in Washington, DC, October 6–10. Plan to take advantage of a range of educational sessions at the Walter E. Washington Convention Center throughout the week. For further information, please contact and look for future session updates in ACS NewsScope and on Facebook.

Non-member residents should consider joining the ACS—the $20 application fee is waived for first-year residents, and all other resident groups can apply for only $20. ACS members enjoy free registration to the Clinical Congress. Apply for membership and register for Clinical Congress today!

Sunday, October 6

Free networking lunch, 11:30 am–12:30 pm

  • Meet with RAS-ACS Leadership.

Focus on RAS-ACS—Resident Leadership Session, 12:30–3:00 pm

  • ACS President A. Brent Eastman, MD, FACS, will deliver the keynote address.
  • Learn how to become involved in RAS-ACS.

RAS Symposium, 3:00–5:30 pm

  • Patient Rankings: Should Patient Feedback Affect Our Pay and Delivery of Care? will be a debate between leaders in surgery on the timely topic of patient rankings and their use in day-to-day practice.

Monday, October 7

Starting Surgical Practice: Essentials for Success, 10:00 am–5:45 pm

  • The ACS Division of Education invites all surgery residents from all postgraduate year (PGY) levels to participate in a special program designed to assist surgical residents with essential nonclinical issues they face during residency training and the transitional period to their post-training career.

Tuesday, October 8

Spectacular Cases, 8:00–11:15 am

  • Spectacular surgical cases that pose challenging management issues will be presented to expert panel members.

Wednesday, October 9

Surgical Jeopardy, 8:00–11:15 am

  • Adapted from the popular TV game show, teams of residents will compete to showcase their surgical knowledge.

Newly Appointed RAS-ACS Liaisons

RAS-ACS Liaison Institution Committee
Eileen M. Duggan, MD Vanderbilt University Patient Education Committee
Shannon Acker, MD University of Colorado Women in Surgery Committee
Michael H. Johnson, MD Washington University in St. Louis Advisory Council for Urology
Alisha Reiss, MD Mount Carmel American Medical Association Residents and Fellows Section
Maya Babu, MD Mayo Clinic Rochester Advisory Council for Neurological Surgery
Adeyemi Ogunleye, MBBS Columbia University Committee on Diversity Issues
Monisha Sudarshan, MD McGill University Committee on Perioperative Care

Volunteers Needed for ACS Committees and Advisory Councils

Following is a list of available positions to serve a three-year term, October 11, 2013, through October 16, 2016.

  • Board of Governors:
    • Surgical Volunteerism and Humanitarian Award
    • Chapter Activities – National Workgroup
    • Chapter Activities – International Workgroup
    • Surgical Training Workgroup
    • Continuing Education Workgroup
    • Patient Education Workgroup
    • Coalition Workgroup
    • Newsletter Workgroup
    • Survey Workgroup
  • Advisory Council for Obstetrics and Gynecology
  • Advisory Council for Colon and Rectal Surgery
  • Commission on Cancer
  • Association of Women Surgeons

If you are interested, please submit the following documents by July 17 to

  • Letter of interest for specific committee/position
  • Letter of support from current program director or supervisor that also indicates the applicant will have sufficient time off to partake in activities
  • Current curriculum vitae

2013 Leadership Scholarships for Residents and Associate Fellows

RAS-ACS is accepting applications for the eighth annual Leadership Scholarships for Residents and Associate Fellows of the College. The scholarships cover tuition, travel, and subsistence for one of several ACS courses and will be awarded competitively to four young surgeons who best exemplify an important mission of RAS-ACS—developing future leaders for the field of surgery.

The available courses are:

  • Clinical Trials, November 2013
  • Leadership Conference and Advocacy Summit, March 29–April 1, 2014
  • Residents as Teachers and Leaders, Spring 2014

Applicants should submit the following documents for consideration by the selection committee:

  • a letter of request detailing the reasons for application and course desired
  • a letter of support from the applicant's program director or department chair confirming that the applicant will be able to take time away from the department to attend the course
  • a letter of support from a colleague, mentor, or other staff person supporting the individual's application
  • current curriculum vitae.

Only complete application packages will be considered and must be received no later than August 2. Send all application packages electronically to the RAS-ACS Administrator at

Register Now for Simulation Course

Surely you've been exposed to surgical simulation in your residency. How would you like the opportunity to experience a world-class surgical simulation center and gain behind-the-scenes access to its learning stations, methodologies, and technologies used to educate and train learners in the areas of surgery, trauma, emergency medicine, and robotic surgery?

Register now for the 6th Annual ACS AEI Postgraduate Course taking place August 2–3 in Vancouver, BC, and hosted by the Centre of Excellence for Simulation Education and Innovation. Medical students and residents are eligible for a special rate of $180—a significant discount off of the regular cost to attend.

This year's course focuses on "Curriculum Development and Delivery of Interprofessional Education," and has been designed to include both lecture and panel presentations as well as hands-on workshops.

View the agenda and book your hotel accommodations. We encourage you to spend Saturday night after the course in Vancouver and watch the city light up during the International Fireworks Competition, which is an event not to be missed!

To register for the course at the special student rate, please contact Cathy Wojcik at Registration deadline is July 18.

RAS-ACS Committee Reports

Communications Committee

Our committee has wrapped up two of our main projects over the past few weeks. The annual essay contest has been completed and the winners have been selected. We have also completed preparation of our annual RAS-ACS–themed issue of the ACS Bulletin. Each RAS-ACS Subcommittee prepared articles around the central topic of "The Evolution of General Surgical Training." Be sure to check out the August 2013 Bulletin. We prepared these articles specifically to target our membership's perspective. Raphael Sun, MD, has worked diligently to update our RAS-ACS Facebook page. If you have ideas for the Facebook page, please contact Dr. Sun at

Congratulations to the winner of the RAS-ACS essay contest

This year, the fifth annual RAS-ACS Communications Committee Essay Contest topic was "How Surgeons Deal with Complications." Participants were asked to write an essay of 500 words or less, describing a method for dealing with complications that is unique to the surgeon. In all, we received 26 submissions that were reviewed by a panel of RAS-ACS Committee members. Congratulations to Elisha Brownson, MD, a PGY 3 general surgery resident at Boston Medical Center (MA), whose essay "Snap" was selected as the 2013 winner. Her essay will appear in a future issue of the Bulletin, and she will receive a cash award of $500 at the 2013 ACS Clinical Congress. The top-five runners-up were: JaBaris D. Swain, MD, a resident at Brigham and Women's Hospital, Boston; Pablo Serrano, MD, a resident at the University of Toronto, Canada; Tad Kim, MD, a resident at the University of Mississippi Medical Center, Jackson; William Yi, MD, a resident at Medstar Washington Hospital Center, Washington, DC; and G. Paul Wright, MD, a PGY2 resident at Michigan State University, Lansing. Their essays will also be published in a future issue of the Bulletin. Thank you to everyone who participated this year.

Articles for the Bulletin of the American College of Surgeons

The Communications Committee invites Resident members to submit articles on topics relevant to issues facing us. Accepted articles will be submitted for publication in the Bulletin. Please submit articles ideas to and include the words "RAS-ACS Bulletin Submission," the date, and your last name in the subject line of the e-mail. Manuscripts should be no more than 3,200 words in length, well-written, and cite relevant literature, if appropriate. We look forward to hearing from you.

Get involved with our Committee

We hold conference calls on the second Wednesday of each month. It is easy to get involved—simply call in and listen, and if there is something that interests you, speak up and volunteer! If you cannot make the call, please e-mail us and let us know that you would like to become involved.

Juliet Emamaullee, MD, PhD
Chair, RAS-ACS Communications Committee
General Surgery Resident
Emory University, Atlanta, GA

Membership Committee

The Membership Committee extends its thanks to all applicants for the International Exchange Program, which was made possible by the generosity of the ACS International Relations Committee and the RAS-ACS. We had an overwhelming number of very qualified applicants and are proud of your interest and involvement.

Congratulations to:

  • Haytham Kaafarani, MD, MPH, from Massachusetts General Hospital, Boston, on being selected to attend the meeting in Italy
  • Leigh Ann Dageforde, MD, from Vanderbilt University, Nashville, TN, on being selected to attend the meeting in Ireland

We are still tallying the submissions for Lebanon and Australia, and the selected applicants will be announced soon.

The Membership Committee has created a new Welcome Packet that will be distributed to all incoming interns starting later this summer. We are also working on an informational brochure. We are always looking to increase our membership, so please feel free to join our monthly conference calls on the third Wednesday of every month. We are here to represent you!

Nicolas J. Mouawad, MD, MPH, MRCS
Chair, RAS-ACS Membership Committee
Vascular Surgery Fellow
The Ohio State University, Columbus

Dino Spaniolas, MD
Vice-Chair, RAS-ACS Membership Committee
General Surgery
Dartmouth-Hitchcock Medical Center, Lebanon, NH

Education Committee

The Education Committee has completed two contributions to the Bulletin that discuss the changing structure of surgical training from a historical perspective (with reviews of the changing training programs in vascular, cardiothoracic, and plastic surgery) and from an expert perspective (through interviews with leaders in the field).

We continue to work on Surgical Jeopardy and bringing Jeopardy to the regional society meetings. Please join us by contributing questions to our growing database.

We have developed a survey on learning styles in surgical education. We would greatly appreciate your input. This survey is voluntary, anonymous, and will not affect your participation. The survey takes about 5 minutes to complete. Take the survery.

If you want to get involved in the RAS-ACS Education Committee, please join our monthly conference call on the fourth Wednesday of every month. E-mail us with any questions or comments!

Nina Glass, MD
Chair, RAS-ACS Education Committee
General Surgery
Bellevue Hospital Center, New York, NY

Feibi Zheng, MD, MBA
Vice-Chair, RAS-ACS Education Committee
General Surgery
Methodist Hospital, Houston, TX

Issues Committee

In recent months, the Issues Committee has finalized speakers and a moderator for the RAS-ACS Symposium during the 2013 Clinical Congress (this year's topic is "Patient Rankings: Should Patient Feedback Determine Surgeon Pay and Rankings?"). The Committee also selected an essay winner (who will be announced later this month); discussed a name change for our committee; developed a formal RAS-ACS briefing at the annual Leadership Conference and Advocacy Summit; and enhanced RAS-ACS involvement with the ACS Division of Advocacy and Health Policy and the Political Action Committee (PAC) staff.

We welcome your involvement! Please join us the first Wednesday of every month. Please e-mail me if you have any questions!

Maya Babu, MD
Chair, RAS-ACS Issues Committee
Neurological Surgery
Mayo Clinic, Rochester, MN

ACS Committee Reports

ACS Health Policy and Advocacy Group

For those of you who are unaware of the Health Policy and Advocacy Group group and its important work, the ACS defines its purpose as follows.

  • Identify public policy issues and concerns affecting surgeons and our patients.
  • Prioritize these issues and concerns, identify those on which the ACS should focus its attention and resources, and recommend these priorities to the Board of Regents.
  • Develop action plans for addressing these issues, including recommending positions and initiatives the College should adopt.
  • Expand and monitor mechanisms by which the ACS makes surgeons, our patients, and the public aware of our health policies and agendas.
  • Develop and maintain mechanisms by which legislative and regulatory issues can be addressed in a timely and effective manner.

As many of you are aware, the effects of sequestration and the Medicare Sustainable Growth Rate (SGR) have led to many new challenges in recent months. The ACS leadership and the Division of Advocacy and Health Policy (DAHP) continue to work with legislators in search of a solution. I urge all of you who are interested in learning more about the efforts of the ACS DAHP to visit their home page.

In addition, the recent response by ACS Executive Director David Hoyt, MD, FACS, regarding the second draft of the joint Ways and Means and Energy and Commerce Committees' SGR Proposal is extremely enlightening as is the June edition of The ACS Advocate.

I look forward to continuing to serve as your liaison to this important group. If you have any comments, suggestions, or concerns, feel free to contact me.

Paul M. Jeziorczak, MD, MPH
ACS Health Policy and Advocacy Group Liaison
Medical College of Wisconsin Affiliated Hospitals, Milwaukee


Annual Board Retreat

At the annual retreat, the American College of Surgeons Professional Association Political Action Committee (ACSPA-SurgeonsPAC) Board reviewed results from the previous election cycle. In all, the PAC supported 93 surgery-friendly candidates, mostly in close races. Of those we supported, the PAC had an excellent 92-percent success rate. Fellows and RAS-ACS members are encouraged to stay in contact with their legislators and to communicate with the PAC if there are candidates that we should consider supporting.

The ACSPA-SurgeonsPAC Board also set goals for this year's fundraising. Our goal for this year is to have 100-percent participation by College and RAS-ACS leadership and to have 10 percent of all eligible members donating. Last year, 32 percent of the RAS-ACS leadership and 1 percent of RAS-ACS members overall donated to the PAC. So far we're on track to improve the RAS-ACS leadership participation, but to reach the 10-percent overall participation goal we need approximately 1,000 new RAS-ACS donors. We are exploring several ways to help raise awareness among RAS-ACS members. In the meantime, there will continue to be e-mail solicitations and ACSPA-SurgeonsPAC events at the Clinical Congress to keep members up to date on PAC activities.

Advocacy Summit

The Advocacy Summit in Washington, DC, was a great success. Many of the RAS-ACS members who attended the conference received scholarships from the College to offset travel expenses. The educational portion of the conference focused on the College's key advocacy agenda, including payment reform, graduate medical education (GME) funding, and liability reform. Meetings with legislators were very successful. After the Summit, a version of one of the College's key disaster preparedness bills was introduced in the House of Representatives; introduction of the companion bill in the Senate is expected soon. These successes are the direct result of Fellows and RAS-ACS members meeting with their legislators as they advocated for sensible policy changes that would enhance patient care nationwide. Watch for Action Alerts and contact your legislators in state and district offices. Your voice does make a difference!

Brian J. Gavitt, MD, MPH
ACSPA-SurgeonsPAC Liaison
General Surgery Resident Physician
UC Davis Medical Center, Sacramento, CA

Commission on Cancer

The spring meeting of the Commission on Cancer (CoC)—May 16–17 at ACS headquarters in Chicago, IL—featured a variety of high-impact, innovative developments that will undoubtedly enhance the care and lives of cancer patients nationwide.

The CoC is a consortium of professional organizations dedicated through standard-setting, prevention, research, education, and the monitoring of comprehensive quality of care to improving the survival and quality of life for cancer patients. To meet this mission, 52 professional organizations make up the program that includes more than 1,500 CoC-accredited cancer programs across the country. There are five primary committees within the organization, including the Liaison, Quality Integration, Member Organization, Accreditation, and Education committees.

Although each committee is doing important work, the Quality Integration Committee—chaired by Christopher Pezzi, MD, FACS—has been especially prolific in the past year. One of the committee's main objectives is to establish standards and define quality measures and tools for use by CoC-accredited cancer programs. Particularly important was the approval of a number of new cancer-specific quality measures developed by experts from around the country and based on high-quality evidence. These standards include the delivery of adjuvant therapies for esophageal and rectal cancers and setting minimal lymph node benchmarks in gastric and pancreatic cancers. Other important developments include public reporting initiatives for prospective payment system–exempt cancer centers beginning in 2014, as well as a new collaboration with the Pennsylvania Health Care Quality Alliance to publicly report outcomes in that state. In the coming year, the CoC will also allow voluntary public reporting of cancer programs practice profile report results from accredited cancer programs on the CoC website.

Other high-impact priorities include improved resources for accredited cancer programs such as new quality measures added to the Rapid Quality Reporting System, best practice repository, and standards resource repository. Of particular interest to CoC-accredited programs is the release of the National Cancer Data Base Public Use Files to more than 150 independent researchers from virtually every region of the country. This will allow unparalleled access to data and will undoubtedly result in numerous advances in the field of oncology.

There is clearly a lot going on at the CoC, and residents are encouraged to participate in state- and national-level activities. Please contact your state representative to find out how you can get involved.

William H. Ward, MD
CoC Liaison
General Surgery
Naval Medical Center Portsmouth, VA

Ryan P. Merkow, MD, MS
CoC Liaison
General Surgery
University of Colorado Denver

Committee on Ethics

The Committee on Ethics continues to develop robust educational tracks for the 2013 and 2014 Clinical Congresses. Annual sessions such as the Ethics and Philosophy Lecture, Ethics Colloquium, Meet-the-Expert Luncheons, and Town Hall Meetings will highlight distinguished faculty from around the country. While the sessions for 2013 are set, please feel free to send your suggestions for future topics, sessions, speakers, or collaborations.

This year, Bruce Gewertz, MD, FACS, will deliver the annual Ethics and Philosophy Lecture. His topic will be, "Sustaining Fulfillment in Work and Life." The Ethics Colloquium will be on "End-of-Life Issues for Surgical Patients." A Meet-the-Expert Luncheon will cover "Burning Surgical Issues in Ethics: Collaboration with Industry and Potential Conflicts of Interest." A Town Hall Meeting will delve into "Ethics in Advertising: What Is the Surgeon's Responsibility." Finally, the Committee on Ethics will cosponsor sessions dealing with managing conflict of interest in research and innovation, the geriatric surgery patient, and perioperative and end-of-life issues.

The Committee on Ethics has also been revising the College's policy statement on perioperative Do-Not-Resuscitate (DNR) orders. This was done to ensure clarity and context regarding the need for "required reconsideration" of DNR orders for the surgical patient rather than an automatic cancellation of advanced directives. Required consideration allows for the respect of patient autonomy while enhancing patient safety and perioperative team communication.

The Committee on Ethics has also considered opportunities to expand the ethics resources and learning opportunities available to Fellows, residents, and students. A number of options are being evaluated to ensure that a strong and diversified ethics curriculum is available to all members.

Eric A. Singer, MD, MA
Committee on Ethics Liaison
Urological Surgery
The Cancer Institute of New Jersey, New Brunswick

Comprehensive Communications Committee

The Comprehensive Communications Committee met in Chicago on May 6. The meeting included vital discussions regarding the Committee's mission to ensure consistent messaging for all College programs and initiatives.

Participants debated the development of several preformed comments on public issues that impact the College. The goal is to address these issues proactively so that when they become hot-button public topics, the College can quickly respond with a position statement. The challenge is to predict which issues require a College response. Potential topics initially would include: Medicare and an SGR replacement strategy, GME funding and surgical workforce implications, and the public reporting of surgical outcomes.

The College is also revamping its website as well as other online properties. The goal is to present a more concise, more accessible Web presence, which will improve online interaction with the College membership. Late last year, executive leadership of the College selected Siteworx as a third-party vendor that will provide design and systems technology for the Web redevelopment project. Siteworx will use a combination of current content as well as input from several focus group surveys from within the College membership over the last several years.

Finally, the Committee discussed the current role of the College in social media. A presentation from Jerry Schwartz, Social Media Manager, elaborated on the College's current efforts to use social media—especially, Twitter. The Committee discussed using Twitter more effectively to elicit feedback from members and to alert members to specific issues.

If you have comments or questions that you would like proposed to the Committee, please feel free to e-mail me.

Farrell Adkins, MD
Comprehensive Communications Committee Liaison
General Surgery
Cleveland Clinic Florida, Weston

International Relations Committee

The International Relations Committee (IRC) remains pivotal in promoting and fostering global interaction and exchange among surgeons. IRC leadership met in Los Angeles, CA, where specific components of the IRC have been redefined with general agreement and approval on consolidating the international aspects of the ACS. The IRC Executive Committee has drafted 13 goals for 2013 focusing on international engagement. Committee members are working to revitalize the IRC by unifying the ACS' international perspective and maintaining the IRC as the hub for international integration with easier access to the Board of Regents and the Board of Governors.

The IRC activities, congruent with the ACS' commitment to international scholarships, emphasize the strategy, vision, efficiency, and coordination necessary to achieve this purpose. Current changes will restructure and introduce new subcommittees with specific goals that can direct priorities toward deliverables and milestones. These plans will be formally presented to the full IRC and the Board of Regents in the near future.

ACS President A. Brent Eastman, MD, FACS, discussed his plans for a meeting with international surgical leaders in the summer of 2013 to expand the international scope of the College. RAS-ACS and IRC conducted a productive meeting regarding the International Exchange program. Herbert Chen, MD, FACS, was pleased to learn of the interest generated from the program as well as its solid progress in securing host nations that will reciprocate the exchange among residents and promote international exchange. The IRC hopes increase the reach of this program from four to eight nations, and possibly even more.

Nicolas J. Mouawad, MD, MPH, MRCS
Chair, IRC Liaison
Vascular Surgery Fellow
The Ohio State University, Columbus

Medical Student Education Committee

The Medical Student Education Committee has worked hard to organize the Medical Student Program (MSP) at the Clinical Congress. In order to reach the most students in different stages of medical school, we have been busy brainstorming ideas to reach not only the preclinical years, but also the ready-to-match students, those interested in surgical subspecialties, and international graduates. One of the most exciting things you can look forward to seeing at the MSP this year is the "Out of the Box SIG" (student interest groups)—students submit innovative new ideas for SIGs and winners will be chosen. We are very excited for the MSP this year. We look forward to meeting the bright, young minds that hope to join us in the field of surgery.

Priya Iyer, MD
Medical Student Education Committee Representative
General Surgery
Cleveland Clinic Foundation, OH

Young Fellows Association

The Young Fellows Association (YFA) is welcoming new Fellows with a new style of receiving line at the annual Convocation Ceremony and is developing a program dedicated to new Fellows on the following day known as "The Initiates Program." The program features high-yield topics for surgeons at this stage of their careers and offers an opportunity to meet leaders of the College.

The YFA will again offer a mentorship program. Mentors have been identified and an e-mail seeking applicants will be sent to all young Fellows soon. The mentorship program strives to connect young Fellows with a mentor who can help them develop as a leader within organized surgery.

Heena Santry, MD, FACS
Young Fellows Association Liaison
General Surgery
UMass Memorial Medical Center, Worcester, MA

Advisory Council Reports

Advisory Council for Colon and Rectal Surgery

The Advisory Council for Colon and Rectal Surgery continues to develop ACS programs that support colorectal surgeons. The semi-annual Advisory Council meeting was held in conjunction with the American Society of Colon and Rectal Surgeons (ASCRS) meeting in Phoenix, AZ, on April 28. Advisory Council members were updated by ACS Board of Governors representative James Fleshman, MD, FACS, regarding exciting restructuring plans within the Board of Governors that sustain a strong and broad representation of various types of surgical specialties within the College. The group endorsed continued strong representation from colorectal surgeons.

Steven D. Wexner, MD, FACS, provided an update representing the ACS Board of Regents focusing on the College's efforts in improving surgical quality and discussions of improving surgical training through a novel Transition to Practice (TTP) paradigm. The TTP program is intended to help fill perceived gaps in surgical training today and will be piloted at seven institutions nationally in 2013–2014 and generated positive excitement through the group.

The success of the ACS involvement with the American Board of Internal Medicine's Choosing Wisely campaign led to participation of the ASCRS as well. The Choosing Wisely campaign has generated much attention in the lay media with the goal of reducing unnecessary, poorly substantiated, or redundant medical tests and procedures.

The group reviewed attendance figures and participant evaluations from the 2012 ACS Clinical Congress sessions and noted trends to guide future colorectal session offerings. The remainder of the time involved committee housekeeping issues, award and position nominations, project delegation, and planning the future colorectal sessions at the 2013 and 2014 ACS Clinical Congress meetings.

Michael F. McGee, MD
Advisory Council for Colon and Rectal Surgery Liaison
Colorectal Surgery
Northwestern Memorial Hospital, Chicago, IL

Advisory Council for Neurological Surgery

The Advisory Council for Neurological Surgery has worked to improve ACS-offered educational resources for neurosurgeons in practice and in training offered through the ACS, to develop more focused offerings at the Clinical Congress for neurosurgeons, and to update the ACS online database for patients with information on neurosurgeons who are Fellows.

I have had the opportunity to write a newsletter article that will be featured in the Young Neurosurgeons Newsletter to encourage neurosurgical residents and fellows to become RAS-ACS members and have promoted RAS-ACS membership to neurosurgical residents and fellows through the Young Neurosurgeons Committee. As an Association for Women Surgeons member, I am promoting RAS-ACS involvement to the council.

Maya Babu, MD
Advisory Council for Neurological Surgery Liaison
Mayo Clinic, Rochester, MN
Neurological Surgery

Advisory Council for Orthopaedic Surgery

Much has occurred in the last year regarding the subspecialty of orthopedic surgery. From resident training issues and improving hospital safety for arthroplasty patients, to issues of medical necessity and reimbursement and coding, there have been a number of important trends to report.

From the perspective of orthopedic surgery trainees, there is a continued evolution in work-hours and duty limits. Strict adherence to guidelines has shifted certain clinical responsibilities to higher-level residents and fellows. Maintaining seamless continuity of care is a continued goal with more frequent shift changes, while program directors frequently attempt to balance service and education responsibilities. More study is needed, not only in the effects on patient morbidity and mortality, but also in evaluating key training metrics and resident satisfaction with this process. As with previous years, ancillary support staff and increased hiring of mid-level providers will be a continued focus, especially in high-volume orthopedic fields like joint arthroplasty and sports medicine.

From a health policy standpoint, much work has been done in Washington, DC, to petition increased funding for musculoskeletal clinical and basic science research. Orthopedic initiatives like Capitol Hill Days and the National Orthopedic Leadership Conference have identified and developed avenues for orthopedic research funding. In an era of increasing federal budgetary restrictions, the focus on preserving funding sources is as important as ever. Recent orthopedic groups, including those from the American Association of Hip and Knee Surgeons, have met with leadership at the Centers for Medicare & Medicaid Services to discuss further coding and reimbursement issues. Other evolving issues include developing appropriate use criteria for surgical, imaging, and other orthopedic interventions. This dovetails with the work being done to protect the orthopedic surgeon's autonomy in determining the "medical necessity" of procedures. One key initiative is the formation of a "Boots on the Ground" program. This program appoints orthopedic surgeon leaders in each state, who will collectively provide an early-warning system for emerging policy and health care concerns related to orthopedic surgery.

As we experience new work-hour regulations, coding and reimbursement scenarios, and patient safety initiatives, it is important to continually evaluate the effectiveness and challenges of these processes. Orthopedic surgeons face many of the same problems as other surgical specialties. Collective knowledge, as through the ACS, may offer mutually beneficial solutions to these issues. Both academic and private institutions will be faced with the changes of regulatory compliance, patient safety, and educational initiatives.

Atul F. Kamath, MD
Advisory Council for Orthopaedic Surgery Liaison
Orthopedic Surgery
Rochester, MN

Advisory Council for Otolaryngology—Head and Neck Surgery

The Advisory Council for Otolaryngology—Head and Neck Surgery represented the specialty of otolaryngology at the Overuse Summit organized by The Joint Commission and the American Medical Association. Among the five overuse issues targeted during the summit was the use of tympanostomy tubes in children with middle ear effusions of short duration (two months or less). With input from our committee, the focus shifted to improving diagnosis of otitis media with effusion and supporting evidence-based treatment guidelines emanating from the American Academy of Otolaryngology-Head and Neck Surgery.

We also supported the campaign to educate families and physicians about the dangers of button battery ingestion/aspiration and placement in the nose and ears. The goal of the campaign is to organize resources among the American Academy of Pediatrics (AAP), the American Broncho-Esophagological Association, the American Society of Pediatric Otolaryngology, the American Academy of Otolaryngology-Head and Neck Surgery, and the ACS for public education, and, ultimately, to introduce legislation to change the packaging and labeling of these potentially dangerous items. This resolution was presented at the AAP Leadership Forum in December and was selected for top ten status, which means that it will be highlighted as one of the most important topics in education and advocacy by the AAP national leadership.

We are also working to promote otolaryngology programs at the 2013 Clinical Congress, which will include sessions on thyroid cancer, head and neck trauma, neck mass evaluation, and controversies in parathyroid surgery.

Megan Durr, MD
Advisory Council for Otolaryngology—Head and Neck Surgery Liaison
University of California, San Francision

Advisory Council for Plastic and Maxillofacial Surgery

The ACS Advisory Council for Plastic and Maxillofacial Surgery held their interim meeting on April 21, in New Orleans, LA, during the American Association of Plastic Surgeons (AAPS) 92nd annual meeting. Both the American Society of Plastic Surgeons (ASPS) and the AAPS meetings were held in New Orleans this past academic year and are the two most widely attended plastic surgery meetings of the year.

The ACS Advisory Council for Plastic and Maxillofacial Surgery continues to represent the interests of the multifaceted profession of plastic surgery, with representatives from the aforementioned groups as well as the American Council of Academic Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Society of Maxillofacial Surgeons (ASMS), the Canadian Society of Plastic Surgeons, the Plastic Surgery Foundation, the Plastic Surgery Research Council, the American Board of Plastic Surgery, the ACS Board of Regents, and the ACS-RAS.

The Advisory Council, which nominated several candidates to the American Board of Plastic Surgery, also made nominations for the Jacobson Innovation Award and the Sheen Award. Both awards are for innovation and excellence in surgical research. Susan Mackinnon, MD, FACS, FRCSC, a plastic surgeon in St. Louis, MO, won the Jacobson award in 2013 for her "pioneering and innovative leadership as a scientist and clinician in the field of nerve regeneration and peripheral nerve surgery." Both awards are open to anyone in medicine, not only plastic surgeons. We are proud that Dr. Mackinnon was this year's recipient.

The Advisory Council continues to highlight the importance of collaboration and, through interactions with general surgery residents, has organized the following multidisciplinary panels for the 2013 Clinical Congress: "Chest Wall Reconstruction," "Long-Term Outcomes of Combat Wound Care," "The Patient's Wound is Not Healing: Now What?," "Can Your New Partner Operate? Mentoring Your New Partner," "Complications of Esophageal Surgery Procedures," "Are CT Scans Killing Patients? Innovative Technologies for the Treatment of Incontinence and Prolapse," and "Reimbursement in the Age of ACO Bundling: What Are Surgeons Worth?" We also discussed possible topics for next year's Clinical Congress. The Advisory Council is also working on a taxonomy of topics in plastic surgery that will help the ACS Education Committee balance the topics addressed from year to year.

Upcoming meetings and courses that are invaluable to plastic surgery trainees are:

  • ASPS Plastic Surgery Coding Workshop, August 3–4 in Chicago
  • ASMS Basic Maxillofacial Principles and Techniques Course, August 9–11 in Philadelphia, PA
  • ASPS Oral and Written Board Preparation Course, August 28–31 in Chicago
  • International Society of Craniofacial Surgeons Annual Meeting, September 10–14 in Jackson Hole, WY
  • American Society for Surgery of the Hand Annual Meeting, October 3–5 in San Francisco, CA
  • ACS Clinical Congress, October 6–10 in Washington, DC

I welcome queries about the myriad and wide-ranging topics that the Advisory Council for Plastic and Maxillofacial Surgery cover.

Christian Vercler, MD
Advisory Council for Plastic and Maxillofacial Surgery Liaison
Plastic and Reconstructive Surgery
University of Michigan, Ann Arbor

Advisory Council for Vascular Surgery

The Advisory Council for Vascular Surgery held an interim meeting during the Society for Vascular Surgery Annual Meeting. Joseph L. Mills, MD, FACS, from Tucson, AZ, and Bruce Perler, MD, FACS, from Baltimore, MD, will be nominated to serve as members for the upcoming vacancy for the Surgery Residency Review Committee in June 2014. We focused our discussion on developing vascular sessions for the upcoming Clinical Congress. The main focus will be on vascular surgery for general surgeons in the context of trauma, rural, and venous procedures. Additionally, there will likely be some sessions focusing on current review of hot topics such as results of the OVER trial (long-term results for elective endovascular versus open repair of abdominal aortic aneurysm) and contemporary management of asymptomatic carotid stenosis.

As the RAS-ACS liaison to the Advisory Council for Vascular Surgery, I would be interested in hearing if there are any general surgery resident–specific topics that may be of interest for future meetings.

Aaron C. Baker, MD, MS
Advisory Council for Vascular Surgery
PGY 4 Surgery Resident
UC Davis Medical Center, Sacramento, CA

RAS Executive Board

Brian Santin, MD, Chair
Rob Winfield, MD, Vice Chair
Joseph Sakran, MD, Secretary
Heena Santry, MD, Ex-Officio

RAS Governing Board

Maya Babu, MD
Aaron Baker, MD
Megan Durr, MD
Juliet Emamaulle, MD
Alhambra Frarey, MD
Nina Glass, MD
Atul Kamath, MD
Michael McGee, MD
Nick Mouawad, MD
Israel Nosnik, MD
Mehul Raval, MD
Lauren Smithson, MD
Renée Solomon, MD
Elliot Wakeam, MD
Christian Vercler, MD

Join RAS Today!

RAS was formed to benefit the surgeons of the future through involvement in activities of the College. Learn more about the RAS and the many benefits—access to the ACS Job Bank, various ACS publications, and more—offered to its members. Join RAS today!

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For additional information regarding the benefits and activities of the RAS-ACS, please contact Peg Haar at