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2017

January
An Interview with Dr Mark Katlic, Sinai Hospital

February
An Interview with Dr. Timothy Pawlik, The Ohio State University Wexner Medical Center

2016

January
How to Prepare for an Interview

February
Selecting a Surgical Mentor
March
How do you select a mentor? Who should serve as your advisor? What is a sponsor?
April/May
A Primer for Your Job Search" 2015 SSAT Resident Education Committee Panel

July
An Interview with Selwyn Vickers, MD: What he Learned from his “Greatest Failure” and Pancreatic Leaks

August
Something Personal and Something Professional: An Interview with Barry Salky, MD

October
An Interview with Dr. Christopher Brandt and Dr. Christopher McHenry

November
Building the Foundation of a Successful Career in Surgery and Looking Forward to New Challenges An Interview with Dr Kevin E. Behrns

December
An Interview with Dr Kevin E. Behrns

2015

January
Introduction to
Physician Contracting
February
Productivity Targets, Duties, and Responsibilities
March
How to Build a Successful Surgery Practice
April
2nd Annual SSAT Surgical Fellowship Fair
May/June
2nd Annual SSAT Surgical Fellowship Presentations and Overview
July
Fellowship Program Directors Survey Results: How to Strengthen Your Fellowship Application
August
How To Score Well on the ABSITE
September
Academic Conferences: Types of Conferences and the Top 10 Tips for Attending
October
How to Make a Good Presentation

November
How to Write a Good Manuscript

December
How to Obtain Strong Letters of Recommendation and Write a Good Personal Statement

2014

April
Welcome to SSAT Residents Corner
May
Inaugural Surgical Fellowship Fair
June
Why Residents Choose One Path Over Another
July
The Nuts and Bolts of Fellowship
August
What Else to Consider Before Applying for Fellowship
September
Tips for Obtaining the Fellowship I Want
October
How do I find a job: where do I start?
November
A Guide to Selecting a Job
December
Tips for Understanding Contracts




February 2017

An Interview with Dr. Timothy Pawlik, The Ohio State University Wexner Medical Center

This month, the Society for Surgery of the Alimentary Tract (SSAT) Resident Corner had the pleasure of interviewing Dr. Timothy Pawlik, Chair of Surgery at The Ohio State University Wexner Medical Center. We had the opportunity to hear his thoughts about the following questions:

  1. What did you find the most challenging about transitioning from the role of a trainee to a practicing surgeon, and what choices did you make that you think helped foster your academic success?
  2. If you had chosen a career outside medicine, what would you be doing now?
  3. How did your interests in theology and philosophy shaped your approach to medicine and surgery?
  4. What is the most important thing that we can do as surgeons to improve outcomes for pancreatobiliary cancer patients?
  5. What advice would you give to a young surgeon joining an established practice, who wants to introduce enhanced recovery pathways or other evidence-based care systems where they have not been practiced historically?
  6. If you could direct the resources of the NIH for research in GI malignancies in any way you wished, what would be your top priorities?

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January 2017

An Interview with Dr Mark Katlic, Sinai Hospital

On behalf of the SSAT Resident and Fellow Education Committee, we would like to welcome you to SSAT "Residents Corner", a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery.

This edition of the Society for Surgery of the Alimentary Tract (SSAT) Resident Corner features an interview of Dr Mark Katlic, who serves as Chief of the Department of Surgery and Surgeon-in-Chief at Sinai Hospital and is Director of the Sinai Center for Geriatric Surgery. He has extensive experience performing general surgery and thoracic surgery, as well as geriatric surgery for elderly patients. The following questions are asked and answered during this interview:

  1. What helpful hints can you give residents about innovation in Surgery?
  2. How did you determine metrics and evaluation of an aging surgeon?
  3. What is the future of the Aging Surgeon Program started by you at Sinai Hospital?
  4. Are there lessons for residents in your somewhat unusual career?
  5. What are your hobbies?
  6. If you were not a surgeon, what would you choose as your career?

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December 2016

An Interview with Dr Stephen R.T. Evans, Executive Vice President for Medical Affairs and Chief Medical Officer, MedStar Health

On behalf of the SSAT Resident and Fellow Education Committee, we would like to welcome you to SSAT "Residents Corner", a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery.

This edition of the Society for Surgery of the Alimentary Tract (SSAT) Resident Corner features an interview of Dr Stephen R. T. Evans, current Executive Vice President for Medical Affairs and Chief Medical Officer for MedStar Health. He is the former Chair of the Department of Surgery at Georgetown University Hospital and is the current Chair of the American Board of Surgery (ABS). The following questions are asked and answered during this interview:

  1. What motivates you to get out of bed in the morning when your alarm goes off?
  2. What is your favorite memory from last week?
  3. What is your activity of choice outside of work?
  4. What is the accomplishment in your lifetime that means the most to you and why?
  5. What is your favorite operation: if you could only pick one to do every day for the rest of your career which would it be and why?
  6. Do you ever stop for a moment and consider the impact you have had on the field of surgery? What is your perception of what this has been or what do you hope it to be?
  7. What is your #1 goal for change in surgical education over the next year and why is this important?
  8. Is there anything on your bucket list in either your personal life or your career that you are willing to share?

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November 2016

Building the Foundation of a Successful Career in Surgery and Looking Forward to New Challenges An Interview with Dr Kevin E. Behrns

On behalf of the SSAT Resident and Fellow Education Committee, we would like to welcome you to SSAT "Residents Corner", a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery.

Dr. Kevin E. Behrns (incoming Vice President of Medical Affairs and Dean of St. Louis School of Medicine, St. Louis, MO, and current Vice-President of SSAT), discusses how he developed a successful career as a leading scholar, surgeon, and educator. This video includes his opinion on the value of research during surgical training, the importance of quality in healthcare, and the future role surgeons will play in the care of patients. It ends with advice to medical students, residents, and junior faculty on how to maintain a well-balanced career and family life while being engaged in lifelong learning.

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October 2016

An Interview with Dr. Christopher Brandt and Dr. Christopher McHenry

On behalf of the SSAT Resident and Fellow Education Committee, we would like to welcome you to SSAT "Residents Corner", a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery.

This month Dr. Sergio J. Bardaro interviewed two interesting surgeons, Dr. Christopher Brandt, Richard Fratianne Professor of Surgery and Chairman of Surgery at MetroHealth Medical Center – Case Western Reserve University, Associate Examiner of the American Board of Surgery, and current President of the Association for Surgical Education, and Dr. Christopher McHenry, Vice-Chairman of Surgery at MetroHealth Medical Center – Case Western Reserve University, past President of Central Surgical Association, Midwest Surgical Association and American Association of Endocrine Surgeons, current Director of the American Board of Surgery and Chairman of the Surgical Oncology Board.

Drs. Brandt and McHenry have spent their entire careers, over 25 years each, at Case Western Reserve University, MetroHealth Medical Center, which is very unusual in the current medical culture. In this video you will hear about their unique experiences and stories. We hope that these inspire you as much as they have inspired us to be proud of our backgrounds and to enjoy our workplaces and profession. We hope you enjoy the interview with these two outstanding surgeons.

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August 2016

Something Personal and Something Professional: An Interview with Barry Salky, MD

This month’s Resident Corner highlights Dr. Barry Salky, Professor of Surgery at Mount Sinai Hospital in New York, New York and a pioneer in minimally invasive surgery. In keeping with this year’s theme of asking leaders in GI Surgery something personal and professional, he will share with us his first nonmedical job in the first video and his management of achalasia patients following laparoscopic Heller myotomy in the second video.

Enjoy!


Interview with Dr. Barry Salky Part I

Interview with Dr. Barry Salky Part II

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July 2016

Welcome (back) to a new academic year!

For Residents Corner, the theme last year was how to well-position yourself to be competitive for your fellowship application. This year, Residents Corner will be highlighting monthly interviews with leaders in surgery, first asking them a question about life in general, then asking a clinical practice-type question. This month’s issue below features Dr. Selwyn Vickers (outgoing President of the SSAT and Dean of the University of Alabama School of Medicine), who discusses his “greatest failure” and what he learned, and then pancreatic leaks. Thank you Dr. Vickers!

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April/May 2016

A Primer for Your Job Search
2015 SSAT Resident Education Committee Panel

In this month’s Resident’s corner, we will be talking about getting a job after residency or fellowship:

  • First, Jennifer Tseng, MD of Beth Israel Deaconess discusses the ins and outs of employment contracts. So far in your career, you’ve been told where to work, what to do, and how much you’ll be paid. Dr. Tseng offers insight in what to look for and how to negotiate for what you want.

  • Next, Mark Talamini, MD of Stony Brook University School of Medicine describes the pluses and minuses of a full time academic career in surgery in the era of “ObamaCare”.

  • Third, Brent Mathews, MD of the Carolinas Health System presents an insightful discussion on population level health care delivery in "What it means to be a part of a multi-specialty group".

  • Finally, Mark Talamonti, MD, of the North Shore University Health System points out:
    • The current market trends in medicine and how they are impacting health care systems—these trends are changing the economics of the marketplace in surgery, and being abreast of them will help in your search for that job that kicks off a career in surgery;
    • The different roles played by a mentor, advisor, and sponsor; and
    • Important characteristics to consider when selecting these people.
We hope you enjoy this excellent panel from last year’s SSAT Annual Meeting at DDW2015!


Contract Issues by Jennifer F. Tseng, MD, MPH
 
Full Time Academics by Mark Talamini, MD
 

Impact of Health Systems by Mark Talamonti, MD
 
Contract Issues by Brent Matthews, MD

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March 2016

How do you select a mentor? Who should serve as your advisor? What is a sponsor?

This month, Dr. Michael Ujiki (Chief of General Surgery at NorthShore University) along with Dr. Ben Shogan (PGY5 at the University of Chicago) and Luke Stockdale (Physician Assistant student from Rosalind Franklin University) discuss:

  • the different roles played by a mentor, advisor, and sponsor; and
  • important characteristics to consider when selecting these people

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February 2016

Selecting a Surgical Mentor

This Resident Corner Update gives insights on how to select a surgical mentor. Drs. Blake Fernandez, Avery Engelbrecht, Christiana Shaw, and Sanda Tan share what mentors can do for Residents, Fellows and Junior Faculty; what qualities to look for in a mentor; the mentee responsibilities; and how to sustain a mentorship.

Click here to download the PDF of the SSAT Residents Corner reference slides on “Selecting a Surgical Mentor”.

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January 2016

How to Prepare for an Interview

This Resident Corner Update provides reference slides on “How to Prepare for an Interview”.



Click here to download the PDF of the SSAT Residents Corner reference slides on “How to Prepare for an Interview”.

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December 2015

How to Obtain Strong Letters of Recommendation and Write a Good Personal Statement

This Resident Corner Update presented to you by the Society for Surgery of the Alimentary Tract provides information on obtaining strong Letters of Recommendation and writing a good Personal Statement.

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November 2015

How to Write a Good Manuscript

The November edition of SSAT Residents Corner focuses on "How to write a good manuscript”. The video features Dr. Maria Altieri, a third year general surgery resident, and Dr. Mark Talamini, the chairman of the Department of Surgery at Stony Brook University Hospital and the Editor-in-Chief for Surgical Endoscopy. Writing a manuscript is a craft that has to be mastered. The video features helpful tips and instructions.

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October 2015

How to Make a Good Presentation

The October edition of SSAT Residents Corner focuses on "How to make a good presentation”. The video features Maitham A Moslim, a second year general surgery resident and Matthew D Kroh, the director of the surgical endoscopy at Cleveland Clinic Foundation. As residents, we have the chance to present every day during rounds, on weekly basis during mortality and morbidity conferences and even for some of us during local or national meetings. You will hear tips and tricks about how a resident at this level of training can deliver a quality conference presentation on the podium or during a poster session and get his/her message across.

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September 2015

Academic Conferences: Types of Conferences and the Top 10 Tips for Attending

Continuing on with our theme of How to Strengthen Your Fellowship Application, this month’s Resident Corner is on Academic Conferences. Dr. Yalini Vigneswaran, a surgery resident at the University of Chicago, reviews the types of conferences and reasons for attending conferences, and gives her top 10 tips for attending conferences.

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August 2015

How To Score Well on the ABSITE

This month SSAT Resident’s Corner focuses on "How to Score Well on the ABSITE." The video features Dr. Konstantin Umanskiy, Program Director of Colon and Rectal Fellowship and Associate Program Director of General Surgery Residency at the University of Chicago. You will hear about the importance of performing well on the ABSITE as well as guidance and tips on how to best prepare for the exam. The video also contains personal advice from two PGY3 General Surgery residents from the University of Chicago, Dr. Monika Krezalek and Dr. Puneet Singh.

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July 2015

Fellowship Program Directors Survey Results: How to Strengthen Your Fellowship Application

This month’s Residents Corner features Dr. Ezra Teitelbaum, PGY5 at Northwestern University and resident member of the SSAT Resident Education Committee, discussing results from a survey of fellowship program directors by the SSAT Resident Education Committee. Recognizing that there are limited existing data to help residents prepare a successful application, fellowship program directors across the United States and Canada were asked what aspects of fellowship application were deemed to be the most important in ranking applicants. We hope, these results will help residents know how to strengthen their fellowship application and to obtain their fellowship of choice.

In the coming months, Residents Corner will highlight many of these areas such as,

  • How do I score well on the ABSITE?
  • Academic conferences
  • How to give a good presentation
  • How do I write a good manuscript?
  • Letters of recommendation and personal statement
  • How to prepare for an interview? How to interview well
  • Finding a mentor/being a mentee
  • Sponsorship vs mentorship vs advisors

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May/June 2015

2nd Annual SSAT Surgical Fellowship Presentations and Overview

Following its successful inauguration 1 year ago in Chicago, the 2nd annual SSAT Surgical Fellowship Fair took place in Washington D.C. during the 2015 Digestive Disease Week. This event was established under the leadership of the SSAT and the SSAT Resident Education Committee in order to provide a forum to help residents decide whether to pursue fellowship training.

The symposium was divided into 7 presentations – one for each subspecialty and each given by a leader from the national surgical society representing each fellowship. Each talk provided a wealth of information on each subspecialty and focused on various aspects, from the pre-fellowship application process and the many factors required to make you a competitive candidate, to the expectations during training, and to the post-fellowship career landscape, including salary, job availability, types of practices, etc. The Fair was well attended by both trainees and staff, and was subsequently followed by an informative and high-yield group Q&A discussion that provided trainees additional information.

Fellowship presentations included:

  • Surgical Oncology (Society of Surgical Oncology) – Dr. James Pingpank Jr.
  • HPB (Americas Hepatico-Pancreato-Biliary Association) – Dr. Rohan Jeyarajah
  • Colorectal (American Society of Colon and Rectal Surgeons) – Dr. David Margolin
  • MIS (Society of American Gastrointestinal and Endoscopic Surgeons) – Dr. Aurora Pryor
  • Bariatric (American Society for Metabolic and Bariatric Surgery) – Dr. John Morton
  • Trauma (American Association for the Surgery of Trauma) – Dr. Thomas Scalea
  • American College of Surgeons’ Transition to Practice Program – Dr. John Hunter

As a general surgery resident it can often be daunting given the various career options available, especially since we do not always get early exposure to every subspecialty. Our decision-making is often subjective and biased by mentors that we strive to emulate. Barely having started as a senior, residents have to ask themselves who to network with, who to do research with, which society meetings to attend. For instance, if you are interested in upper GI surgery, should you attend SAGES, SSAT, or other GI or thoracic surgery conferences? Further exacerbating this dilemma is the considerable overlap between fellowships and the significant heterogeneity amongst various nation-wide programs within each track. For instance, if you are interested in treating cancer patients, should you attend SSO or AHPBA, given the recent interest you developed in liver surgery during your hepato-pancreato-biliary surgery rotation? These are all very important and career-altering decisions that this symposium was designed to address.

If you were unable to attend this year’s Fellowship Fair, consider joining us next year or take the time to watch the video presentations below from this year’s Fair. We hope they will help you become better informed to follow the path that is best suited for your interests, objectives and personality. Remember to share this link with your colleagues so that they may benefit as well!

On behalf of the committee, we sincerely thank the invited speakers for their time, as this important event would otherwise not be possible.

We hope to see you in future years.

Amin Madani (Symposium Co-Moderator)


Amin Madani, MD and Ezra Teitelbaum, MD, surgical residents and SSAT Resident Education Committee members provide an introduction to the SSAT 2nd Annual Surgical Fellowship Fair, match overview, and important statistics on training and fellowships.
 
James F. Pingpank, Jr., MD, FACS, Division of Hepatobiliary Surgery, Surgical Oncology Services, Department of Surgery, University of Pittsburgh, Pittsburgh, PA presents Surgical Oncology Fellowships and the Society of Surgical Oncology (SSO)
 

D. Rohan Jeyarajah, MD, Chair-PD Committee, Americas Hepato-Pancreato-Biliary Association (AHPBA), and Vice President of the Fellowship Council presents HPB fellowships and the AHPBA.
 
David A. Margolin, MD, FACS, FASCRS, Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, Professor of Surgery, Ochsner Clinical School, University of Queensland presents Rectal Surgery Fellowships and the American Socity of COlon and Rectal Surgery (ASCRS).
 

Aurora Pryor, MD, Fellowship Council Secretary/Treasurer and Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Treasurer presents Minimally Invasive Surgery Fellowships and SAGES.
 
Stacy A. Brethauer, MD, the Secretary/Treasurer of the American Society for Metabolic and Bariatric Surgery (ASMBS) presents Bariatric Surgery and the ASMBS.
 

Thomas M. Scalea, MD , Professor of Surgery, University of Maryland Medical Center, and American Association for the Surgery of Trauma (AAST) representative presented Acute Care Surgery Fellowships and the AAST.
 
John G. Hunter, MD, FACS, the Oregon Health and Science University Professor and Chair of Surgery, and Steering Committee Member of the American College of Surgeons (ACS): Transitions to Practice Program presented the ACS Transition to Programs and represented the American Board of Surgery (ABS).

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April 2015

2nd Annual SSAT Surgical Fellowship Fair

The SSAT Residents Corner for April 2015 highlights the upcoming 2nd Annual SSAT Surgical Fellowship Fair occurring during DDW on May 16th in the University of DC & Catholic University Room of the Marriott Marquis, Washington D.C.

The fellowships represented include:

  • Surgical oncology
  • Minimally invasive surgery
  • Colon and rectal surgery
  • Acute care and trauma surgery
  • The transition to practice program
  • Hepatobiliary surgery
  • Bariatric surgery

Representatives from SSO, SAGES, ASCRS, AAST, ACS, AHPBA, and ASMBS will discuss their particular type of fellowship training and what it takes to get one.

Subspecialty Society Invited Speakers
Society of Surgical Oncology (SSO) James Pingpank, Jr
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Aurora Pryor
American Society of Colon and Rectal Surgeons (ASCRS) David Margolin
American Association for the Surgery of Trauma (AAST) Thomas Scalea
ACS Transition to Practice Program John Hunter
Americas Hepato-Pancreato-Biliary Association (AHPBA) D. Rohan Jeyarajah
American Society for Metabolic and Bariatric Surgery (ASMBS) John Morton

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March 2015

How to Build a Successful Surgery Practice

Need advice on starting your first year as an attending surgeon?
Is there an optimal way to develop your practice?

This month SSAT Resident’s Corner highlights “How to Build a Successful Surgery Practice” with interviews of Drs. Woody Denham, John Linn, Stephen Haggerty, and Michael Ujiki from NorthShore University HealthSystem in Evanston, Illinois. Learn how to develop relationships with your referring providers and set yourself up not just for a successful first year, but a productive career.

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February 2015

Productivity Targets, Duties, and Responsibilities

In this month’s Residents Corner, Dr. Michael House from the Indiana University School of Medicine explores "Productivity Targets, Duties, and Responsibilities." We hope that you will find it informative. Enjoy!

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January 2015

Introduction to Physician Contracting

This month’s Residents Corner focuses on Physician Contracting. Dr. Kenneth Lee from the University of Pittsburgh reviews the basics of reviewing a contract, including:

  • The Offer Letter
  • The Employment Agreement
  • Metrics of a physician contract
  • Relative Value Units
  • Quality Measures
  • Incentive Plans
  • Other Compensation Considerations
Don't negotiate your first job without being informed!

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December 2014

Tips for Understanding Contracts

This month’s Resident Corner explores the topic of “Tips for Understanding Contracts” with Dr. Vanita Ahuja, who is a hospital-employed surgeon at WellSpan Health York Hospital in York, Pennsylvania; Dr. John J. Castronuovo, Jr, who is Vice President of Surgical Services at WellSpan Health; and Ms. Amy L. Nelson, who is an Associate General Counsel at WellSpan Health Administration. In their video, they introduce concepts of,

  • Compensation types (RVUs, productivity and base salary, incentives)
  • Terms of separation (restrictive covenants)
  • Other benefits to consider (paid vs scheduled time off, CME, society memberships, other specialty training)
These concepts or terms may be unfamiliar to some of you, and if they are, ‘now’ is a great time to start talking to people around you to become acquainted with them and learn the advantages/disadvantages of different components!

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November 2014

A Guide to Selecting a Job

This month at SSAT Residents Corner, Dr. Kenric Murayama from Abington Memorial Hospital presents A Guide to Selecting a Job.

The first video outlines Deciding Your Priorities, including:
  • What is important to you and your family?
  • What is important to you professionally?
  • What are your career goals?
  • What are your financial goals?
  • What are your retirement goals?
  • Did you enjoy the environment you trained in?
 
The second video outlines Job Models, including:
  • The Academic Job
  • The Academic-Affiliated Job
  • Private Multispecialty Group Practice
  • Private Small Group Practice

Dr. Murayama provides advice, pitfalls, and caveats regarding finding the right fit when choosing your first job.

Be sure to attend the esteemed Job Search Panel Session at the 56th Annual SSAT Meeting held in conjunction with DDW 2015 on May 15-19, 2015 in Washington, DC!

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October 2014

How do I find a job: where do I start?

Career planning is best approached with a strong mission statement and list of objectives for accomplishing initial success. The common aphorism is that “one learns as much in the first five years of practice as one learns in five years of residency”. This truism makes effective career placement a priority. The candidate should examine the potential partners and referring doctors as carefully as the contract negotiation and benefits to ensure professional growth.

  • The best initial start is to work with the program coordinator for the residency and/or fellowship to determine what employers have been contacting the program for recruitment. The best career placements are often with alumni in the city or region where the residency/fellowship is located. Mentorship is essential and the program director of the residency/fellowship can effectively mentor candidates for career placement as an advocate with community physicians and other academic programs. If a candidate is interested in a particular type of academic setting or area resumes with cover letters can be sent to hospitals and university departments as to cover an entire region or career specialty.

  • Another key venue to start the job search is with the local chapter of the American College of Surgeons and the national American College of Surgeons Clinical Congress. Recruiters from hospitals and private corporations are often present at these events to meet directly with candidates to discuss opportunities. Local surgical societies at the city or state level also serve as great avenues to meet surgeons that are recruiting a junior colleague.

  • The Journal of the American College of Surgeons also has extensive career listings. It should be noted that most academic institutions advertise in peer-reviewed journals.

  • Society web pages often provide career listings especially useful for residents and fellows looking for a tailored specialty experience. The specialty society meetings can also be an effective venue to meet recruiters personally and discuss opportunities with hospital representatives. Specialty societies often hold fellowship and career counseling sessions at their annual meetings that help alert candidates to career openings and potential practice areas.

  • Recruitment firms can be contacted for help with career placement, and this is now often done through on-line search portals. The caveat to using a recruiter is to remember that these companies always work for their clients that are primarily hospital networks and larger practices. This truism makes extensive research and investigation, including legal contract review, a must since there is often fine print that limits what often appear to be “golden opportunities”.

  • Upon entering initial conversations with hospitals and recruiters, the candidate should examine benefits, with special attention to salary, potential or projected bonuses, financial expectations, vacation, continuing medical education, support for taking board examinations, health-care benefits, malpractice coverage, and retirement benefits. Some practices have restrictive covenants within the employment agreement (statement in the contract that attempts to keep an individual from leaving the group and practicing within a certain distance or non-compete clauses).

In summary, the initial career search can begin with either connections through training institutions or with web-based recruitment media, but it should be noted that personal mentoring and legal counsel are critical for making the best decisions.


Useful Links

Medical Organization Job Boards

Web Portals


Contributed by:
Brian R. Davis, MD
Associate Professor and Program Director
Texas Tech Paul L. Foster School of Medicine
El Paso, Texas
SSAT Resident Education Committee Member

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September 2014

Tips for Obtaining the Fellowship I Want

As cited in the June Residents Corner, 70-80% of residents plan to do a fellowship. In previous segments, we have considered,

  • “Do I need to do a fellowship?” (June)
  • “What are the nuts and bolts of fellowships” (July)
  • “What else should I consider before applying for a fellowship” (August)

Now in the September Residents Corner, we consider “Tips for obtaining the fellowship I want.” Based on NRMP data for 2014, of applicants who applied to Colorectal Surgery fellowship, 31.3% obtained their 1st choice fellowship spot, 7.8% their 2nd choice, 10.2% their 3rd choice, 22.7% obtained a spot in greater than their 3rd choice, and 28.1% of applicants did not match.1 Similar findings were found for applicants matching into Surgical Oncology fellowships (see Table). For fellowships through the Fellowship Council, such as Minimally Invasive Surgery, the 2013 match rate for applicants was 64%.2

Fellowship Matches

The two videos below discuss overall tips in obtaining the fellowship of your choice. In creating the first video, Dr. Sanda Tan and Dr. Christiana Shaw from the University of Florida College of Medicine surveyed different fellowship directors, residents going through the process, and their own experiences to offer guidance on a successful fellowship application. Please click here to see the transcript. In the second video, Dr. Daniel Herron, Program Director of the Minimally Invasive Surgery Fellowship at the Mount Sinai School of Medicine in New York gives a candid overview of how they select who to interview and then who to rank in the match.

We hope that you enjoy and find the information helpful!

Stay tuned in for the upcoming months which will start to cover “Finished with Training, How Do I Find a Job?”

1http://www.nrmp.org/wp-content/uploads/2013/08/National-Resident-Matching-Program-NRMP-Results-and-Data-SMS-2014-Final.pdf
2https://fellowshipcouncil.org/fellowship-programs/match-statistics/

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August 2014

What Else to Consider Before Applying for Fellowship

When asked by medical students how to choose a specialty, these are the five considerations I suggest they ponder:

  1. Does the topic excite and interest?
  2. How do you want to interact with your patients? Not at all? Just verbally and attentively? “Pushing pills?” Cut them open and take something out?
  3. How much patient care? None at all? Shift work? Just outpatient / inpatient /intensive care? Or all the above, along with operative care?
  4. Will you like your patients? Not just in terms of age or sex, but by patient personality.
  5. How will your personal growth be affected? Will you be more contemplative? Will you be more decisive and action oriented?

What I think matters less is how much time commitment is needed and personality fit. Those of us who have chosen General Surgery as our professional clinical base likely answered the above as follow:

  1. Surgery excites and interests us.
  2. We want to invade our patient’s body, to either rearrange or remove “things.”
  3. We take full responsibility for our patients’ clinical needs, whether in the outpatient setting, emergency room, inpatient, in the ICU, or in the operating room.
  4. Most of us like patients with acute needs; we fix them and get them on their way. Some of us like to check on them for a long while though.
  5. We have become more decisive, more confident, more action oriented.

In addition, we have accepted the time commitment to make our patients better, as well as make ourselves better. We have pushed ourselves even when we felt uncomfortable and uncertain, even when our “fit” in the plan seemed poor.

So now when trying to decide what surgical fellowship to pursue, I think there is still value in revisiting these considerations.

  1. Does the topic excite and interest? We all know, better now than ever, the field of knowledge for general surgery is vast, and the horizon continues to expand. What residency provided is a foundation to understand, a starting reference point to appreciate, and a prefix to ask questions of why we get a certain result, and how could we do better. What a fellowship provides is an opportunity to delve deeper into a particular area of knowledge. We need to keep up with the literature for the rest of our professional life, more so as a specialist surgeon than a general surgeon. So on a nice afternoon, will the specialty journal content still interest us enough to read, rather than be out and about golfing or shopping?

  2. How do you want to interact with your patients? Now that we are comfortable with our ability to get under the patient’s skin, how else do we want to interact with our patients? Would we be happy if we don’t have to operate because their cancer has not recurred or their kidney has not been rejected? Would we be content if our main mode of patient care is in the ICU rather than the operating room? And if operative, with the least invasive mean possible with cannulation and plasty versus minimally invasive and hands “off” with the robot?!

  3. How much patient care? We care for some patients briefly, got them over their injury and have never seen them again. We have care for some whose operative needs have long passed, though they return annually for reassurance of being disease free. We have shared our patient care with our partner, as we leave after having been on call. Now that we can do as much as anyone can, how much do we actually want to do ourselves? Just acute episodic care or comprehensive out-patient, in-patient, intensive, for years?

  4. Will you like your patients? Perhaps it is the human condition, that when confronted with similar problems we react similarly. For instance, Trauma patients tend to be young and invincible, though at times childlike while Surgical Oncology patients tend to be mature and do what it takes to survive. Certainly chronic disease and illness, as well as treatment, can also change our outlook, as evidence by transplant patients or patients with chronic inflammatory bowel diseases. The question here is that once the novelty of the operative case wanes, will we still empathize and care for our patients to be personally gratified and satisfied?

  5. How will your personal growth be affected? Surgical specialists for the most part are rarities, and given the nature of the specialty work, are valued rarities. Specialist works are often time multidisciplinary in nature, as we work along nephrologists, gastroenterologist, radiologists or oncologists. In such a setting leadership will be required, and most will naturally look to us. Our leadership skills, developed through years of working in a hierarchal system in the operating room and on the wards will be tested and challenged. The hierarchy we are used to will not be in place with colleagues like the medical or radiologic specialists. New leadership skills will need to be developed, as well as flexibility in their implementation as we lead. Some fellowships will offer and demand more leadership than others, and this might be worth considering as well when choosing a fellowship. Will we want more leadership responsibility? How much more?


Huan N Vu, MD
Associate Professor
Chief of Surgical Oncology
Hunter Holmes McGuire VAMC
SSAT Resident Education Committee Member

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July 2014

The Nuts and Bolts of Fellowship

This month on SSAT Resident’s corner we’ll be exploring the various options for post-surgical residency fellowships and residencies. Note that certain residencies are increasingly following an “integrated pathway” where admission is from medical school graduation rather than after a general surgery residency – this includes Plastics, Thoracic, and Vascular. These may in the future develop into a process more like the surgical subspecialties we commonly think of like orthopedics, urology, and ENT. Other residencies have an “independent pathway” where you can sit for general surgery boards as well as specialty boards.

The majority of fellowships out there that are considered after a 5-year general surgery residency are not ACGME approved, but most of them have a certifying body that provide some oversight and standards towards the educational experience of the fellowship. The options and numbers listed in the table below will certainly change over time. Note that while integrated pathway programs require planning during your MS-3 year, the majority of surgical fellowships have application deadlines during your PGY-4 or PGY-5 residency year for entry after graduation from a general surgery residency. You may need to decide based on your area of interest, whether trauma, pediatrics, bariatrics, or cancer, or a particular organ system or part of the body. Also important are the market forces for the part of the world you would like to live in, as well as if you want to practice in an academic or a community setting. There are a lot of ways to practice as a general surgeon, and while surgical specialization may be considered a necessary evil driven by greater complexity in science, technique, and patient management, it is important to educate yourself the best you can to develop into the kind of surgeon you would like to become.

Regards,
Sabha Ganai, MD, PhD
Southern Illinois University


Surgical Residencies and Fellowships

Graduate Medical Education Program Table
*Bold indicates Certifying Board(s) providing training requirements and examination process for the graduate medical education pathway. Brackets indicate fellowships existing within a sponsoring organization and may include a curriculum and/or minimum standards for the training experience.
 †To be eliminated after July 1, 2015
 ‡19-ACGME approved, 3 Canadian with reciprocity


Links:

*Fellowship Council application and match for Non-ACGME Advanced Colorectal and Thoracic fellowships
is in progress. For more details click here.

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June 2014

Why Residents Choose One Path Over Another

At some point in general surgical training, most residents ask themselves whether to pursue subspecialty training or go directly into practice. While recent statistics suggest that 70-80% of residents plan to do a fellowship1-3, this can be a difficult decision with many factors to consider. In fact, as many as 15% of PGY4 residents remain undecided3. Recent publications have sought to identify reasons residents choose one path over another.

For residents who pursued fellowships, top reasons cited are,

  • genuine interest in the area of specialty2-4
  • perception that it is necessary to be competitive in the job market3,5
  • belief that it will increase earning potential3,5
  • belief that it will result in a better lifestyle5
  • lack of confidence in skills2,4

For residents who decided to go directly into practice, the top reasons include,

  • wanting a broad-based traditional practice2
  • feeling confident in their skills2,3
  • having already invested significant time in surgical training3
  • financial benefit to entering practice earlier3

The two videos below highlight junior surgeons who have recently made the decision and senior surgeons with their words of wisdom and advice to residents currently making the decision.

Thus, many factors must be weighed in the decision and each will have different value for each individual. The first main question to answer seems to be, “What sort of practice do I want?” and the second, “Do I have the skills to get me there?”

  • If academic practice, a fellowship is highly recommended. If private practice, it may depend on the particular practice being joined. In support of this, a recent study compared the skills required by the job market with those of graduating trainees6. Overall 34% of jobs required fellowship training, lowest in rural practices (18%), and highest in academic programs (92%). Of nonacademic metropolitan practices, 28% required fellowships.

  • Is there is a particular field of interest? In the video above, both of the junior surgeons who chose to go directly into practice liked the broad practice of general surgery, while both of the junior surgeons who chose to do a fellowship wanted a focused practice.

  • What was training experience like? For example, 80% of graduating general surgery chief residents were comfortable being on call at a Level 1 trauma center, while 60% felt uncomfortable performing esophagectomies, 48% with hepatic lobectomies, and 38% pancreaticoduodenectomies2. If joining a private practice that covers a Level 2 trauma center, one may feel entirely comfortable without doing a fellowship. Alternatively, if a hepatobiliary focus in private practice is wanted, one may consider pursuing a hepatobiliary or surgical oncology fellowship depending on their level of experience in residency.

In the end, surgery is a diverse and rewarding profession. We are all privileged to practice it. Whatever path you choose for whatever reasons, make it something you will love.

Sincerely,
SSAT Resident Education Committee

1. Borman KR, Vick LR, Biester TW, Mitchell ME (2008) Changing demographics of residents choosing fellowships: longterm data from the American Board of Surgery. J Am Coll Surg 206:782-789.

2. Friedell ML, VanderMeer TJ, Cheatham ML, Fuhrman GM, Schenarts PJ, Mellinger JD, Morris JB (2014) Perceptions of graduating general surgery chief residents: are they confident in their training? J Am Coll Surg 218:695-706.

3. Coleman JJ, Esposito TJ, Rozycki GS, Feliciano DV (2013) Early subspecialization and perceived competence in surgical training: are residents ready? J Am Coll Surg 216:764-773.

4. Napolitano LM, Savarise M, Paramo JC, Soot LC, Todd SR, Gregory J, Timmerman GL, Cioffi WG, Davis E, Sachdeva AK (2014) Are general surgery residents ready to practice? A survey of the American College of Surgeons Board of Governors and Young Fellows Association. J Am Coll Surg 218:1063-1072.

5. Yeo H, Viola K, Berg D, Lin Z, Nunez-Smith M, Cammann C, Bell RH, Sosa JA, Krumholz HM, Curry LA (2009) Attitudes, training experiences and professional expectations of US general surgery residents. JAMA 302:1301-1308.

6. Decker MR, Bronson NW, Greenberg CC, Dolan JP, Kent KC, Hunter JG (2013) The general surgery job market: analysis of current demand for general surgeons and their specialized skills. J Am Coll Surg 217:1133-1139.

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May 2014

Inaugural Surgical Fellowship Fair

The inaugural Surgical Fellowship Fair took place on May 3, 2014 at the Hyatt Regency Hotel in Chicago during Digestive Disease Week 2014. Organized by the SSAT Resident Education Committee, this event was well-attended by trainees and was a great success. Attendees took advantage of a wealth of information to help them decide: “Which fellowship is right for me?”

As general surgery residents, we are faced with various career options after residency training and choosing which path to take can be a very daunting task. While some of us contemplate whether to pursue additional fellowship training, others contemplate which of the various fellowship options are best suited for their interests and personality. Some may question whether to pursue minimally-invasive surgery or bariatric surgery. Others ask themselves whether it is more optimal to apply for surgical oncology or hepato-pancreatico-biliary surgery. There is considerable overlap between fellowship programs and significant heterogeneity amongst the various programs nation-wide within each fellowship track.

Also, the decision-making process tends to be highly subjective. We lack exposure to every facet of surgery and we are dependent on our interactions with role models during residency, creating bias in our perceptions of the various sub-specialties. Further complicating this issue is the increasing pressure to commit ourselves earlier during our training. Barely having started as a senior resident, we need to start narrowing down our options. We begin asking ourselves questions such as: “Who should I network with?”, “Who should I do research with?”, “Which society meetings should I attend?”

To help ease this process, the Fellowship Fair aims to provide a comprehensive overview of the various career options. This year, leaders from 5 major surgical societies representing each GI surgical fellowship (minimally-invasive surgery, hepatico-pancreatico-biliary surgery, bariatric surgery, colorectal surgery, and surgical oncology) participated in a unique and informative discussion. Points of discussion included:

  • What are the match statistics?
  • What is the current and future job landscape?
  • What are program directors looking for in a prospective applicant?
  • The day in the life of a surgeon in that sub-specialty
  • Do I even need a fellowship?
  • Why should I pursue a career in that sub-specialty?

On behalf of the committee, thank you to all who attended the Fair and for helping us establish such an important event. We look forward to seeing you and your colleagues in subsequent years.

Sincerely,
Amin Madani, MD,
PGY3, General Surgery
McGill University
SSAT Resident Education Committee Member

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April 2014

Welcome to SSAT Residents Corner

On behalf of the SSAT Resident Education Committee, we would like to welcome you to SSAT “Residents Corner”, a video-blog highlighting areas of interest for surgical trainees looking to focus on a career in gastrointestinal surgery. Over the months ahead, we will discuss the following topics:

  • Do I need a fellowship?
  • How do I land a job?
  • How can I excel in academic surgery?
  • Are there ways to help me transition to community surgical practice?
  • How can I make the most out of research time?
  • How should I go about finding a mentor?

We hope to highlight opportunities for residents to participate in various SSAT activities, as well as to get involved in providing ideas and potentially future content for the Residents Corner. Becoming a Candidate member of the SSAT is not only easy, but is a great opportunity to start off a career in GI surgery!

Upcoming Resident Event
Choosing a fellowship is a difficult decision and involves consideration of a multitude of factors. This Spring, we are excited to highlight the SSAT Surgical Fellowship Fair held on Saturday, May 3rd, 2014 during Digestive Disease Week in Chicago, Illinois. Representatives from five major surgical societies will be available to provide you with information and to answer questions related to their fellowship programs and career options:

  • Colorectal Surgery (ASCRS)
  • Hepatobiliary Surgery (AHPBA)
  • Minimally Invasive Surgery (SAGES)
  • Bariatric Surgery (ASBMS)
  • Surgical Oncology (SSO)

This will be a great opportunity for you to obtain more insight into the various options available for fellowship training in gastrointestinal surgery.



Be sure to participate via #SSAT14 on Twitter or on our Facebook Page!

We hope to see you at #DDW14!


Ken Murayama, MD, SSAT Resident Education Committee Chair, Abington Memorial Hospital
Jayleen Grams, MD, PhD, University of Alabama, Birmingham
Sabha Ganai, MD, PhD, Southern Illinois University
Amin Madani, MD, Surgical Resident, McGill University

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